Assessment of bone scans in advanced prostate carcinoma using fully automated and semi-automated bone scan index methods

Takahashi, Yoshiko; Yoshimura, Mana; Suzuki, Kunihito; Hashimoto, Tsuyoshi; Hirose, Hideji; Uchida, Kenji; Inoue, Shoichi; Koizumi, Kiyoshi; Tokuuye, Koichi

doi:10.1007/s12149-012-0617-0

Cited by 26 publications

(21 citation statements)

References 8 publications

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“…Recently, an automated platform for BSI has been developed and is now commercially available. The few studies, that have been published on the use of this platform report promising results [16][17][18][19][20][21][22][23]. BSI has been found to be an independent prognostic marker of prognosis in more settings.…”

Section: Introductionmentioning

confidence: 99%

Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

et al. 2015

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ObjectiveTo evaluate the Bone Scan Index (BSI) for prediction of castration resistance and prostate cancer-specific survival (PCSS). In this retrospective study, we used novel computerassisted software for automated detection/quantification of bone metastases by BSI. Patients with prostate cancer are M-staged by whole-body bone scintigraphy (WBS) and categorised as M0 or M1. Within the M1 group, there is a wide range of clinical outcomes. The BSI was introduced a decade ago providing quantification of bone metastases by estimating the percentage of bone involvement. Being too time consuming, it never gained widespread clinical use. Patients and MethodsIn all, 88 patients with prostate cancer awaiting initiation of androgen-deprivation therapy due to metastases were included. WBS was performed using a two-headed c-camera. BSI was obtained using the automated platform EXINI bone (EXINI Diagnostics AB, Lund, Sweden). In Cox proportional hazard models, time to castration-resistant prostate cancer (CRPC) and PCSS were modelled as the dependent variables, whereas prostate-specific antigen (PSA) level, Gleason score and BSI were used as explanatory factors. For Kaplan-Meier estimates, BSI groups were dichotomously split into: BSI <1 and BSI ≥1. Discrimination between prognostic models was explored using the concordance index (C-index). ResultsThe mean (range) age of the patients was 72 (52-92) years, the median (range) PSA level was 73 (4-5 740) ng/mL, the mean (range) Gleason score was 7.7 (2-10), and the mean (range) BSI was 1.0 (0-9.2). During a mean (range) follow-up of 26 (8-49) months, 48 patients became castration resistant and 15 had died; most (13) ConclusionBSI obtained using a novel automated computer-assisted algorithm appears to be a useful predictor of outcome for time to CRPC and PCSS in patients with hormone-sensitive metastatic prostate cancer.

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Section: Introductionmentioning

confidence: 99%

Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

et al. 2015

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“…The different routes of metastasis can produce different distribution features of bone metastases, although the studies by Morgan et al [3] and Dodds et al [4] do not support this viewpoint. Bone scintigraphy is an important technique in the detection of bone metastases for evaluating the stage of the malignant tumor [5] and the prognosis of the patient [6], as well as for assessing the tumor response to therapy [7], and the effectiveness of the therapeutic schedule [8]. This tool can be used to scan the entire skeleton of patients, thereby allowing all bone lesions to be displayed in their entirety.…”

Section: Introductionmentioning

confidence: 99%

Distribution Features of Skeletal Metastases: A Comparative Study between Pulmonary and Prostate Cancers

2015

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Bone scintigraphies are widely applied for detecting bone metastases. The aim of this study was to investigate distribution features of bone metastases in pulmonary and prostate cancers. Bone scintigraphies were performed in 460 patients with pulmonary cancer and 144 patients with prostate cancer. Patients were divided into three groups according to the total number of bone metastases: few bone metastases, moderate bone metastases, and extensive bone metastases. We compared the distribution of bone metastases in the two cancers, and analyzed the relationship between the distribution of metastatic lesions and their metastatic patterns. A total of 2279 and 2000 lesions of bone metastases were detected in 258 patients with pulmonary cancer and 102 patients with prostate cancer, respectively. In patients with few bone metastases, the distributions of metastatic lesions in the vertebrae (χ2 = 16.0, P = 0.000) and thoracic bones (χ2 = 20.7, P = 0.002) were significantly different between pulmonary and prostate cancers. In cases with moderate bone metastases, the distributions in the vertebrae (χ2 = 6.6, P = 0.010), pelvis (χ2 = 15.1 P = 0.000), and thoracic bones (χ2 = 38.8, P = 0.000) were also significantly different between the two cancers. However, in patients with extensive bone metastases, the distributions were very similar. As the total number of bone metastases increased, their distribution in pulmonary cancer did not noticeably change, but the distribution in the vertebrae and thoracic bones of prostate cancer patients significantly changed. Accordingly, the distribution characteristics of bone metastases differed in pulmonary and prostate cancers, mainly in the early stages of metastasis.

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“… EOD grade classification (modified according to Takahashi et al, 2012 [ 19 ]) : 0 - normal or abnormal findings due to benign bone disease; 1 - ≤6 bone metastases, (each of which is ≤50% of the size of the size of a vertebral body); 2 - between 6 and 20 bone metastases; 3 - >20 bone metastases but less than or equal to that on a ‘‘super bone scan’’; 4 - ‘‘super bone scan’’ or its equivalent (eg, metastasis to >75% of the ribs, vertebrae, and pelvic bones) Ra-223 = Radium-223 dichloride; MBq = Megabecquerel; PSA = Prostate-specific antigen; LHRH-A = Luteinizing hormone-releasing hormone agonist; ALP = Alkaline phosphatase; BS = Bone scintigraphy; EOD = Extent of disease; SD = Stable disease; PR = Partial remission; PD = Progressive disease …”

Section: Resultsmentioning

confidence: 99%

Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy

et al. 2017

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Radium-223 dichloride (Ra-223) is the first bone-targeting agent showing improvement in overall survival in patients with castration-resistant prostate cancer (CRPC) and bone metastases. We aimed to assess feasibility of Ra-223 treatment in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Ten patients with primary bone metastases received Ra-223 following radical prostatectomy (RP). Changes in alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were recorded, while pain intensity was evaluated using the self-reporting Brief Pain Inventory (BPI) questionnaire. Bone scintigraphy (BS) was performed to assess treatment response. Seven patients completed six cycles of Ra-223. Discontinuation was due to leuko- and lymphopenia, progressive lymph node metastasis or newly diagnosed liver metastasis. Treatment-related adverse events occurred in three patients and included leuko- and lymphopenia, fatigue, abdominal discomfort and nausea. Overall, a median decrease of 28% in ALP and a median decrease of 83% in PSA were noted at follow-up. However, PSA progressed in five patients at follow-up. Improvement of pain was observed in all patients (median decrease of 36% after 3 cycles and of 40% at the end of therapy). On BS, three patients showed remission, four had stable disease, and one showed progressive disease at follow-up. Our results suggest that Ra-223 for primary bone metastases in patients with mHSPC after RP is feasible and alleviates pain. ALP, rather than PSA, may be a good marker for assessing treatment response. Ra-223 could therefore be taken into consideration as part of a multimodal approach for carefully selected patients with advanced prostate cancer.

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Assessment of bone scans in advanced prostate carcinoma using fully automated and semi-automated bone scan index methods

Cited by 26 publications

References 8 publications

Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

Distribution Features of Skeletal Metastases: A Comparative Study between Pulmonary and Prostate Cancers

Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer after radical prostatectomy

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