title: A narrowing range of bone scan in newly diagnosed prostate cancer patients: A retrospective comparative study.
abstract: OBJECTIVE
  The objective of the following study is to clarify a suitable group whereby a bone scan could be spared at the initial staging of prostate cancer, we wished to identify the possible relationship between bone metastasis and clinical and pathological parameters including serum total prostate specific antigen (PSA) concentration, alkaline phosphatase (ALP), biopsy Gleason Score (GS), and percentage of pathological cores.
  
  
  METHODS
  We reviewed the results of 220 bone scintigraphies, which were done between January 1, 2011 and June 30, 2013 in patients with newly diagnosed prostate cancer. These parameters were evaluated together with standard clinicopathological data to determine the prediction ability of the bone scan by univariate and multivariate analyses.
  
  
  RESULTS
  Bone metastases were seen in 44 patients of all 220 patients (20%, 95% confidence interval, 17-24%). In univariate analysis, PSA and biopsy GS were useful in predicting the bone scan result, but ALP and percentage of pathological cores was not. In multivariate analysis, the single most useful parameter in predicting the bone scan result was PSA (P < 0.001).
  
  
  CONCLUSIONS
  A bone scan seems to be impractical in newly diagnosed prostate cancer patients with serum PSA level <20 ng/ml and GS up to seven and pre-treatment PSA is the best predictor of the need for the bone scan according to results of this study.
authors.affiliation: Department of Urology, Ankara Research and Training Hospital, Ankara, Turkey.
authors.forename: Berat Cem
authors.initials: BC
authors.lastname: Özgür
authors.affiliation: Department of Nuclear Medicine, Ankara Dışkapı Research and Training Hospital, Ankara, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Gültekin
authors.affiliation: Department of Urology, Ankara Dışkapı Research and Training Hospital, Ankara, Turkey.
authors.forename: Musa
authors.initials: M
authors.lastname: Ekici
authors.affiliation: Department of Pathology, Ankara Dışkapı Research and Training Hospital, Ankara, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Yılmazer
authors.affiliation: Department of Pathology, Ankara Dışkapı Research and Training Hospital, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Alper
keywords: Alkaline phosphatase; Gleason; bone scan; pathological cores; prostate cancer; prostate specific antigen
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