Bone scans overstage prostate cancer at initial staging compared with PSMA PET: Study

Bone scans have been discovered to overstage prostate most cancers at preliminary staging in comparison with prostate-specific membrane antigen (PSMA) PET, based on new analysis published within the November situation of the Journal of Nuclear Medication. The numerous false-positive fee of metastases on bone scans implies that definitive remedy for native illness could have been withheld from sufferers inappropriately.

PSMA PET is extra correct than CT and bone scans for staging sufferers with prostate cancer and, in recent times, has develop into the usual imaging modality at preliminary staging. Practically all prostate most cancers trials have used CT and bone scans for staging, nevertheless, and the easiest way to use these knowledge to sufferers staged with PSMA PET stays unclear.

“Most analysis up to now has targeted on the elevated sensitivity of PSMA PET versus typical imaging corresponding to bone scans and CT,” mentioned Thomas Hope, MD, vice chair of scientific operations and technique within the Division of Radiology and Director of Molecular Remedy on the College of California in San Francisco. “On this research, my colleagues and I took the other strategy and checked out the place PSMA PET was adverse when bone scans had been optimistic.”

The multicenter retrospective diagnostic research included 167 prostate most cancers sufferers in numerous disease states who had been imaged with bone scans and PSMA PET inside 100 days. Three blinded readers interpreted every research. Utilizing PSMA PET scans because the reference normal, researchers evaluated positive predictive valueadverse predictive worth, and specificity for bone scans in addition to inter-reader reproducibility, positivity fee, uptake on PSMA PET, and variety of lesions.

Whereas the specificity of bone scans was discovered to be excessive and related throughout illness states, the optimistic predictive worth of bone scans at preliminary staging was discovered to be a lot decrease than within the general inhabitants. In comparison with PSMA PET, greater than half (57 %) of bone scans at preliminary staging had been discovered to include false-positive metastases.

“Reasonably than receiving definitive radiation remedy for localized illness, these sufferers could have acquired remedy geared toward stopping the additional unfold of what was incorrectly recognized as metastatic illness,” mentioned Hope “These outcomes convey into query apply knowledge from clinical trials which might be based mostly on bone scans to sufferers who obtain PSMA PET. Trying on the huge image, this research highlights the significance of understanding how check traits influence affected person administration.”