#0746

Is bone scan necessary of low/very low prostate cancer patients? A retrospective study in Taiwan

M. Chen¹, C. Chen²

¹Cardinal Tien Hospital, Department of urology, New Taipei City, Taiwan
²National Taiwan University Hospital, Department of urology, Taipei City, Taiwan

Introduction:

EAU guideline of prostate cancer recommends a bone scan for newly diagnosed patients with International Society of Urological Pathology (ISUP) grade group 3 disease, which implicated patients of unfavorable intermediate-, high and very high-risk prostate cancer according to American Urological Association and National Comprehensive Cancer Network. The current AUA guidelines recommend that clinicians should not routinely perform imaging in asymptomatic patients with low- or intermediate-risk prostate cancer, and those imaging types should be reserved for patients with high-risk disease. We aimed to validate the necessity of bone scan in low- and very low risk newly diagnosed prostate cancer.

Material and methods:

This single center retrospective study included patient with treatment naïve low- and very low risk from 2011 to 2019 at National Taiwan University Hospital. All of the patients presented with Gleason score 3+3, with mean age 66.7 years old and mean prostate specific antigen (PSA) 6.17 ng/ml,. We traced back the images performed upon diagnosis, with latest within 3 months upon pathological confirmation. Findings among urology field and other fields were reviewed individually. Bone scan is mainly studied while other images discussed concomitantly.

Results:

The data included 250 patients with low- and very-low risk. Amongst the results, imaging utilization included pelvic MRI (96.4%, 241 patients), bone scan (88.4%, 221 patients) and CT (6.0%, 15 patients). Bone scan was performed in 88.4% of patients, 5(2.3%) of which was noted with PCa-significant findings of bone, however all of them were not considered metastases after repeated discussion of multiple radiologist and oncologist experts.