Bone Scan Index predicts outcome in patients with metastatic hormone‐sensitive prostate cancer

Abstract

ObjectiveTo evaluate the Bone Scan Index (BSI) for prediction of castration resistance and prostate cancer-specific survival (PCSS). In this retrospective study, we used novel computerassisted software for automated detection/quantification of bone metastases by BSI. Patients with prostate cancer are M-staged by whole-body bone scintigraphy (WBS) and categorised as M0 or M1. Within the M1 group, there is a wide range of clinical outcomes. The BSI was introduced a decade ago providing quantification of bone metastases by estimating the percentage of bone involvement. Being too time consuming, it never gained widespread clinical use. Patients and MethodsIn all, 88 patients with prostate cancer awaiting initiation of androgen-deprivation therapy due to metastases were included. WBS was performed using a two-headed c-camera. BSI was obtained using the automated platform EXINI bone (EXINI Diagnostics AB, Lund, Sweden). In Cox proportional hazard models, time to castration-resistant prostate cancer (CRPC) and PCSS were modelled as the dependent variables, whereas prostate-specific antigen (PSA) level, Gleason score and BSI were used as explanatory factors. For Kaplan-Meier estimates, BSI groups were dichotomously split into: BSI <1 and BSI ≥1. Discrimination between prognostic models was explored using the concordance index (C-index). ResultsThe mean (range) age of the patients was 72 (52-92) years, the median (range) PSA level was 73 (4-5 740) ng/mL, the mean (range) Gleason score was 7.7 (2-10), and the mean (range) BSI was 1.0 (0-9.2). During a mean (range) follow-up of 26 (8-49) months, 48 patients became castration resistant and 15 had died; most (13) ConclusionBSI obtained using a novel automated computer-assisted algorithm appears to be a useful predictor of outcome for time to CRPC and PCSS in patients with hormone-sensitive metastatic prostate cancer.

223Ra Therapy of Advanced Metastatic Castration-Resistant Prostate Cancer: Quantitative Assessment of Skeletal Tumor Burden for Prognostication of Clinical Outcome and Hematologic Toxicity

“…The automated BSI for the assessment of skeletal tumor burden in patients with prostate cancer is an example of such a diagnostic tool. The BSI has been proven to be valuable for prognostication, prediction, and response assessment in prostate cancer patients (11,(19)(20)(21).…”

Prediction of Time to Castration-Resistant Prostate Cancer Using Bone Scan Index in Men with Metastatic Hormone-Sensitive Prostate Cancer

“…Although some studies have demonstrated the usefulness of BSI, unfortunately, only a few have included significant clinical information such as blood data. Poulsen et al [8] iPSA, initial prostate-specific antigen; Hb, hemoglobin; LDH, lactate dehydrogenase; CRP, C-reactive protein; EOD, extent of disease on bone scan; ALP, alkaline phosphatase; BSI, bone scan index.…”

Repeatability of quantitative parameters of 18F-fluoride PET/CT and biochemical tumour and specific bone remodelling markers in prostate cancer bone metastases

“…Bone scan index (BSI, i.e. total skeletal uptake on 99m Tc-diphosphonate bone scanning) has been shown to be a useful predictor of outcome of time to castration-resistant prostate cancer and survival in patients with hormone-sensitive metastatic prostate cancer [19]. The TLF index investigated in this study is similar to BSI, but direct comparisons are needed before 18F-fluoride could be favoured.…”