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Prostate Cancer: Staging (MP11): Moderated Poster 11: Friday, September 10, 2021

MP11-18 THE CONCORDANCE BETWEEN CONVENTIONAL COMPUTED TOMOGRAPHY AND NUCLEAR MEDICINE BONE SCINTIGRAPHY IN THE IDENTIFICATION OF PROSTATE CANCER METASTASES TO BONE

Weinstein, Corey; Seiden, Benjamin; Pak, So Yeon; Karsala, Nikhil; Vo, Thy; Sun, Natalie; Akivis, Yonatan; Myrie, Akya; Barnett, Jack; Shidid, Sarah; Esdaille, Ashanda; Hyacinthe, Llewellyn

doi: 10.1097/JU.0000000000001984.18
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INTRODUCTION AND OBJECTIVE:

The AUA/ASTRO/SUO 2017 Guidelines recommend the use of cross sectional imaging (CT or MRI) and Nuclear Medicine Bone Scan(NMBS) for staging high-risk localized prostate cancer (PCa). Studies have compared PET/CT with NMBS in identifying Osseous Metastasis (OM) in PCa, but data on the use of CT for this purpose is limited. We compared detection rates of OM between CT and NMBS in men receiving initial staging scans for PCa.

METHODS:

Patients who underwent NMBS and CT as part of the initial imaging workup for metastatic PCa at Kings County Hospital and Downstate Medical Center from 2014-2019 were identified through retrospective chart review. Exclusion criteria were patients with PCa and additional malignancy, undergoing imaging for recurrence, dual scans done ≥3 months apart, and those on androgen deprivation therapy. Presence of OM was determined by radiologic interpretation reports and confirmed with bone biopsy or clinical follow up. Cohen’s kappa(κ) was used to assess concordance. Sensitivity, specificity, positive and negative predictive values(PPV and NPV) were calculated. All analysis was conducted using IBM SPSS Statistic 27.

RESULTS:

141 male patients with dual scans were included in this study. Table one shows patient characteristics. 123(87.2%) of our patients had concordant imaging results (κ=0.704). 18 (12.8%) had discordant findings. When stratified by concordant pairs, both CT and NMBS accurately diagnosed 88/92(95.7%) and 31/31(100%) non-metastatic and metastatic cases, respectively. Amongst the entire cohort, CT accurately diagnosed 97/104(93.3%) and 32/37(86.5%) non-metastatic and metastatic cases, respectively. NMBS accurately diagnosed 91/104(87.5%) and 36/37(97.3%) non-metastatic and metastatic cases, respectively. A NPV of 95.1% and a PPV of 91.9% were calculated for CT.

CONCLUSIONS:

Our study shows high concordance, good inter-rater reliability (κ=0.704), and comparable specificity and sensitivity between CT and NMBS in detecting OM in PCa. Potential benefits of CT as a singular staging tool for PCa also include soft tissue retroperitoneal staging, serendipitous detection of abdominal/pelvic pathology, reduced healthcare costs secondary to clinically redundant evaluations.

Source of Funding:

None

© 2021 by American Urological Association Education and Research, Inc.