Bone scans overstage prostate cancer at initial staging compared with PSMA PET: Study (Bone scans falsely show metastasis)

Medical Xpress / Society of Nuclear Medicine / Journal of Nuclear Medicine ^ | Nov. 9, 2023 | Thomas A. Hope et al

[ConservativeMind]

Bone scans have been found to overstage prostate cancer at initial staging compared to prostate-specific membrane antigen (PSMA) PET, according to new research. The significant false-positive rate of metastases on bone scans means that definitive therapy for local disease may have been withheld from patients inappropriately.

PSMA PET is more accurate than CT and bone scans for staging patients with prostate cancer and, in recent years, has become the standard imaging modality at initial staging. Nearly all prostate cancer trials have used CT and bone scans for staging, however, and the best way to apply those data to patients staged with PSMA PET remains unclear.

The multicenter retrospective diagnostic study included 167 prostate cancer patients in various disease states who were imaged with bone scans and PSMA PET within 100 days. Three blinded readers interpreted each study. Using PSMA PET scans as the reference standard, researchers evaluated positive predictive value, negative predictive value, and specificity for bone scans as well as inter-reader reproducibility, positivity rate, uptake on PSMA PET, and number of lesions.

While the specificity of bone scans was found to be high and similar across disease states, the positive predictive value of bone scans at initial staging was found to be much lower than in the overall population. Compared to PSMA PET, more than half (57 percent) of bone scans at initial staging were found to contain false-positive metastases.

"Rather than receiving definitive radiation treatment for localized disease, these patients may have received treatment aimed at preventing the further spread of what was incorrectly identified as metastatic disease," said Hope "These results bring into question how to apply data from clinical trials that are based on bone scans to patients who receive PSMA PET."

[ConservativeMind]

Don’t rely on your doctor’s bone scan for prostate cancer. Go find someone who will get you a PSMA PET scan, instead.

[ConservativeMind]

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[Red Badger]

I had an MRI about a month ago for prostate cancer.

They reported as none found.....................

[trebb]

Yep - PET scans are the best way to determine staging - if your doctor wants to use xrays or CT Scans as their method of determination, it’s time to find a new doctor