Article ; Online: Diagnostic and cost-effectiveness of axial skeleton MRI in staging high-risk prostate cancer.
BJUI compass
2023 Volume 4, Issue 3, Page(s) 346–351
Abstract: Introduction: Current literature suggests that axial skeleton magnetic resonance imaging (AS-MRI) is more sensitive than Tc 99m bone scintigraphy (BS) for detecting bone metastases (BM) in high-risk prostate cancer (PCa). However, BS is still widely ... ...
Abstract | Introduction: Current literature suggests that axial skeleton magnetic resonance imaging (AS-MRI) is more sensitive than Tc 99m bone scintigraphy (BS) for detecting bone metastases (BM) in high-risk prostate cancer (PCa). However, BS is still widely performed. Its diagnostic accuracy has been studied; however, its feasibility and cost implications are yet to be examined. Methods: We reviewed all patients with high risk PCa undergoing AS-MRI over a 5-year period. AS-MRI was performed on patients with histologically confirmed PCa and either PSA > 20 ng/ml, Gleason ≥8, or TNM Stage ≥T3 or N1 disease. All AS-MRI studies were obtained using a 1.5-T AchievaPhilips™MRI scanner. We compared the AS-MRI positivity and equivocal rate with that of BS. Data were analysed according to Gleason score, T-stage and PSA. Multivariate logistic regression analyses were used to quantify the strength of association between positive scans and clinical variables. Feasibility and burden of expenditure was also evaluated. Results: Five hundred three patients with a median age of 72 and a mean PSA of 34.8 ng/ml were analysed. Eighty-eight patients (17.5%) were positive for BM on AS-MRI (mean PSA 99 [95% CI 69.1-129.9]). Comparatively 409 patients (81.3%) were negative for BM on AS-MRI (mean PSA 24.7 (95% CI [21.7-27.7]) ( Conclusion: The use of AS-MRI to stage BM in high-risk PCa is both feasible and results in a reduced burden of expenditure. |
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Language | English |
Publishing date | 2023-01-31 |
Publishing country | United States |
Document type | Journal Article |
ISSN | 2688-4526 |
ISSN (online) | 2688-4526 |
DOI | 10.1002/bco2.210 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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