Which patients with prostatic carcinoma require a staging bone scan?
OBJECTIVE
To determine whether the level of prostate-specific antigen (PSA) can be used to decide which patients with newly diagnosed prostatic carcinoma require a staging bone scan.


METHODS
Of patients referred during an 18-month period for a staging bone scan, 98 (median age 72 years, range 52-89) had had their serum PSA level determined within 4 weeks of the bone scan and were assessed retrospectively for the presence of bony metastases.


RESULTS
Of the 98 patients, 26 who had bone scans showing bony metastases had a PSA level > 40 ng/mL. Reviewing the other published studies showed that in those newly diagnosed patients with a PSA level of < 20 ng/mL, the probability of having bony metastases detected on a bone scan was < 1%.


CONCLUSIONS
A staging bone scan can be omitted in the vast majority of patients with newly diagnosed prostatic carcinoma and a PSA level < 20 ng/mL.
Kemp
P M
PM
Department of Nuclear Medicine, Addenbrooke's NHS Trust, Cambridge, UK.
Maguire
G A
GA
Bird
N J
NJ
D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D018579:Patient Selection; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000473:pathology*; D011877:Radionuclide Imaging; D012189:Retrospective Studies
D017430:Prostate-Specific Antigen