LIMITED ROLE OF RADIONUCLIDE BONE SCINTIGRAPHY IN PATIENTS WITH PROSTATE SPECIFIC ANTIGEN ELEVATIONS AFTER RADICAL PROSTATECTOMY

Abstract

No AccessJournal of UrologyClinical Urology: Original Articles1 Oct 1998LIMITED ROLE OF RADIONUCLIDE BONE SCINTIGRAPHY IN PATIENTS WITH PROSTATE SPECIFIC ANTIGEN ELEVATIONS AFTER RADICAL PROSTATECTOMY MICHAEL L. CHER, FERNANDO J. BIANCO, JOHN S. LAM, LAWRENCE P. DAVIS, DAVID J. GRIGNON, WAEL A. SAKR, MOUSUMI BANERJEE, J. EDSON PONTES, and DAVID P. WOOD MICHAEL L. CHERMICHAEL L. CHER , FERNANDO J. BIANCOFERNANDO J. BIANCO , JOHN S. LAMJOHN S. LAM , LAWRENCE P. DAVISLAWRENCE P. DAVIS , DAVID J. GRIGNONDAVID J. GRIGNON , WAEL A. SAKRWAEL A. SAKR , MOUSUMI BANERJEEMOUSUMI BANERJEE , J. EDSON PONTESJ. EDSON PONTES , and DAVID P. WOODDAVID P. WOOD View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62545-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Bone scintigrams of patients with increasing serum prostate specific antigen (PSA) after radical prostatectomy are only rarely positive. We identify clinical parameters that would improve our ability to select patients for this imaging study. Materials and Methods: We reviewed all bone scintigrams done at our institution between 1991 and 1996 in patients with persistently increasing serum PSA after radical prostatectomy. What prompted the clinician to obtain the bone scintigram was trigger PSA (tPSA). The rate of increase in PSA to tPSA was measured by tPSA/time from radical prostatectomy (slope 1) and tPSA/time from last undetectable PSA (slope 2). These parameters were evaluated together with standard clinicopathological data in univariate and multivariate analyses to determine the ability to predict the bone scintigram result. Results: In univariate analysis tPSA (p = 0.003), slope 1 (p = 0.005) and slope 2 (p = 0.004) were useful in predicting the bone scintigram result but pathological stage, Gleason score, preoperative PSA and time to recurrence were not. In multivariate analysis the single most useful parameter in predicting the bone scintigram result was tPSA (p = 0.01). Based on a logistic regression model the probability of a positive bone scintigram was less than 5% until tPSA increased to 40 to 45 ng./ml. Conclusions: In patients with increasing serum PSA after radical prostatectomy current serum PSA is the best predictor of the bone scintigram result. Furthermore, there is limited usefulness of bone scintigraphy until PSA increases above 30 to 40 ng./ml. 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Google Scholar From the Departments of Urology, Radiology and Pathology, Wayne State University School of Medicine and Program in Genitourinary Oncology, Karmanos Cancer Institute, Detroit, Michigan© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byRobertson N, Sala E, Benz M, Landa J, Scardino P, Scher H, Hricak H and Vargas H (2018) Combined Whole Body and Multiparametric Prostate Magnetic Resonance Imaging as a 1-Step Approach to the Simultaneous Assessment of Local Recurrence and Metastatic Disease after Radical ProstatectomyJournal of Urology, VOL. 198, NO. 1, (65-70), Online publication date: 1-Jul-2017.Giovacchini G, Picchio M, Briganti A, Cozzarini C, Scattoni V, Salonia A, Landoni C, Gianolli L, Di Muzio N, Rigatti P, Montorsi F and Messa C (2018) [11C]Choline Positron Emission Tomography/Computerized Tomography to Restage Prostate Cancer Cases With Biochemical Failure After Radical Prostatectomy and No Disease Evidence on Conventional ImagingJournal of Urology, VOL. 184, NO. 3, (938-943), Online publication date: 1-Sep-2010.Choueiri T, Dreicer R, Paciorek A, Carroll P and Konety B (2018) A Model That Predicts the Probability of Positive Imaging in Prostate Cancer Cases With Biochemical Failure After Initial Definitive Local TherapyJournal of Urology, VOL. 179, NO. 3, (906-910), Online publication date: 1-Mar-2008.Sandler H and Eisenberger M (2007) Assessing and Treating Patients With Increasing Prostate Specific Antigen Following Radical ProstatectomyJournal of Urology, VOL. 178, NO. 3S, (S20-S24), Online publication date: 1-Sep-2007.OKOTIE O, ARONSON W, WIEDER J, LIAO Y, DOREY F, deKERNION J and FREEDLAND S (2018) PREDICTORS OF METASTATIC DISEASE IN MEN WITH BIOCHEMICAL FAILURE FOLLOWING RADICAL PROSTATECTOMYJournal of Urology, VOL. 171, NO. 6 Part 1, (2260-2264), Online publication date: 1-Jun-2004.WILKINSON S and CHODAK G (2018) THE ROLE OF 111INDIUM-CAPROMAB PENDETIDE IMAGING FOR ASSESSING BIOCHEMICAL FAILURE AFTER RADICAL PROSTATECTOMYJournal of Urology, VOL. 172, NO. 1, (133-136), Online publication date: 1-Jul-2004.MOUL J (2018) PROSTATE SPECIFIC ANTIGEN ONLY PROGRESSION OF PROSTATE CANCERJournal of Urology, VOL. 163, NO. 6, (1632-1642), Online publication date: 1-Jun-2000. Volume 160Issue 4October 1998Page: 1387-1391 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information MICHAEL L. CHER More articles by this author FERNANDO J. BIANCO More articles by this author JOHN S. LAM More articles by this author LAWRENCE P. DAVIS More articles by this author DAVID J. GRIGNON More articles by this author WAEL A. SAKR More articles by this author MOUSUMI BANERJEE More articles by this author J. EDSON PONTES More articles by this author DAVID P. WOOD More articles by this author Expand All Advertisement PDF downloadLoading ...