title: Is it safe to omit baseline bone scan for newly diagnosed prostate cancer patients?
abstract: OBJECTIVE
  The aim of this study is to modify and validate a novel screening tool to determine the necessity of bone scans in Chinese PCa patients at the time of diagnosis.
  
  
  METHODS
  Five-hundred-and-one patients diagnosed with PCa between 2010 and 2013 at Zhongshan Hospital, Fudan University, were included in the study. All received bone scans using technetium 99m methylene diphosphonate (99mTc-​MDP) at the initial staging. Age, prostate-specific antigen (PSA) and alkaline phosphatase (ALP) at diagnosis, disease stage, and biopsy Gleason score were collected from all patients. Multivariate logistic regression analysis and discrimination analysis were performed. A validation analysis of this screening tool was performed by Shanghai Cancer Center, Fudan University.
  
  
  RESULTS
  Among the 501 patients, 84 (16.7%) of them had BM. The area under the ROC curve was 0.9006 (95% CI, 0.87-0.93). The sensitivity of the cut-off point was 94.1%, and the speciﬁcity was 58.3%. The validation analysis demonstrated an area under the ROC curve of 0.846 (95% CI, 0.805-0.887).
  
  
  CONCLUSIONS
  Study results demonstrated that a baseline bone scan can be safely omitted for cT1-T3 PCa patients who have a PSA ≤39 ng/ml and an ALP ≤88 IU/l. This novel screening tool may help determine the necessity of including a bone scan at the time of initial diagnosis of PCa.
authors: Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors: Yiwei
authors: Y
authors: Wang
authors: Fangning
authors: F
authors: Wan
authors: Lei
authors: L
authors: Xu
authors: Naiqing
authors: N
authors: Zhao
authors: Zhibing
authors: Z
authors: Xu
authors: Hang
authors: H
authors: Wang
authors: Guomin
authors: G
authors: Wang
authors: Dingwei
authors: D
authors: Ye
authors: Jianming
authors: J
authors: Guo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000378:metabolism; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002681:China; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000150:complications* / Q000175:diagnosis*; D012372:ROC Curve; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013669:Technetium Tc 99m Medronate / Q000737:chemistry
chemical_list: D000469:Alkaline Phosphatase; D017430:Prostate-Specific Antigen; D013669:Technetium Tc 99m Medronate