Pd06-05 the Mri-Invisible Prostate Cancer: Incidence and Significance

Abstract

PSA of 0.3 ng/mL. Pre-operatively, 32% of men underwent a bone scan; this decreased slightly to 22% post-treatment. CT use was more common than bone scan both before and after treatment, while MRI was the least common. The majority (63%) of bone scans was obtained in men who did not receive adjuvant or salvage ADT at a median PSA 0.13 ng/mL (Figure). Median PSA at time of post prostatectomy bone scan was 0.24 ng/mL. On multivariable modeling, increased bone scan use was associated with D'Amico risk category (OR 1.3, 95% CI [1.2-1.4]) and receipt of adjuvant or salvage treatment (OR 3.1, 95% CI [2.9-3.3]), but not with pre-treatment PSA (OR 1.0, 95% CI [1.0-1.0]) or comorbidity (OR 1.1, 95% CI [0.9-1.2]).CONCLUSIONS: We found a substantial rate of bone scan utilization after radical prostatectomy, comparable to the pre-operative setting. The majority was performed for PSA <1ng/mL where likelihood of a positive test is miniscule. More judicious use of imaging seems warranted in this population.