title: JOURNAL CLUB: Identification of Bone Metastasis With Routine Prostate MRI: A Study of Patients With Newly Diagnosed Prostate Cancer.
abstract: OBJECTIVE
  The purpose of this study was to evaluate whether routine prostate MRI is adequate for detection of bone metastasis in patients with newly diagnosed prostate cancer.
  
  
  METHODS
  The study included 308 patients with newly diagnosed prostate cancer who underwent prostate MRI. Two radiologists categorized MRI findings as normal, metastasis, or equivocal. Histologic analysis or best valuable comparator based on comprehensive review of images and clinical follow-up studies were used as reference standards. Clinicopathologic variables and MRI findings were compared between patients with and those without bone metastasis by use of chi-square and t tests. The diagnostic performance of prostate MRI for detecting bone metastasis was assessed by ROC analysis. Subgroup analysis was performed for patients at high risk of bone metastasis.
  
  
  RESULTS
  Twenty-one (6.8%) patients had bone metastasis. They had significantly higher prostate-specific antigen levels (p = 0.015) and Gleason scores (p < 0.001) than those without bone metastasis. The diagnostic performance of MRI was as follows: sensitivity, 95.2%; specificity, 99-100%; positive predictive value, 86.9-100%; negative predictive value, 99.7%. For 119 patients at high risk of bone metastasis, these values were 95%, 100%, 100%, and 99%. Only 1 of the 21 (4.8%) patients had bone metastasis only in an area not explored with prostate MRI, that is, the thoracic spine.
  
  
  CONCLUSIONS
  The diagnostic performance of routine prostate MRI for identifying bone metastasis in patients with newly diagnosed prostate cancer was excellent.
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.
authors.forename: Sungmin
authors.initials: S
authors.lastname: Woo
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.
authors.forename: Sang Youn
authors.initials: SY
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.|2 Institute of Radiation Medicine and Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
authors.forename: Seung Hyup
authors.initials: SH
authors.lastname: Kim
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.|2 Institute of Radiation Medicine and Kidney Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
authors.forename: Jeong Yeon
authors.initials: JY
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen
keywords: MRI; bone metastasis; prostate cancer