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Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH

OBJECTIVE: To review follow-up imaging after equivocal bone scans in men with castration resistant prostate cancer (CRPC) and examine the characteristics of equivocal bone scans that are associated with positive follow-up imaging. METHODS: We identified 639 men from five Veterans Affairs Hospitals w...

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Autores principales: Hanyok, Brian T., Everist, Mary M., Howard, Lauren E., De Hoedt, Amanda M., Aronson, William J., Cooperberg, Matthew R., Kane, Christopher J., Amling, Christopher L., Terris, Martha K., Freedland, Stephen J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Second Military Medical University 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595156/
https://www.ncbi.nlm.nih.gov/pubmed/31297315
http://dx.doi.org/10.1016/j.ajur.2019.01.004
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author Hanyok, Brian T.
Everist, Mary M.
Howard, Lauren E.
De Hoedt, Amanda M.
Aronson, William J.
Cooperberg, Matthew R.
Kane, Christopher J.
Amling, Christopher L.
Terris, Martha K.
Freedland, Stephen J.
author_facet Hanyok, Brian T.
Everist, Mary M.
Howard, Lauren E.
De Hoedt, Amanda M.
Aronson, William J.
Cooperberg, Matthew R.
Kane, Christopher J.
Amling, Christopher L.
Terris, Martha K.
Freedland, Stephen J.
author_sort Hanyok, Brian T.
collection PubMed
description OBJECTIVE: To review follow-up imaging after equivocal bone scans in men with castration resistant prostate cancer (CRPC) and examine the characteristics of equivocal bone scans that are associated with positive follow-up imaging. METHODS: We identified 639 men from five Veterans Affairs Hospitals with a technetium-99m bone scan after CRPC diagnosis, of whom 99 (15%) had equivocal scans. Men with equivocal scans were segregated into “high-risk” and “low-risk” subcategories based upon wording in the bone scan report. All follow-up imaging (bone scans, computed tomography [CT], magnetic resonance imaging [MRI], and X-rays) in the 3 months after the equivocal scan were reviewed. Variables were compared between patients with a positive vs. negative follow-up imaging after an equivocal bone scan. RESULTS: Of 99 men with an equivocal bone scan, 43 (43%) received at least one follow-up imaging test, including 32/82 (39%) with low-risk scans and 11/17 (65%) with high-risk scans (p = 0.052). Of follow-up tests, 67% were negative, 14% were equivocal, and 19% were positive. Among those who underwent follow-up imaging, 3/32 (9%) low-risk men had metastases vs. 5/11 (45%) high-risk men (p = 0.015). CONCLUSION: While 19% of all men who received follow-up imaging had positive follow-up imaging, only 9% of those with a low-risk equivocal bone scan had metastases versus 45% of those with high-risk. These preliminary findings, if confirmed in larger studies, suggest follow-up imaging tests for low-risk equivocal scans can be delayed while high-risk equivocal scans should receive follow-up imaging.
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spelling pubmed-65951562019-07-11 Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH Hanyok, Brian T. Everist, Mary M. Howard, Lauren E. De Hoedt, Amanda M. Aronson, William J. Cooperberg, Matthew R. Kane, Christopher J. Amling, Christopher L. Terris, Martha K. Freedland, Stephen J. Asian J Urol Original Article OBJECTIVE: To review follow-up imaging after equivocal bone scans in men with castration resistant prostate cancer (CRPC) and examine the characteristics of equivocal bone scans that are associated with positive follow-up imaging. METHODS: We identified 639 men from five Veterans Affairs Hospitals with a technetium-99m bone scan after CRPC diagnosis, of whom 99 (15%) had equivocal scans. Men with equivocal scans were segregated into “high-risk” and “low-risk” subcategories based upon wording in the bone scan report. All follow-up imaging (bone scans, computed tomography [CT], magnetic resonance imaging [MRI], and X-rays) in the 3 months after the equivocal scan were reviewed. Variables were compared between patients with a positive vs. negative follow-up imaging after an equivocal bone scan. RESULTS: Of 99 men with an equivocal bone scan, 43 (43%) received at least one follow-up imaging test, including 32/82 (39%) with low-risk scans and 11/17 (65%) with high-risk scans (p = 0.052). Of follow-up tests, 67% were negative, 14% were equivocal, and 19% were positive. Among those who underwent follow-up imaging, 3/32 (9%) low-risk men had metastases vs. 5/11 (45%) high-risk men (p = 0.015). CONCLUSION: While 19% of all men who received follow-up imaging had positive follow-up imaging, only 9% of those with a low-risk equivocal bone scan had metastases versus 45% of those with high-risk. These preliminary findings, if confirmed in larger studies, suggest follow-up imaging tests for low-risk equivocal scans can be delayed while high-risk equivocal scans should receive follow-up imaging. Second Military Medical University 2019-07 2019-01-18 /pmc/articles/PMC6595156/ /pubmed/31297315 http://dx.doi.org/10.1016/j.ajur.2019.01.004 Text en © 2019 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Hanyok, Brian T.
Everist, Mary M.
Howard, Lauren E.
De Hoedt, Amanda M.
Aronson, William J.
Cooperberg, Matthew R.
Kane, Christopher J.
Amling, Christopher L.
Terris, Martha K.
Freedland, Stephen J.
Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH
title Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH
title_full Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH
title_fullStr Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH
title_full_unstemmed Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH
title_short Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH
title_sort practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: results from search
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595156/
https://www.ncbi.nlm.nih.gov/pubmed/31297315
http://dx.doi.org/10.1016/j.ajur.2019.01.004
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