PDF(Pubmed)
Abstract：
BACKGROUND: Bone is one of the common sites of metastasis from prostate carcinoma. Bone scintigraphy (BS) is one of the most sensitive imaging modalities currently used for bone metastatic work-up. Skeletal metastasis in prostate carcinoma commonly involves pelvic bones but rarely involves extrapelvic-extraspinal sites.
OBJECTIVE: To retrospectively analyze the BS data to determine the pattern of skeletal metastases in the prostate carcinoma.
METHODS: This retrospective observational study involves patients with biopsy-proven prostate carcinoma referred for BS for staging assessment. Patients with abnormal BS were evaluated for the pattern of skeletal involvement and data were presented in descriptive format in the form of percentages.
RESULTS: A total of 150 patients with biopsy-proven prostate cancer who were referred for staging were included in the study. Thirteen of 150 patients (8.67%) had no abnormal uptake on planar images, ruling out metastatic disease. Twenty-four patients (16%) had heterogeneous uptake in the spine with distribution characteristic of degenerative disease and no scan pattern of metastatic disease. Thirty patients (20%) had multifocal uptake involving both pelvic and extra pelvic bones on planar images typical for skeletal metastasis and were considered metastatic. Eighty-three out of 150 patients (55.3%) had increased tracer uptake, which was indeterminate, thus, single photon emission computed tomography-computed tomography (SPECT-CT) was acquired, which showed 51 with metastatic disease, 31 benign lesions, and one indeterminate finding. Seven of 150 patients had exclusive pelvic bone uptake, which was found to be metastatic in 4/7 patients in SPECT-CT. Fifty six out of 150 patients showed exclusive extrapelvic tracer uptake, of which only 3 had vertebral metastatic disease. None of the patients with increased uptake exclusively in the extrapelvic-extraspinal location was metastatic.
CONCLUSIONS: The incidence of exclusive extrapelvic skeletal metastatic disease in prostate carcinoma is 2% (excluding one patient with indeterminate findings). Further, none of the patients in the current study had exclusive extrapelvic-extraspinal metastasis. Thus, exclusive extrapelvic-extraspinal focal abnormality on planar BS carries a very low probability of metastatic disease and hence, further imaging or SPECT-CT can be safely avoided in such cases.
OBJECTIVE: To retrospectively analyze the BS data to determine the pattern of skeletal metastases in the prostate carcinoma.
METHODS: This retrospective observational study involves patients with biopsy-proven prostate carcinoma referred for BS for staging assessment. Patients with abnormal BS were evaluated for the pattern of skeletal involvement and data were presented in descriptive format in the form of percentages.
RESULTS: A total of 150 patients with biopsy-proven prostate cancer who were referred for staging were included in the study. Thirteen of 150 patients (8.67%) had no abnormal uptake on planar images, ruling out metastatic disease. Twenty-four patients (16%) had heterogeneous uptake in the spine with distribution characteristic of degenerative disease and no scan pattern of metastatic disease. Thirty patients (20%) had multifocal uptake involving both pelvic and extra pelvic bones on planar images typical for skeletal metastasis and were considered metastatic. Eighty-three out of 150 patients (55.3%) had increased tracer uptake, which was indeterminate, thus, single photon emission computed tomography-computed tomography (SPECT-CT) was acquired, which showed 51 with metastatic disease, 31 benign lesions, and one indeterminate finding. Seven of 150 patients had exclusive pelvic bone uptake, which was found to be metastatic in 4/7 patients in SPECT-CT. Fifty six out of 150 patients showed exclusive extrapelvic tracer uptake, of which only 3 had vertebral metastatic disease. None of the patients with increased uptake exclusively in the extrapelvic-extraspinal location was metastatic.
CONCLUSIONS: The incidence of exclusive extrapelvic skeletal metastatic disease in prostate carcinoma is 2% (excluding one patient with indeterminate findings). Further, none of the patients in the current study had exclusive extrapelvic-extraspinal metastasis. Thus, exclusive extrapelvic-extraspinal focal abnormality on planar BS carries a very low probability of metastatic disease and hence, further imaging or SPECT-CT can be safely avoided in such cases.
摘要：
背景：骨是前列腺癌转移的常见部位之一。骨闪烁显像（BS）是目前用于骨转移检查的最敏感的成像方式之一。前列腺癌的骨骼转移通常涉及骨盆骨，但很少涉及骨盆外-脊柱外部位。
目的：回顾性分析BS数据以确定前列腺癌中骨骼转移的模式。
方法：这项回顾性观察性研究涉及活检证实为前列腺癌的患者，这些患者接受BS分期评估。评估BS异常患者的骨骼受累方式，并以百分比形式以描述性格式呈现数据。
结果：共有150例经活检证实的前列腺癌患者被纳入研究，这些患者被转诊为分期。150例患者中有13例（8.67%）在平面图像上没有异常摄取，排除转移性疾病。24例患者（16％）的脊柱吸收不均，具有退行性疾病的分布特征，没有转移性疾病的扫描模式。30例患者（20％）在典型的骨转移平面图上有涉及骨盆和骨盆外骨骼的多灶性摄取，被认为是转移性的。150名患者中有83名(55.3%)示踪剂摄取增加，这是不确定的，因此，获得单光子发射计算机断层扫描-计算机断层扫描（SPECT-CT），显示51患有转移性疾病，31个良性病变,和一个不确定的发现。150例患者中有7例有完全的骨盆骨摄取，在SPECT-CT中发现有4/7的患者转移。150名患者中有56名患者表现出专有的肾盂外示踪剂摄取，其中只有3人患有椎体转移性疾病。仅在肾盂外-脊柱外位置摄取增加的患者均无转移性。
结论：前列腺癌中唯一的肾盂外骨骼转移疾病的发生率为2%（不包括一名有不确定发现的患者）。Further,本研究中的患者均无唯一的肾盂外-脊柱外转移.因此，平面BS上唯一的肾盂外-脊柱外局灶性异常携带转移疾病的可能性非常低，因此，在这种情况下，可以安全地避免进一步成像或SPECT-CT。
目的：回顾性分析BS数据以确定前列腺癌中骨骼转移的模式。
方法：这项回顾性观察性研究涉及活检证实为前列腺癌的患者，这些患者接受BS分期评估。评估BS异常患者的骨骼受累方式，并以百分比形式以描述性格式呈现数据。
结果：共有150例经活检证实的前列腺癌患者被纳入研究，这些患者被转诊为分期。150例患者中有13例（8.67%）在平面图像上没有异常摄取，排除转移性疾病。24例患者（16％）的脊柱吸收不均，具有退行性疾病的分布特征，没有转移性疾病的扫描模式。30例患者（20％）在典型的骨转移平面图上有涉及骨盆和骨盆外骨骼的多灶性摄取，被认为是转移性的。150名患者中有83名(55.3%)示踪剂摄取增加，这是不确定的，因此，获得单光子发射计算机断层扫描-计算机断层扫描（SPECT-CT），显示51患有转移性疾病，31个良性病变,和一个不确定的发现。150例患者中有7例有完全的骨盆骨摄取，在SPECT-CT中发现有4/7的患者转移。150名患者中有56名患者表现出专有的肾盂外示踪剂摄取，其中只有3人患有椎体转移性疾病。仅在肾盂外-脊柱外位置摄取增加的患者均无转移性。
结论：前列腺癌中唯一的肾盂外骨骼转移疾病的发生率为2%（不包括一名有不确定发现的患者）。Further,本研究中的患者均无唯一的肾盂外-脊柱外转移.因此，平面BS上唯一的肾盂外-脊柱外局灶性异常携带转移疾病的可能性非常低，因此，在这种情况下，可以安全地避免进一步成像或SPECT-CT。
