Bone scan index: A new biomarker of bone metastasis in patients with prostate cancer

Abstract

Bone scintigraphy is one of the first-line imaging modalities for the screening and follow up of bone metastasis in patients with prostate cancer. The amount (%) of bone metastasis can be calculated using a bone scan index thanks to recent advances in quantitative bone scintigraphy. Since an artificial neural network was applied for hot-spot characterization and quantitation, the bone scan index has become a simple, reproducible and practical means of quantifying bone metastasis. The bone scan index is presently considered as an imaging biomarker of bone metastasis. The present article summarizes the principles and application of bone scan index using dedicated software (EXINI bone in Europe and North America; BONENAVI in Japan), and the advantages and cautions of using the bone scan index. The bone scan index could serve as a practical marker with which to monitor disease progression and treatment effects in multicenter studies, and to manage prostate and other types of cancer in the clinical setting.

State‐of‐the‐art imaging techniques in the management of preoperative staging and re‐staging of prostate cancer

“…11 C‐choline or 18 F‐choline PET/CT has mostly been investigated in restaging after primary treatment . However, its diagnostic accuracy is still suboptimal .…”

“…84 11 C-choline or 18 F-choline PET/CT has mostly been investigated in restaging after primary treatment. 85 However, its diagnostic accuracy is still suboptimal. 86 Reported data show a variable DR according to PSA level, ranging from 36% if PSA relapse is <1 ng/mL to 73% if PSA at relapse is >3 ng/mL.…”

Role of bone scan index in the prognosis and effects of therapy on prostate cancer with bone metastasis: Study design and rationale for the multicenter Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan Index (PROSTAT‐BSI) study

“…The recommendations of the St. Gallen Advanced Prostate Cancer Consensus Conference 2015 emphasize the importance of regular treatment monitoring and risk-adapted approaches. 10 A Japanese registry of patients with prostate cancer and bone metastasis has been established and their baseline characteristics were determined. Therefore, the BSI could be a promising quantitative marker of radiographic progression.…”

“…2 Although the extent of disease can be determined to some degree by counting hot spots, the complex nature of radiotracer accumulation hampers the general applicability of bone scans. 10 Several prior studies have shown that computer-assisted analysis improves classification and is thus applicable to diagnostics. [5][6][7] This software is called BONENAVI (FUJIFILM RI Pharma, Tokyo, Japan) in Japan, and was revised from the original EXINI bone software (EXINI Diagnostics, Lund, Sweden) in a multicenter project involving a large Japanese database.…”

Editorial Comment to Role of bone scan index in the prognosis and effects of therapy on prostate cancer with bone metastasis: Study design and rationale for the multicenter Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan Index (PROSTAT‐BSI) study

“…2 Eight years after that work was published, Sadik et al were the first to report use of a computer-assisted diagnosis system for calculating BSI. 4,5 As noted above, BSI has recently become recognized for its ability to provide useful information for PC patients with bone metastatic disease. 4,5 As noted above, BSI has recently become recognized for its ability to provide useful information for PC patients with bone metastatic disease.…”