Gamagraphy of skelet and detection of bone metastases in prostate cancer patients : analysis of examinations realized in years 2009 – 2011 and overview of comparative studies
D. Svoradová(1), D. Cích(2), M. Bartovic(2), B. Balogová(1,2)
1 Lekárska fakulta UK Bratislava
2 Klinika nukleárnej medicíny OÚSA a LFUK, Bratislava
INTRODUCTION:
Bone scintigraphy is well established imaging modality for visualisation of cortical bone reaction to metastatic involvement by prostate cancer. Evolution of prescription of examination in time may reflect its clinical impact in the context of other available imaging modalities.
AIM:
The aim of this retrospective analysis was to evaluate the clinical impact of bone scintigraphy in prostate cancer in the context of other available methods trough
analysis of evolution of its prescription in time. The aim of the study was not to evaluate the diagnostic performances of bone scintigraphy, which results from comparative studies are discussed separately.
METHODS:
During 12 quarters since 01/2009 to 12/2011 a survey of prescriptions of bone scintigraphy in prostate cancer patients was performed. If available, the clinical context, PSA and initial Gleason score were analysed. The frequency of negative, equivocal and positive findings for bone metastatic disease was quoted.
RESULTS:
720 bone scintigraphies in 490 patients (age 43 – 90 years) were performed. Inter-quarterly, a significant fluctuations of total number of examination (p = 0,002) was observed, however, only a minimal decrease in its total number was observed annually. In 74% of patients one single examination was performed, in 16% of patients 2 and in 10% of patients 3 or more examinations (3 to 7) were performed. In 58% of exanination, it was a first-time examination. At the time of the examination, serum PSA levels were significantly higher at initial staging than in other clinical situations (p < 0,001). In 61% of examinations (60% of patients) initial Gleason‘s score was >7 and was significantly higher in the case of positive findings than in the case of negative ones (p = 0,0007), and similarly for PSA values (p < 0,001). Overall 60% negative, 20% equivocal and 20% positive findings were reported.
CONCLUSION:
During 3 consecutive years a minimal, not significant decrease in total number of bone scintigraphies in prostate cancer patients was observed. According to results of comparative studies, the bone scintigraphy is not anymore the most sensitive method for detection of bone metastases of prostate cancer, nevertheless, in our conditions, other routine functional imaging methods of nuclear medicine are not yet available.
KEY WORDS:
prostate cancer, bone scintigraphy, PET/CT, Gleason score, PSA
