Abstract
Recent reports suggest that radionuclide bone scan (BS) may not be necessary in the standard staging evaluation of patients with prostate cancer when serum prostate-specific antigen (PSA) levels are normal. To evaluate the ability of PSA to predict BS findings, we retrospectively reviewed the case records of 118 consecutive patients (median age 73 years, range 50–90 years) with newly diagnosed, untreated, pathologically proven prostate cancer who underwent BS and serum PSA sampling within a period of no more than 3 months. Fifty-four out of 118 BSs demonstrated metastatic bone disease. A PSA value of less then 10 ng/ml excluded bone metastasis; of 35 patients with a serum PSA level of 20 ng/ml or less, seven had a positive BS (negative predictive value of 80%). These findings provide additional confirmation of the value of low serum PSA concentrations in excluding the need for a staging BS, although the threshold for a high value of negative predictive accuracy is lower than previously reported.
Similar content being viewed by others
References
Terris MK, Klonecke AS, Ross McDougall I, et al. Utilization of bone scans in conjunction with prostate-specific antigen levels in the surveillance for recurrence of adenocarcinoma after radical prostatectomy.J Nucl Med 1991; 32: 1713–1717.
Schild SE, Buskirk SJ, Robinow JS, et al. The results of radiotherapy for isolated elevation of serum PSA levels following radical prostatectomy.Int J Radiat Oncol Biol Phys 1992; 23: 141–145.
Sassine AM, Schulman C. Clinical use of prostate-specific antigen in the staging of patients with prostatic carcinoma.Eur Urol 1993; 23: 348–351.
Freitas JE, Gilvydas R, Ferry JD, et al. The clinical utility of prostate-specific antigen and bone scintigraphy in prostate cancer follow up.J Nucl Med 1991; 32: 1387–1390.
Ritter MA, Messing EM, Shanahan TG, et al. Prostate-specific antigen as a predictor of radiotherapy response and patterns of failure in localized prostate cancer.J Clin Oncol 1992; 10: 1208–1217.
Mulders PF, Fernandez del Moral P, Theeuwes AG, et al. Value of biochemical markers in the management of disseminated prostatic cancer.Eur Urol 1992; 21: 2–5.
Miller JI, Ahman FR, Drach GW, et al. The clinical usefulness of serum prostate specific antigen after hormonal therapy of metastatic prostate cancer.J Urol 1992; 147: 956–961.
Hetherington JW, Siddal JK, Cooper EH. Contribution of bone scintigraphy, prostate acid phosphatase and prostatic-specific antigen to the monitoring of prostate cancer.Eur Urol 1988; 14: 1–5.
Fincker F, Sauvan R, Pasquier J. Systematic association of PAP and PSA determinations to bone scintigraphy in prostate cancer.Am J Clin Oncol 1988; 11 (Suppl 2): S68-S70.
Shih WJ, Wierzbinski B, Collins J, et al. Correlation of prostate-specific antigen and technetium-99-HMDP bone imaging.Clin Nucl Med 1989; 14: 750–755.
Chybowski FM, Larson Keller JJ, Bergstralh EJ, et al. Predicting radionuclide bone scan findings in patients with newly diagnosed, untreated prostate cancer: prostate specific antigen is superior to all other clinical parameters.J Urol 1991; 145: 313–318.
Pantelides ML, Bowman SP, George SJ. Levels of prostate specific antigen that predict skeletal spread in prostate cancer.Br J Urol 1992; 70: 299–303.
Miller PD, Eardley I, Krby RS. Prostate specific antigen and bone scan correlation in the staging and monitoring of patients with prostatic cancer.Br J Urol 1992; 70: 295–298.
Viswanath S, Palmer MA, Ojha HO, et al. Routine estimation of prostate specific antigen prior to clinic attendance in patients with symptoms of bladder outlet obstruction.Br J Urol 1993;72:187–189.
Oesterling JE, Martin SK, Bergstralh EJ, Lowe FC. The use of prostate-specific antigen in staging patients with newly diagnosed prostate cancer.JAMA 1993; 269: 57–60.
Mostofi FK. Grading of prostatic carcinoma.Cancer Chemother Rep 1975; 59: 111.
Carter HB, Coffey DS. Prostate cancer: the magnitude of the problem in the United States. In: Coffey DS, Resnick MI, Dorr FA, et al., eds. A multidisciplinary analysis of controversies of the management of prostate cancer. New York, London: Plenum Press; 1988: 1–7.
O'Donoghue EP, Constable AR, Sherwood T, et al. Bone scanning and plasma phosphatases in carcinoma of the prostate.Br J Urol 1978; 50: 172–177.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rudoni, M., Antonini, G., Favro, M. et al. The clinical value of prostate-specific antigen and bone scintigraphy in the staging of patients with newly diagnosed, pathologically proven prostate cancer. Eur J Nucl Med 22, 207–211 (1995). https://doi.org/10.1007/BF01081514
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF01081514