214 results on '"bone scan index"'
Search Results
2. Evaluation of two-dimensional total bone uptake (2D-TBU) and bone scan index (BSI) extracted from active bone metastatic burden on the bone scintigraphy in patients with radium-223 treatment
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Fukai, Shohei, Daisaki, Hiromitsu, Umeda, Takuro, Shimada, Naoki, Terauchi, Takashi, and Koizumi, Mitsuru
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- 2024
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3. Flare phenomenon visualized by 99mTc-bone scintigraphy has prognostic value for patients with metastatic castration-resistant prostate cancer
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Zhang, Xue, Nakajima, Kenichi, Mizokami, Atsushi, Horikoshi, Hiroyuki, Nishimoto, Koshiro, Hashine, Katsuyoshi, Matsuyama, Hideyasu, Takahashi, Satoru, Wakabayashi, Hiroshi, and Kinuya, Seigo
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- 2024
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4. The DASciS Software for BSI Calculation as a Valuable Prognostic Tool in mCRPC Treated with 223RaCl2: A Multicenter Italian Study.
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De Feo, Maria Silvia, Frantellizzi, Viviana, Bauckneht, Matteo, Farcomeni, Alessio, Filippi, Luca, Rizzini, Elisa Lodi, Lavelli, Valentina, Stazza, Maria Lina, Di Raimondo, Tania, Fornarini, Giuseppe, Rebuzzi, Sara Elena, Filippo, Mammini, Mammucci, Paolo, Marongiu, Andrea, Monari, Fabio, Rubini, Giuseppe, Spanu, Angela, and De Vincentis, Giuseppe
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CASTRATION-resistant prostate cancer ,PROGNOSTIC tests ,BONE metastasis ,RADIONUCLIDE imaging ,NUCLEAR medicine - Abstract
Background/Aim: Radium-223 dichloride (
223 RaCl2 ) represents a therapeutic option for metastatic castration-resistant prostate cancer (mCRPC) patients dealing with symptomatic bone metastases. The identification of baseline variables potentially affecting the life-prolonging role of223 RaCl2 is still ongoing. Bone scan index (BSI) defines the total load of bone metastatic disease detected on a bone scan (BS) and is expressed as a percentage value of the whole bone mass. The aim of this multicenter study was to assess the impact of baseline BSI on overall survival (OS) in mCRPC patients treated with223 RaCl2 . For this purpose, the DASciS software developed by the Sapienza University of Rome for BSI calculation was shared between six Italian Nuclear Medicine Units. Methods: 370 pre-treatment BS were analyzed through the DASciS software. Other clinical variables relevant to OS analysis were taken into account for the statistical analysis. Results: Of a total of 370 patients, 326 subjects had died at the time of our retrospective analysis. The median OS time from the first cycle of223 RaCl2 to the date of death from any cause or last contact was 13 months (95%CI 12–14 months). The mean BSI value resulted in 2.98% ± 2.42. The center-adjusted univariate analysis showed that baseline BSI was significantly associated with OS as an independent risk factor (HR 1.137, 95%CI: 1.052–1.230, p = 0.001), meaning that patients with higher BSI values had worse OS. When adjusting for other measures on multivariate analysis, in addition to Gleason score and baseline values of Hb, tALP, and PSA, baseline BSI was confirmed to be a statistically significant parameter (HR 1.054, 95%CI: 1.040–1.068, p < 0.001). Conclusions: Baseline BSI significantly predicts OS in mCRPC treated with223 RaCl2 . The DASciS software was revealed to be a valuable tool for BSI calculation, showing rapid processing time and requiring no more than a single demonstrative training for each participating center. [ABSTRACT FROM AUTHOR]- Published
- 2023
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5. Bone scan index on bone scintigraphy and radiation therapy for bone metastases from cancers other than prostate and breast cancers: A retrospective observational study.
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Ishibashi, Naoya, Maebayashi, Toshiya, Kimura, Yuki, and Okada, Masahiro
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RADIONUCLIDE imaging , *BONE metastasis , *RADIOTHERAPY , *CANCER radiotherapy , *PROSTATE cancer , *METASTASIS , *BREAST cancer , *BONES , *BREAST tumors , *BONE tumors , *PROSTATE tumors , *RETROSPECTIVE studies , *PROSTATE - Abstract
Objective: In this study, we aimed to use new automatic analysis software (VSBONE bone scan index (BSI); Nihon Medi-Physics, Tokyo, Japan) to investigate whether the pre-radiation therapy (RT) BSI, derived from bone scintigraphy (BS) images, is a prognostic indicator in patients undergoing RT for bone metastases from cancers other than breast or prostate cancer.Materials and Methods: In this retrospective single-institution study, we analyzed data of 51 patients who had undergone whole-body scintigraphy before receiving RT for bone metastases from cancers other than breast and prostate cancer between 2013 and 2019. Their bone metastases preradiation BSI were automatically calculated using newly developed software (VSBONE BSI; Nihon Medi-Physics, Tokyo, Japan). Univariate and multivariate analyses were performed to identify associations between selected clinical variables and overall survival (OS).Results: We did not find a significant association between BSI and OS. However, we did find that younger patients had significantly better OS than older patients (P = 0.016 and P = 0.036, respectively). In addition, BSI were significantly lower in patient with solitary or osteolytic bone metastases than in those with osteoblastic or mixed bone metastases (P = 0.035 and P ≤ 0.001, respectively), and significantly higher in those with lung cancer than in those with other types of cancer (mean BSI 3.26% vs. 1.97%; P = 0.009).Conclusion: The only significant association with survival identified in this study was for age at the time of BS and at time of diagnosis of bone metastases. [ABSTRACT FROM AUTHOR]- Published
- 2022
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6. Development of a Prognostic Model of Overall Survival for Metastatic Hormone-Naïve Prostate Cancer in Japanese Men.
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Nakagawa, Ryunosuke, Iwamoto, Hiroaki, Makino, Tomoyuki, Naito, Renato, Kadomoto, Suguru, Akatani, Norihito, Yaegashi, Hiroshi, Kawaguchi, Shohei, Nohara, Takahiro, Shigehara, Kazuyoshi, Izumi, Kouji, Kadono, Yoshifumi, Takamatsu, Atsushi, Yoshida, Kotaro, and Mizokami, Atsushi
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STATISTICS , *HORMONE-dependent tumors , *TIME , *MULTIVARIATE analysis , *METASTASIS , *RETROSPECTIVE studies , *LACTATE dehydrogenase , *KAPLAN-Meier estimator , *SURVIVAL analysis (Biometry) , *DESCRIPTIVE statistics , *PROSTATE tumors , *OVERALL survival , *TUMOR grading , *DISEASE risk factors - Abstract
Simple Summary: Treatment strategies have changed dramatically in recent years with the development of a variety of agents for metastatic hormone-naïve prostate cancer. There is a need to identify prognostic factors for the appropriate choice of treatment for patients with hormone-naïve prostate cancer in Japanese men. Among the prostate cancer patients receiving treatment at our institution from 2000 to 2019, 198 patients with bone or visceral metastases at the initial diagnosis were included in the study. We retrospectively examined these factors of the overall survival, and identified Gleason pattern 5 content, bone scan index ≥ 1.5, and lactate dehydrogenase evels ≥ 300 IU/L as prognostic factors. Using these three factors, we developed a new prognostic model for overall survival that can more objectively predict the prognosis of patients simply and objectively. Background: Treatment strategies have changed dramatically in recent years with the development of a variety of agents for metastatic hormone-naïve prostate cancer (mHNPC). There is a need to identify prognostic factors for the appropriate choice of treatment for patients with mHNPC, and we retrospectively examined these factors. Methods: Patients with mHNPC treated at our institution from 2000 to 2019 were included in this study. Overall survival (OS) was estimated retrospectively using the Kaplan–Meier method, and factors associated with OS were identified using univariate and multivariate analyses. A prognostic model was then developed based on the factors identified. Follow-up was terminated on 24 October 2021. Results: The median follow-up duration was 44.2 months, whereas the median OS was 85.2 months, with 88 patients succumbing to their disease. Multivariate analysis identified Gleason pattern (GP) 5 content, bone scan index (BSI) ≥ 1.5, and lactate dehydrogenase (LDH) levels ≥ 300 IU/L as prognostic factors associated with OS. We also developed a prognostic model that classified patients with mHNPC as low risk with no factor, intermediate risk with one factor, and high risk with two or three factors. Conclusions: Three prognostic factors for OS were identified in patients with mHNPC, namely GP5 inclusion, BSI ≥ 1.5, and LDH ≥ 300. Using these three factors, we developed a new prognostic model for OS that can more objectively predict patient prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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7. Clinical Significance of the Highest Regional Bone Scan Index in Patients with Metastatic Castration–Resistant Prostate Cancer.
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Nakai, Yasushi, Iemura, Yusuke, Miyasaka, Toshiteru, Hori, Shunta, Miyake, Makito, Marugami, Nagaaki, Fujimoto, Kiyohide, and Tanaka, Nobumichi
- Abstract
Purpose: This study evaluated the clinical utility of the highest bone scan index (BSI), among other BSIs, for each bone metastatic site in patients with bone metastatic castration–resistant prostate cancer (bmCRPC). Methods: Thirty patients, diagnosed with bmCRPC by bone scintigraphy, were included. Total BSI, the number of hot spots, and regional BSI on each hot spot from bone scintigraphy at diagnosis with bmCRPC were evaluated by VSBONE BSI®. Highest regional BSI was defined as the highest value among regional BSIs on each hot spot in each patient. Related factors to overall survival and skeletal-related events (SREs) were evaluated using the Cox proportional-hazards model. Results: The median follow-up time from diagnosis with bmCRPC was 29.0 months. During this time, 24 patients died, of which 22 patients died from prostate cancer. On univariate analysis, alkaline phosphatase (ALP) [Hazard ratio (HR): 5.96, 95% confidence interval (CI): 2.05–17.3] and highest regional BSI (HR: 2.01, 95% CI: 1.17–7.05) had significant correlation with overall survival. On multivariate analysis, ALP (HR: 4.79, 95% CI: 1.61–14.2) had significant correlation with overall survival. SREs were found in eight patients. Only the highest regional BSI (HR: 9.99, 95% CI: 2.46–40.6) significantly correlated with SREs on univariate analysis. Conclusion: Highest regional BSI may provide important information regarding prognosis and SREs in patients with bmCRPC. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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8. Predicting the Prognosis of Prostate Cancer Bone Metastasis Using the Bone Scan Index and Hot Spots Calculated Using VSBONEⓇ Bone Scan Index from Tc-99m-Hydroxymethylene Diphosphonate Bone Scintigraphy.
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Higashiyama, Shigeaki, Yoshida, Atsushi, and Kawabe, Joji
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RADIONUCLIDE imaging , *BONE metastasis , *PROSTATE cancer prognosis , *METASTASIS , *BONE cancer , *PROSTATE cancer - Abstract
Introduction: The bone scan index (BSI) is widely used as a quantitative indicator of bone metastasis, therapeutic effect assessment, and prognosis prediction in prostate cancer. However, the BONE NAVI, which calculates BSI, only supports bone scintigraphy using Tc-99m-methylene diphosphonate. We developed the VSBONEⓇ BSI, which calculates BSI from bone scintigraphy using Tc-99m-hydroxymethylene diphosphonate (HMDP). The purpose of this study was to demonstrate that the BSI calculated using VSBONEⓇ BSI and hot spots (HS), which indicates the number of abnormal accumulations, are useful prognostic factors for patients with prostate cancer bone metastasis, similar to BONE NAVI. Methods: We analyzed 322 patients who underwent bone scintigraphy for prostate cancer bone metastasis at our hospital. Initial bone scintigraphy was performed using Tc-99m-HMDP. All cases were retrospectively examined for their outcome and time to the final outcome. The results obtained were compared with the BSI and HS calculated using VSBONEⓇ BSI. Results: When the patients were divided into two groups, HS >2 and HS ≤2, the HS ≤2 group had a significantly longer survival time (p < 0.001). In addition, when divided into two groups, BSI >0.46 and BSI ≤0.46, the survival time of the BSI ≦0.46 group was significantly longer (p < 0.001). Conclusion: BSI and HS obtained using VSBONEⓇ BSI may be useful as prognostic predictors, similar to those obtained using BONE NAVI. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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9. Comparison of skeletal segmentation by deep learning-based and atlas-based segmentation in prostate cancer patients.
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Motegi, Kazuki, Miyaji, Noriaki, Yamashita, Kosuke, Koizumi, Mitsuru, and Terauchi, Takashi
- Abstract
Objective: We aimed to compare the deep learning-based (VSBONE BSI) and atlas-based (BONENAVI) segmentation accuracy that have been developed to measure the bone scan index based on skeletal segmentation. Methods: We retrospectively conducted bone scans for 383 patients with prostate cancer. These patients were divided into two groups: 208 patients were injected with
99m Tc-hydroxymethylene diphosphonate processed by VSBONE BSI, and 175 patients were injected with99m Tc-methylene diphosphonate processed by BONENAVI. Three observers classified the skeletal segmentations as either a "Match" or "Mismatch" in the following regions: the skull, cervical vertebrae, thoracic vertebrae, lumbar vertebrae, pelvis, sacrum, humerus, rib, sternum, clavicle, scapula, and femur. Segmentation error was defined if two or more observers selected "Mismatch" in the same region. We calculated the segmentation error rate according to each administration group and evaluated the presence of hot spots suspected bone metastases in "Mismatch" regions. Multivariate logistic regression analysis was used to determine the association between segmentation error and variables like age, uptake time, total counts, extent of disease, and gamma cameras. Results: The regions of "Mismatch" were more common in the long tube bones for VSBONE BSI and in the pelvis and axial skeletons for BONENAVI. Segmentation error was observed in 49 cases (23.6%) with VSBONE BSI and 58 cases (33.1%) with BONENAVI. VSBONE BSI tended that "Mismatch" regions contained hot spots suspected of bone metastases in patients with multiple bone metastases and showed that patients with higher extent of disease (odds ratio = 8.34) were associated with segmentation error in multivariate logistic regression analysis. Conclusions: VSBONE BSI has a potential to be higher segmentation accuracy compared with BONENAVI. However, the segmentation error in VSBONE BSI occurred dependent on bone metastases burden. We need to be careful when evaluating multiple bone metastases using VSBONE BSI. [ABSTRACT FROM AUTHOR]- Published
- 2022
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10. The DASciS Software for BSI Calculation as a Valuable Prognostic Tool in mCRPC Treated with 223RaCl2: A Multicenter Italian Study
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Maria Silvia De Feo, Viviana Frantellizzi, Matteo Bauckneht, Alessio Farcomeni, Luca Filippi, Elisa Lodi Rizzini, Valentina Lavelli, Maria Lina Stazza, Tania Di Raimondo, Giuseppe Fornarini, Sara Elena Rebuzzi, Mammini Filippo, Paolo Mammucci, Andrea Marongiu, Fabio Monari, Giuseppe Rubini, Angela Spanu, and Giuseppe De Vincentis
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mCRPC ,DASciS software ,bone scan index ,radium-223 ,overall survival ,bone metastasis ,Biology (General) ,QH301-705.5 - Abstract
Background/Aim: Radium-223 dichloride (223RaCl2) represents a therapeutic option for metastatic castration-resistant prostate cancer (mCRPC) patients dealing with symptomatic bone metastases. The identification of baseline variables potentially affecting the life-prolonging role of 223RaCl2 is still ongoing. Bone scan index (BSI) defines the total load of bone metastatic disease detected on a bone scan (BS) and is expressed as a percentage value of the whole bone mass. The aim of this multicenter study was to assess the impact of baseline BSI on overall survival (OS) in mCRPC patients treated with 223RaCl2. For this purpose, the DASciS software developed by the Sapienza University of Rome for BSI calculation was shared between six Italian Nuclear Medicine Units. Methods: 370 pre-treatment BS were analyzed through the DASciS software. Other clinical variables relevant to OS analysis were taken into account for the statistical analysis. Results: Of a total of 370 patients, 326 subjects had died at the time of our retrospective analysis. The median OS time from the first cycle of 223RaCl2 to the date of death from any cause or last contact was 13 months (95%CI 12–14 months). The mean BSI value resulted in 2.98% ± 2.42. The center-adjusted univariate analysis showed that baseline BSI was significantly associated with OS as an independent risk factor (HR 1.137, 95%CI: 1.052–1.230, p = 0.001), meaning that patients with higher BSI values had worse OS. When adjusting for other measures on multivariate analysis, in addition to Gleason score and baseline values of Hb, tALP, and PSA, baseline BSI was confirmed to be a statistically significant parameter (HR 1.054, 95%CI: 1.040–1.068, p < 0.001). Conclusions: Baseline BSI significantly predicts OS in mCRPC treated with 223RaCl2. The DASciS software was revealed to be a valuable tool for BSI calculation, showing rapid processing time and requiring no more than a single demonstrative training for each participating center.
- Published
- 2023
- Full Text
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11. A Phase II, Randomized, Open-Label, Multi-arm Study of TAS-115 for Castration-Resistant Prostate Cancer Patients With Bone Metastases.
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Nobuaki Matsubara, Hirotsugu Uemura, Satoshi Nagamori, Hiroyoshi Suzuki, Hiroji Uemura, and Go Kimura
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CLINICAL trials , *CASTRATION-resistant prostate cancer , *BONE metastasis , *DOCETAXEL , *ANEMIA , *HYPOPHOSPHATEMIA - Abstract
New treatments to improve quality of life and survival for castration-resistant prostate cancer patients with bone metastases are needed. We evaluated the safety and efficacy of the oral multikinase inhibitor TAS-115 in 50 patients. Overall, we observed improvements in bone metastasis and pain measures, and acceptable safety profiles with TAS-115. TAS-115 may be a useful treatment for these patients. Introduction: TAS-115 is an oral multikinase inhibitor targeting the MET proto-oncogene, vascular endothelial growth factor receptor, and colony-stimulating factor 1 receptor. We evaluated the efficacy and safety of TAS-115 in castrationresistant prostate cancer (CRPC) patients with bone metastases. Patients and Methods: This phase II study, conducted in Japan, comprised 2 cohorts of CRPC patients. Cohort A included patients with bone metastasis and no history of docetaxel; TAS-115 200 to 400 mg/d was administered with abiraterone and prednisone. Cohort B included patients with symptomatic multiple bone metastases, post- or unfit for docetaxel, randomized 1:1 to receive TAS-115 400 or 600 mg/d orally, once daily, in a repeated weekly schedule of 5 days on/2 days off. The primary endpoint was bone scan index (BSI) response rate at Week 12 in each dose group. Results: Cohorts A and B included 24 and 26 patients, respectively. The 12-week BSI response rates for 200, 300, and 400 mg were 0%, 33.3%, and 16.7% in Cohort A, and for 400 and 600 mg were 7.1% and 25.0% in Cohort B. The best BSI response rates for 200, 300, and 400 mg were 0%, 66.7%, and 16.7% in Cohort A, and for 400 and 600 mg were 7.1% and 33.3% in Cohort B. A = 30% reduction in BPI-SF score was shown in 57.7% of patients in Cohort B. The most frequent Grade = 3 adverse drug reactions were hypophosphatemia (20.8%) in Cohort A and anemia (23.1%) in Cohort B. Conclusion: TAS-115 appears to demonstrate anti-tumor activity and acceptable tolerability in CRPC patients with bone metastases. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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12. Prognostic value of the bone scan index in patients with metastatic castration-resistant prostate cancer: a systematic review and meta-analysis
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Hualin Song, Song Jin, Peng Xiang, Shuai Hu, and Jie Jin
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BSI ,Bone scan index ,Metastatic castration-resistant prostate cancer ,mCRPC ,Meta-analysis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Many studies have reported the prognostic significance of the bone scan index (BSI) for metastatic castration-resistant prostate cancer (mCRPC); however, these reports are controversial. This study investigated the BSI in mCRPC and its relationship with prognosis. Methods The PubMed, Cochrane, and Embase databases were searched systematically for relevant articles published before September 1, 2019. Hazard ratios (HRs) were used to investigate the prognostic value. Results This study finally identified 9 eligible studies. The results suggested that high baseline BSI predicted poor OS (HR = 1.331, 95% CI: 1.081–1.640) and that elevated ΔBSI also predicted poor OS (HR = 1.220, 95% CI: 1.015–1.467). The subgroup analysis stratified by ethnicity showed that the baseline BSI and ΔBSI predicted poor OS in the Asian population but not in the Caucasian population. We also performed a subgroup analysis based on the different cut-off values of baseline BSI. The subgroup of ≤1 showed a significant association with OS in mCRPC patients. Conclusion Our study demonstrated that high baseline BSI and elevated ΔBSI predicted poor OS in patients with mCRPC. Hence, the BSI can serve as a prognostic indicator for mCRPC patients and may therefore guide clinical treatment in the future.
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- 2020
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13. Scintigraphic load of bone disease evaluated by DASciS software as a survival predictor in metastatic castration-resistant prostate cancer patients candidates to 223RaCl treatment
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Frantellizzi Viviana, Pani Arianna, Ippoliti Maria Dea, Farcomeni Alessio, Aloise Irvin, Colosi Mirco, Polito Claudia, Pani Roberto, and Vincentis Giuseppe De
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dascis software ,radium223 dichloride ,bone scan index ,bone disease ,overall survival ,mcrpc ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Aim of our study was to assess the load of bone disease at starting and during Ra-223 treatment as an overall survival (OS) predictor in metastatic castration-resistant prostate cancer (mCRPC) patients. Bone scan index (BSI) is defined as the percentage of total amount of bone metastasis on whole-body scintigraphic images. We present a specific software (DASciS) developed by an engineering team of “Sapienza” University of Rome for BSI calculation.
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- 2019
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14. Development of a Prognostic Model of Overall Survival for Metastatic Hormone-Naïve Prostate Cancer in Japanese Men
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Ryunosuke Nakagawa, Hiroaki Iwamoto, Tomoyuki Makino, Renato Naito, Suguru Kadomoto, Norihito Akatani, Hiroshi Yaegashi, Shohei Kawaguchi, Takahiro Nohara, Kazuyoshi Shigehara, Kouji Izumi, Yoshifumi Kadono, Atsushi Takamatsu, Kotaro Yoshida, and Atsushi Mizokami
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hormone-naïve prostate cancer ,prognostic model ,Gleason pattern ,bone scan index ,lactate dehydrogenase ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Treatment strategies have changed dramatically in recent years with the development of a variety of agents for metastatic hormone-naïve prostate cancer (mHNPC). There is a need to identify prognostic factors for the appropriate choice of treatment for patients with mHNPC, and we retrospectively examined these factors. Methods: Patients with mHNPC treated at our institution from 2000 to 2019 were included in this study. Overall survival (OS) was estimated retrospectively using the Kaplan–Meier method, and factors associated with OS were identified using univariate and multivariate analyses. A prognostic model was then developed based on the factors identified. Follow-up was terminated on 24 October 2021. Results: The median follow-up duration was 44.2 months, whereas the median OS was 85.2 months, with 88 patients succumbing to their disease. Multivariate analysis identified Gleason pattern (GP) 5 content, bone scan index (BSI) ≥ 1.5, and lactate dehydrogenase (LDH) levels ≥ 300 IU/L as prognostic factors associated with OS. We also developed a prognostic model that classified patients with mHNPC as low risk with no factor, intermediate risk with one factor, and high risk with two or three factors. Conclusions: Three prognostic factors for OS were identified in patients with mHNPC, namely GP5 inclusion, BSI ≥ 1.5, and LDH ≥ 300. Using these three factors, we developed a new prognostic model for OS that can more objectively predict patient prognosis.
- Published
- 2022
- Full Text
- View/download PDF
15. Prognosis of patients with prostate cancer and bone metastasis from the Japanese Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan Index cohort study.
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Nakajima, Kenichi, Mizokami, Atsushi, Matsuyama, Hideyasu, Ichikawa, Tomohiko, Kaneko, Go, Takahashi, Satoru, Shiina, Hiroaki, Horikoshi, Hiroyuki, Hashine, Katsuyoshi, Sugiyama, Yutaka, Miyao, Takeshi, Kamiyama, Manabu, Harada, Kenichi, and Ito, Akito
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CASTRATION-resistant prostate cancer , *PROSTATE cancer , *PROSTATE cancer prognosis , *BONE cancer , *BONE metastasis , *METASTASIS , *PROGNOSIS - Abstract
Objective: To determine prognostic factors including the Bone Scan Index in prostate cancer patients receiving standard hormonal therapy and chemotherapy. Methods: This multicenter Prostatic Cancer Registry of Standard Hormonal and Chemotherapy Using Bone Scan Index study involved 30 hospitals and enrolled 247 patients (age 71 ± 8 years) with metastatic hormone‐sensitive prostate cancer (n = 148) under hormone therapy and metastatic castration‐resistant prostate cancer (n = 99) under chemotherapy. The Bone Scan Index (%) was determined by whole‐body bone scintigraphy using 99mTc‐methylenediphosphonate. Patients were classified into tertiles and binary groups, and predictors of all‐cause death including Bone Scan Index, prostate‐specific antigen, and bone metabolic markers were determined using survival and proportional hazard analyses. Results: During a mean follow‐up period of 716 ± 404 days, 81 (33%) of the patients died, and 3‐year mortality rates were 20% and 52% in the metastatic hormone‐sensitive prostate cancer and metastatic castration‐resistant prostate cancer groups, respectively. Survival analysis showed that a Bone Scan Index >3.5% was a significant determinant of death in the metastatic hormone‐sensitive prostate cancer group, whereas prostate‐specific antigen >55 ng/mL before chemotherapy was a determinant of prognosis in the metastatic castration‐resistant prostate cancer group. A Bone Scan Index >3.5% was also associated with a high incidence of prostate‐specific antigen progression in the metastatic hormone‐sensitive prostate cancer group. Patients with metastatic hormone‐sensitive prostate cancer and a better Bone Scan Index response (>45%) to treatment had lower mortality rates than those without such response. Conclusion: The Bone Scan Index and hot spot number are significant determinants of 3‐year mortality, and combining the Bone Scan Index with prostate‐specific antigen should contribute to the management of prostate cancer patients with bone metastasis. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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16. Prognostic impact of bone metastatic volume beyond vertebrae and pelvis in patients with metastatic hormone-sensitive prostate cancer.
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Suzuki, Kotaro, Okamura, Yasuyoshi, Hara, Takuto, Terakawa, Tomoaki, Furukawa, Junya, Harada, Kenichi, Hinata, Nobuyuki, and Fujisawa, Masato
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PROSTATE cancer , *PELVIS , *BONE metastasis , *VERTEBRAE , *OVERALL survival , *PROGNOSIS - Abstract
Background: Although bone metastasis beyond the vertebrae and pelvis has been a key factor in prognostic models of metastatic hormone-sensitive prostate cancer (mHSPC), the clinical significance of it is still unclear. The present study evaluated the prognostic impact of the volume of bone metastasis beyond the vertebrae and pelvis on the outcomes of mHSPC and created an ideal risk classification based on it. Methods: We retrospectively reviewed 197 patients with mHSPC who were treated with combined androgen blockade as the initial treatment between June 2003 and October 2019. We calculated the bone scan index (BSI), including the BSI beyond the vertebrae and pelvis (bBSI), using BONENAVI, and investigated the association between the BSI and the overall survival (OS) of mHSPC. Results: According to the CHAARTED criteria, 91 and 106 patients were classified into the low- and high-volume groups, respectively. Of the 79 patients who did not have visceral metastasis in the high-volume group, those with a bBSI ≤ 0.27 (n = 16) showed a favorable OS, as did those in the low-volume group. The modified CHAARTED high-volume group (presence of visceral metastases or 4 bone lesions with a bBSI > 0.27) showed a significantly shorter OS than others, with a hazard ratio (HR) of 4.69 (p < 0.001), which was higher than that observed with the original CHAARTED criteria (HR = 4.33). Conclusions: Our data suggested that considering the volume of bone metastasis beyond the vertebrae and pelvis may help to improve the accuracy of risk classification. Further large-scale prospective studies are needed to validate our findings. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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17. Nuclear Medicine (Bone Scan, Choline and PSMA PET/CT)
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Goffin, Karolien E., Everaerts, Wouter, Bolla, Michel, editor, and van Poppel, Hendrik, editor
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- 2017
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18. Approaches for Assessment of Response of Bone Metastases to Therapies
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Bombardieri, Emilio, Mungai, Francesco, Bonomi, Maria, Setti, Lucia, Borsatti, Eugenio, Ciocia, Gianluigi, Evangelista, Laura, Bertoldo, Francesco, editor, Boccardo, Francesco, editor, Bombardieri, Emilio, editor, Evangelista, Laura, editor, and Valdagni, Riccardo, editor
- Published
- 2017
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19. Evaluation of usage of bone scan index in assessment of metastatic prostate cancer.
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Ćorović, Halil, Salkica, Nusret, Hadzimusic, Safet, Tinjak, Enis, and Brčaninović, Adel
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PROSTATE cancer ,RADIONUCLIDE imaging of cancer ,BIOMARKERS ,OVERALL survival ,CLINICAL trials - Abstract
Introduction: Prostate cancer has been the leading type of cancer to affect male population, and as such, it is a subject to efforts to furthermore diagnostic tools already in existence as well as development of new ones which will Aid early diagnostic, treatments as well as a follow up procedures and clinical trials. Bone scan index is a useful and objective biomarker used as a valuable tool for determination as to precise bone involvement in advanced cases, as well as a tool to predict the outcome in prostate cancer patients in clinical trials. Methods: This paper is a non-experimental (qualitative) research, that is, a scientific review of the literature. Results: The results we analyzed in this paper were collected from published academic journals. Conclusion: As a new imaging biomarker, bone scan index has potential to predict therapeutic effects and survival of patients with prostate cancer. Using measurable diagnostic image parameters, the bone scan index is important for determining metastatic bone changes in prostate cancer patients. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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20. A prospective study to evaluate the intra-individual reproducibility of bone scans for quantitative assessment in patients with metastatic prostate cancer
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Mariana Reza, Reza Kaboteh, May Sadik, Anders Bjartell, Per Wollmer, and Elin Trägårdh
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Reproducibility ,Prostate cancer ,Bone metastasis ,Bone scan quantitative analysis ,Bone scan index ,Medical technology ,R855-855.5 - Abstract
Abstract Background The Bone Scan Index (BSI) is used to quantitatively assess the total tumour burden in bone scans of patients with metastatic prostate cancer. The clinical utility of BSI has recently been validated as a prognostic imaging biomarker. However, the clinical utility of the on-treatment change in BSI is dependent on the reproducibility of bone scans. The objective of this prospective study is to evaluate the intra-patient reproducibility of two bone scan procedures performed at a one-week interval. Methods We prospectively studied prostate cancer patients who were referred for bone scintigraphy at our centres according to clinical routine. All patients underwent two whole-body bone scans: one for clinical routine purposes and a second one as a repeated scan after approximately one week. BSI values were obtained for each bone scintigraph using EXINI boneBSI software. Results A total of 20 patients were enrolled. There was no statistical difference between the BSI values of the first (median = 0.66, range 0–40.77) and second (median = 0.63, range 0–22.98) bone scans (p = 0.41). The median difference in BSI between the clinical routine and repeated scans was − 0.005 (range − 17.79 to 0). The 95% confidence interval for the median value was − 0.1 to 0. A separate analysis was performed for patients with BSI ≤ 10 (n = 17). Differences in BSI were smaller for patients with BSI ≤ 10 compared to the whole cohort (median − 0.1, range − 2.2-0, 95% confidence interval − 0.1 to 0). Conclusions The automated BSI demonstrated high intra-individual reproducibility for BSI ≤ 10 in the two repeated bone scans of patients with prostate cancer. The study supports the use of BSI as a quantitative parameter to evaluate the change in total tumour burden in bone scans.
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- 2018
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21. Prognostic value of an automated bone scan index for men with metastatic castration-resistant prostate cancer treated with cabazitaxel
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Koichi Uemura, Yasuhide Miyoshi, Takashi Kawahara, Jikuya Ryosuke, Daisuke Yamashita, Shuko Yoneyama, Yumiko Yokomizo, Kazuki Kobayashi, Takeshi Kishida, Masahiro Yao, and Hiroji Uemura
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Prostate cancer ,Castration-resistant ,Survival prediction ,Bone scan index ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background A computer-assisted diagnostic system for analyzing bone scans (BONENAVI) calculates the automated bone scan index (aBSI). Here we evaluated the aBSI as a prognostic imaging biomarker for men with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel. Methods We retrospectively analyzed 48 patients who received cabazitaxel for mCRPC and evaluated the ability of the aBSI to predict overall survival (OS). The Cox proportional hazards model was used to investigate the associations between baseline aBSI at cabazitaxel treatment and OS with the clinical variables as follows: age, number of cycles of docetaxel, serum prostate-specific antigen, hemoglobin (Hb), lactate dehydrogenase (LDH), and alkaline phosphatase. We determined the C-index to evaluate the discriminatory ability of our models when we included or excluded the aBSI from the analyses. Results The median OS after cabazitaxel treatment was 10.0 months, and patients with aBSI ≤1% achieved significantly longer OS compared with patients with aBSI ≥1%. Multivariate analysis showed that age, Hb, LDH, and aBSI were independent prognostic factors of OS. Adding aBSI to the base model increased the C-index from 0.78 to 0.80. Conclusions The aBSI may serve as a useful imaging biomarker for predicting OS among men with mCRPC treated with cabazitaxel. Prospective studies are required to establish the value of aBSI as prognostic imaging biomarker.
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- 2018
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22. Automated measurement of bone scan index from a whole-body bone scintigram.
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Shimizu, Akinobu, Wakabayashi, Hayato, Kanamori, Takumi, Saito, Atsushi, Nishikawa, Kazuhiro, Daisaki, Hiromitsu, Higashiyama, Shigeaki, and Kawabe, Joji
- Abstract
Purpose: We propose a deep learning-based image interpretation system for skeleton segmentation and extraction of hot spots of bone metastatic lesion from a whole-body bone scintigram followed by automated measurement of a bone scan index (BSI), which will be clinically useful. Methods: The proposed system employs butterfly-type networks (BtrflyNets) for skeleton segmentation and extraction of hot spots of bone metastatic lesions, in which a pair of anterior and posterior images are processed simultaneously. BSI is then measured using the segmented bones and extracted hot spots. To further improve the networks, deep supervision (DSV) and residual learning technologies were introduced. Results: We evaluated the performance of the proposed system using 246 bone scintigrams of prostate cancer in terms of accuracy of skeleton segmentation, hot spot extraction, and BSI measurement, as well as computational cost. In a threefold cross-validation experiment, the best performance was achieved by BtrflyNet with DSV for skeleton segmentation and BtrflyNet with residual blocks. The cross-correlation between the measured and true BSI was 0.9337, and the computational time for a case was 112.0 s. Conclusion: We proposed a deep learning-based BSI measurement system for a whole-body bone scintigram and proved its effectiveness by threefold cross-validation study using 246 whole-body bone scintigrams. The automatically measured BSI and computational time for a case are deemed clinically acceptable and reliable. [ABSTRACT FROM AUTHOR]
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- 2020
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23. Scintigraphic load of bone disease evaluated by DASciS software as a survival predictor in metastatic castration-resistant prostate cancer patients candidates to 223RaCl treatment.
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Frantellizzi, Viviana, Pani, Arianna, Ippoliti, Maria Dea, Farcomeni, Alessio, Aloise, Irvin, Colosi, Mirco, Polito, Claudia, Pani, Roberto, and Vincentis, Giuseppe De
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BONE metastasis ,BONE diseases ,CANCER patients ,DIAGNOSTIC imaging ,METASTASIS ,PROSTATE tumors ,RADIONUCLIDE imaging ,RADIOPHARMACEUTICALS ,SURVIVAL ,DATA analysis software - Abstract
Background: Aim of our study was to assess the load of bone disease at starting and during Ra-223 treatment as an overall survival (OS) predictor in metastatic castration-resistant prostate cancer (mCRPC) patients. Bone scan index (BSI) is defined as the percentage of total amount of bone metastasis on whole-body scintigraphic images. We present a specific software (DASciS) developed by an engineering team of "Sapienza" University of Rome for BSI calculation. Patients and methods: 127 mCRPC patients bone scan images were processed with DASciS software, and BSI was tested as OS predictor. Results: 546 bone scans were analyzed revealing that the extension of disease is a predictor of OS (0–3% = 28 months of median survival (MoMS]; 3%–5% = 11 MoMS, > 5% = 5 MoMS). BSI has been analyzed as a single parameter for OS, determining an 88% AUC. Moreover, the composition between the BSI and the 3-PS (3-variable prognostic score) determines a remarkable improvement of the AUC (91%), defining these two parameters as the best OS predictors. Conclusions: This study suggests that OS is inversely correlated with the load of bone disease in mCRPC Ra-223-treated subjects. DASciS software appears a promising tool in identifying mCRPC patients that more likely take advantage from Ra-223 treatment. BSI is proposed as a predictive variable for OS and included to a multidimensional clinical evaluation permits to approach the patients' enrollment in a rational way, allowing to enhance the treatment effectiveness together with cost optimization. [ABSTRACT FROM AUTHOR]
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- 2020
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24. ☆Symposium: Imaging modalities for drug-related osteonecrosis of the jaw (5), utility of bone scintigraphy and 18F-FDG PET/CT in early detection and risk assessment of medication-related osteonecrosis of the jaw (secondary publication).
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Watanabe, Satoru, Nakajima, Kenichi, and Kinuya, Seigo
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RADIONUCLIDE imaging ,OSTEONECROSIS ,RISK assessment ,JAWS ,BONE metastasis - Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a significant side effect of antiresorptive and antiangiogenic drugs. Since MRONJ is intractable, early detection is the best way to limit progression. Bone scintigraphy and
18 F- fluorodeoxyglucose positron-emission tomography can detect minimal and subclinical changes in bones earlier than conventional radiological modalities. A differential diagnosis including MRONJ is recommended when abnormally high uptakes are incidentally detected in the jaws of patients who have bone metastases. Quantitative analysis of uptakes, such as bone scan index of the jaw using neural network analysis and maximum standardized uptake value, could differentiate MRONJ from common dental diseases and be useful for the early detection and risk assessment of MRONJ. [ABSTRACT FROM AUTHOR]- Published
- 2019
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25. Correlation between Automated Bone Scan Index Change after Cabazitaxel and Survival among Men with Castration-Resistant Prostate Cancer.
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Miyoshi, Yasuhide, Sakamoto, Shinichi, Kawahara, Takashi, Uemura, Koichi, Yokomizo, Yumiko, and Uemura, Hiroji
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CASTRATION-resistant prostate cancer , *CABAZITAXEL , *PROSTATE-specific antigen - Abstract
Background: Automated bone scan index (aBSI) change (ΔBSI) after treatment and survival in men with prostate cancer remains unclear. We evaluated the correlation between ΔBSI after cabazitaxel and overall survival (OS) in men with bone metastatic castration-resistant prostate cancer (CRPC). Methods: We retrospectively enrolled 32 men with bone metastatic CRPC who had received cabazitaxel. The correlation between ΔBSI from baseline to 16 weeks after starting cabazitaxel and OS was analyzed by multivariate analysis. Results: Median age and time to CRPC were 70.7 years and 9.5 months, respectively. The median cycles of docetaxel before cabazitaxel were eight. Ten (31.2%) patients had visceral metastases at baseline. Median baseline prostate-specific antigen (PSA) was 123.0 ng/mL. The median aBSIs at baseline and 16 weeks after cabazitaxel were 3.2 and 4.4%, respectively. Improvements in aBSI and PSA after 16 weeks of cabazitaxel occurred in 7 (21.9%) and 12 patients (37.5%), respectively. There were no correlations between ΔBSI and OS (p = 0.55), but PSA change was significantly correlated with OS (p = 0.03) by multivariate analysis. Conclusions: This study demonstrated that ΔBSI from baseline to16 weeks after starting cabazitaxel was not correlated with OS among men with bone metastatic CRPC. Further prospective studies may be warranted to confirm the limited utility of aBSI in this setting. [ABSTRACT FROM AUTHOR]
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- 2019
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26. Predicting the Prognosis of Prostate Cancer Bone Metastasis Using the Bone Scan Index and Hot Spots Calculated Using VSBONEⓇ Bone Scan Index from Tc-99m-Hydroxymethylene Diphosphonate Bone Scintigraphy
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Shigeaki Higashiyama, Atsushi Yoshida, and Joji Kawabe
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Male ,前立腺癌 ,骨転移 ,VSBONE Ⓡ BSI ,Urology ,Prostatic Neoplasms ,Bone Neoplasms ,Technetium Tc 99m Medronate ,BSI ,bacterial infections and mycoses ,Prognosis ,prostate cancer ,Bone scan index ,Bone and Bones ,Tc-99m-HMDP ,Humans ,Radionuclide Imaging ,human activities ,Retrospective Studies ,bone metastasis - Abstract
Introduction: The bone scan index (BSI) is widely used as a quantitative indicator of bone metastasis, therapeutic effect assessment, and prognosis prediction in prostate cancer. However, the BONE NAVI, which calculates BSI, only supports bone scintigraphy using Tc-99m-methylene diphosphonate. We developed the VSBONEⓇ BSI, which calculates BSI from bone scintigraphy using Tc-99m-hydroxymethylene diphosphonate (HMDP). The purpose of this study was to demonstrate that the BSI calculated using VSBONEⓇ BSI and hot spots (HS), which indicates the number of abnormal accumulations, are useful prognostic factors for patients with prostate cancer bone metastasis, similar to BONE NAVI. Methods: We analyzed 322 patients who underwent bone scintigraphy for prostate cancer bone metastasis at our hospital. Initial bone scintigraphy was performed using Tc-99m-HMDP. All cases were retrospectively examined for their outcome and time to the final outcome. The results obtained were compared with the BSI and HS calculated using VSBONEⓇ BSI. Results: When the patients were divided into two groups, HS >2 and HS ≤2, the HS ≤2 group had a significantly longer survival time (p < 0.001). In addition, when divided into two groups, BSI >0.46 and BSI ≤0.46, the survival time of the BSI ≦0.46 group was significantly longer (p < 0.001). Conclusion: BSI and HS obtained using VSBONEⓇ BSI may be useful as prognostic predictors, similar to those obtained using BONE NAVI.
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- 2022
27. Prospective evaluation of computer-assisted analysis of skeletal lesions for the staging of prostate cancer
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Lars J. Petersen, Jesper C. Mortensen, Henrik Bertelsen, and Helle D. Zacho
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Agreement ,Bone scan index ,Bone scintigraphy ,Computer-aided analysis ,Diagnostic properties ,Predictive values ,Medical technology ,R855-855.5 - Abstract
Abstract Background The purpose of this study was to compare the agreement of the bone scan index (BSI) using EXINI BoneBSI versus experts’ readings in the initial staging for bone metastasis in prostate cancer. In addition, the diagnostic outcome was assessed in a large subset of patients where a true reference for metastases could be determined based on clinical and biochemical follow-up and/or supplementary imaging. Methods A total of 342 patients had a bone scintigraphy as part of routine staging for prostate cancer. Supplementary imaging was obtained at the discretion of the referring urologist. After full recruitment, the BSI and the number of malignant lesions were calculated using EXINI BoneBSI, and three imaging experts independently classified bone status by a dichotomous outcome (M1 for bone metastasis, M0 for no bone metastasis). A true reference was available in a subset of the patients based on post-operative prostate-specific antigen responses after radical prostatectomy and/or supplementary imaging. Results Software analysis with a BSI > 0 as the cut-off for metastasis showed excellent agreement with expert classification for M1 disease (96% of the patients) but modest agreement for M0 disease (38%). With a BSI > 1, the agreement was 58% for M1 and 98% for M0. Software analyses based on individual European Association of Urology risk classification did not improve the diagnostic performance. Among patients with a true reference, the software showed metastasis in 64% of the M0 patients but correctly classified metastases in all M1 patients. The sensitivity was 100%, the specificity was 36%, the positive predictive value was 12.6% and the negative predictive value was 100% with a BSI >0 compared with 66.7%, 97.8%, 72.7%, and 97.0% with a BSI > 1. Conclusion The diagnostic value of using EXINI Bone for the BSI in the staging of newly diagnosed prostate cancer is limited.
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- 2017
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28. 3D skeletal uptake of 18F sodium fluoride in PET/CT images is associated with overall survival in patients with prostate cancer
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Sarah Lindgren Belal, May Sadik, Reza Kaboteh, Nezar Hasani, Olof Enqvist, Linus Svärm, Fredrik Kahl, Jane Simonsen, Mads H. Poulsen, Mattias Ohlsson, Poul F. Høilund-Carlsen, Lars Edenbrandt, and Elin Trägårdh
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PET/CT ,Sodium fluoride ,Bone scan index ,Imaging biomarker ,Prostate cancer ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Abstract Background Sodium fluoride (NaF) positron emission tomography combined with computer tomography (PET/CT) has shown to be more sensitive than the whole-body bone scan in the detection of skeletal uptake due to metastases in prostate cancer. We aimed to calculate a 3D index for NaF PET/CT and investigate its correlation to the bone scan index (BSI) and overall survival (OS) in a group of patients with prostate cancer. Methods NaF PET/CT and bone scans were studied in 48 patients with prostate cancer. Automated segmentation of the thoracic and lumbar spines, sacrum, pelvis, ribs, scapulae, clavicles, and sternum were made in the CT images. Hotspots in the PET images were selected using both a manual and an automated method. The volume of each hotspot localized in the skeleton in the corresponding CT image was calculated. Two PET/CT indices, based on manual (manual PET index) and automatic segmenting using a threshold of SUV 15 (automated PET15 index), were calculated by dividing the sum of all hotspot volumes with the volume of all segmented bones. BSI values were obtained using a software for automated calculations. Results BSI, manual PET index, and automated PET15 index were all significantly associated with OS and concordance indices were 0.68, 0.69, and 0.70, respectively. The median BSI was 0.39 and patients with a BSI >0.39 had a significantly shorter median survival time than patients with a BSI 0.53 had a significantly shorter median survival time than patients with a manual PET index 0.11 had a significantly shorter median survival time than patients with an automated PET15 index
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- 2017
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29. Evaluation of usage of bone scan index in assessment of metastatic prostate cancer
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Safet Hadžimusić, Enis Tinjak, Nusret Salkica, Adel Brčaninović, and Halil Ćorović
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medicine.medical_specialty ,Prostate cancer ,business.industry ,General Earth and Planetary Sciences ,Medicine ,Radiology ,business ,medicine.disease ,Bone scan index ,General Environmental Science - Abstract
Introduction: Prostate cancer has been the leading type of cancer to affect male population, and as such, it is a subject to efforts to furthermore diagnostic tools already in existence as well as development of new ones which will Aid early diagnostic, treatments as well as a follow up procedures and clinical trials. Bone scan index is a useful and objective biomarker used as a valuable tool for determination as to precise bone involvement in advanced cases, as well as a tool to predict the outcome in prostate cancer patients in clinical trials.Methods: This paper is a non-experimental (qualitative) research, that is, a scientific review of the literature.Results: The results we analyzed in this paper were collected from published academic journals.Conclusion: As a new imaging biomarker, bone scan index has potential to predict therapeutic effects and survival of patients with prostate cancer. Using measurable diagnostic image parameters, the bone scan index is important for determining metastatic bone changes in prostate cancer patients.
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- 2021
30. Analysis of Bone Scans in Various Tumor Entities Using a Deep-Learning-Based Artificial Neural Network Algorithm—Evaluation of Diagnostic Performance
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Jan Wuestemann, Sebastian Hupfeld, Dennis Kupitz, Philipp Genseke, Simone Schenke, Maciej Pech, Michael C. Kreissl, and Oliver S. Grosser
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bone scan ,bone scan index ,bone metastases ,deep learning ,radiomics ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The bone scan index (BSI), initially introduced for metastatic prostate cancer, quantifies the osseous tumor load from planar bone scans. Following the basic idea of radiomics, this method incorporates specific deep-learning techniques (artificial neural network) in its development to provide automatic calculation, feature extraction, and diagnostic support. As its performance in tumor entities, not including prostate cancer, remains unclear, our aim was to obtain more data about this aspect. The results of BSI evaluation of bone scans from 951 consecutive patients with different tumors were retrospectively compared to clinical reports (bone metastases, yes/no). Statistical analysis included entity-specific receiver operating characteristics to determine optimized BSI cut-off values. In addition to prostate cancer (cut-off = 0.27%, sensitivity (SN) = 87%, specificity (SP) = 99%), the algorithm used provided comparable results for breast cancer (cut-off 0.18%, SN = 83%, SP = 87%) and colorectal cancer (cut-off = 0.10%, SN = 100%, SP = 90%). Worse performance was observed for lung cancer (cut-off = 0.06%, SN = 63%, SP = 70%) and renal cell carcinoma (cut-off = 0.30%, SN = 75%, SP = 84%). The algorithm did not perform satisfactorily in melanoma (SN = 60%). For most entities, a high negative predictive value (NPV ≥ 87.5%, melanoma 80%) was determined, whereas positive predictive value (PPV) was clinically not applicable. Automatically determined BSI showed good sensitivity and specificity in prostate cancer and various other entities. Particularly, the high NPV encourages applying BSI as a tool for computer-aided diagnostic in various tumor entities.
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- 2020
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31. Investigation into the Optimal Strategy of Radium-223 Therapy for Metastatic Castration-Resistant Prostate Cancer
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Yasuo Oguma, Makoto Hosono, Kaoru Okajima, Eri Inoue, Kiyoshi Nakamatsu, Hiroshi Doi, Tomohiro Matsuura, Masahiro Inada, Takuya Uehara, Yutaro Wada, Aritoshi Ri, Yutaka Yamamoto, Kazuhiro Yoshimura, Hirotsugu Uemura, and Yasumasa Nishimura
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General Medicine ,castration resistant ,prostate cancer ,bone metastasis ,radium-223 ,abiraterone ,enzalutamide ,bone scan index ,bone scintigraphy ,quality of life ,palliation - Abstract
The optimal sequence and combination of radium-223 therapy (Ra-223) for castration-resistant prostate cancer with bone metastasis (mCRPC) remain unclear. This study aimed to explore the prognostic factors after Ra-223 administration and to determine the optimal treatment strategy. We enrolled 64 patients with mCRPC who underwent Ra-223 therapy from June 2016 to July 2022 at a single institution in Japan. Overall survival (OS) and pain progression-free survival (p-PFS), which was proposed as a measure of quality of life (QOL), were analyzed using Cox proportional hazards models and log-rank tests, and between-factor analysis was performed with the Mann–Whitney U (MWU) test. Univariable and multivariable analyses revealed prognostic factors; specifically, early treatment (≤third line), completion of six treatment cycles, low bone scan index (BSI) (
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- 2022
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32. Prognostic value of an automated bone scan index for men with metastatic castration-resistant prostate cancer treated with cabazitaxel.
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Uemura, Koichi, Miyoshi, Yasuhide, Kawahara, Takashi, Ryosuke, Jikuya, Yamashita, Daisuke, Yoneyama, Shuko, Yokomizo, Yumiko, Kobayashi, Kazuki, Kishida, Takeshi, Yao, Masahiro, and Uemura, Hiroji
- Subjects
- *
CASTRATION-resistant prostate cancer , *CABAZITAXEL , *CANCER prognosis , *BONES , *COMPUTER-assisted image analysis (Medicine) , *CANCER treatment , *THERAPEUTICS , *ANTINEOPLASTIC agents , *DIAGNOSTIC imaging , *HYDROCARBONS , *PROGNOSIS , *PROSTATE tumors , *BONE density , *PROPORTIONAL hazards models , *KAPLAN-Meier estimator - Abstract
Background: A computer-assisted diagnostic system for analyzing bone scans (BONENAVI) calculates the automated bone scan index (aBSI). Here we evaluated the aBSI as a prognostic imaging biomarker for men with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel.Methods: We retrospectively analyzed 48 patients who received cabazitaxel for mCRPC and evaluated the ability of the aBSI to predict overall survival (OS). The Cox proportional hazards model was used to investigate the associations between baseline aBSI at cabazitaxel treatment and OS with the clinical variables as follows: age, number of cycles of docetaxel, serum prostate-specific antigen, hemoglobin (Hb), lactate dehydrogenase (LDH), and alkaline phosphatase. We determined the C-index to evaluate the discriminatory ability of our models when we included or excluded the aBSI from the analyses.Results: The median OS after cabazitaxel treatment was 10.0 months, and patients with aBSI ≤1% achieved significantly longer OS compared with patients with aBSI ≥1%. Multivariate analysis showed that age, Hb, LDH, and aBSI were independent prognostic factors of OS. Adding aBSI to the base model increased the C-index from 0.78 to 0.80.Conclusions: The aBSI may serve as a useful imaging biomarker for predicting OS among men with mCRPC treated with cabazitaxel. Prospective studies are required to establish the value of aBSI as prognostic imaging biomarker. [ABSTRACT FROM AUTHOR]- Published
- 2018
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33. Relationship between tumor volume and quantitative values calculated using two-dimensional bone scan images.
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Hosokawa, Shota, Inoue, Kazumasa, Takahashi, Yasuyuki, Kawakami, Kazunori, Kano, Daisuke, Nakagami, Yoshihiro, and Fukushi, Masahiro
- Abstract
The bone scan index (BSI) is calculated from a whole-body bone scan image; it shows the tumor burden in bone as a percentage of total skeletal mass. It has been used to determine the prognosis and to assess treatment effects; however, little has been reported on whether the BSI calculated using a two-dimensional image can accurately evaluate the three-dimensional spread in tumor volume. We investigated the relationship between tumor volume and BSI using Monte Carlo simulation (MCS). We simulated a gamma camera and constructed a voxel phantom based on an anthropomorphic phantom computed tomography (CT) image and gamma rays emitted from each part according to technetium-99m-labeled methylene diphosphonate (Tc-MDP) uptake (bone 1, soft tissue 0.2, tumor 2-32). We constructed bone scan images from the obtained counts and analyzed them using the BSI calculation software. The BSI increased with increased tumor uptake (two- to 32-fold). However, there was not always a significant difference between change in BSI and tumor uptake of eight times or greater than that of bone. When BSI was calculated with a tumor having an uptake of four-to-eight times higher than that of bone, the BSI was consistent with tumor volume, but decreased to about half the tumor volume when tumors were in the thoracic spine (Th-spine) segment. The BSI can be a good indicator of tumor volume in most segments, even though it is affected by the tumor's Tc-MDP uptake. Nevertheless, values calculated from the Th-spine should be interpreted carefully. [ABSTRACT FROM AUTHOR]
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- 2017
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34. Automated Bone Scan Index as Predictors of Survival in Prostate Cancer.
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Wiyanto, Joko, Shintawati, Rini, Darmawan, Budi, Hidayat, Basuki, and Kartamihardja, Achmad Hussein Sundawa
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PROSTATE cancer patients , *EARLY detection of cancer , *BONE tumors - Abstract
Prostate cancer (PCa) is the second most diagnosed cancer in men. Early diagnosis and right management of PCa is critical to reducing deaths; the life expectancy is the main factors to be considered in the management of PCa. Among patients who die from PCa, the incidence of skeletal involvement appears to be >85%. Bone scan (BS) is the most common method for monitoring bone metastases in patients with PCa. The extent of bone metastasis was also associated with patient survival until now there is no clinically useful technique for measuring bone tumors and includes this information in the risk assessment. An alternative approach is to calculate a BS index (BSI) and it has shown clinical significance as a prognostic imaging biomarker. Some computer-assisted diagnosis (CAD) systems have been developed to measure BSI and are now available. The aim of this study was to investigate automated BSI (aBSI) measurements as predictors' survival in PCa. Retrospectively cohort studied fifty patients with PCa who had undergone BS between January 2010 and December 2011 at our institution. All data collected was updated up to August 2016. CAD system analyzing BS images to automatically compute BSI measurements. Patients were stratified into three BSI categories BSI value 0, BSI value =1 and BSI value >1. Kaplan-Meier estimates of the survival function and the log-rank test were used to indicate a significant difference between groups stratified in accordance with the BSI values. A total of 35 subjects deaths were registered, with a median survival time 36 months after the follow-up BS of 5 years. Subjects with low aBSI value had longer overall survival in comparison with the other subjects (P = 0.004). aBSI measurements were shown to be a strong prognostic survival indicator in PCa; survival is poor in high-BSI value. [ABSTRACT FROM AUTHOR]
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- 2017
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35. Study of the Usefulness of Bone Scan Index Calculated From 99m-Technetium-Hydroxymethylene Diphosphonate (99mTc-HMDP) Bone Scintigraphy for Bone Metastases from Prostate Cancer Using Deep Learning Algorithms
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Shigeaki Higashiyama, Atsushi Yoshida, and Joji Kawabe
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^{99m}Technetium-hydroxymethylene diphosphonate ,convolutional neural network ,chemistry.chemical_element ,Bone imaging ,BSI ,Technetium ,030218 nuclear medicine & medical imaging ,PSA ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,bone metastases ,parasitic diseases ,medicine ,prostate-specific antigen ,Radiology, Nuclear Medicine and imaging ,前立腺癌 ,骨転移 ,medicine.diagnostic_test ,business.industry ,Therapeutic effect ,Bone metastasis ,bacterial infections and mycoses ,prostate cancer ,medicine.disease ,Bone scan index ,body regions ,Bone scintigraphy ,chemistry ,030220 oncology & carcinogenesis ,Alkaline phosphatase ,business ,human activities ,Algorithm - Abstract
Background: BSI calculated from bone scintigraphy using 99mtechnetium-methylene diphosphonate (99mTc-MDP) is used as a quantitative indicator of metastatic bone involvement in bone metastasis diagnosis, therapeutic effect assessment, and prognosis prediction. However, the BONE NAVI, which calculates BSI, only supports bone scintigraphy using 99mTc-MDP. Aims: We developed a method in collaboration with the Tokyo University of Agriculture and Technology to calculate bone scan index (BSI) employing deep learning algorithms with bone scintigraphy images using 99mtechnetium-hydroxymethylene diphosphonate (99mTc-HMDP). We used a convolutional neural network (CNN), enabling the simultaneous processing of anterior and posterior bone scintigraphy images named CNNapis. Objectives: The purpose of this study is to investigate the usefulness of the BSI calculated by CNNapis as bone imaging and bone metabolic biomarkers in patients with bone metastases from prostate cancer. Methods: At our hospital, 121 bone scintigraphy scans using 99mTc-HMDP were performed and analyzed to examine bone metastases from prostate cancer, revealing the abnormal accumulation of radioisotope (RI) at bone metastasis sites. Blood tests for serum prostate-specific antigen (PSA) and alkaline phosphatase (ALP) were performed concurrently. BSI values calculated by CNNapis were used to quantify the metastatic bone tumor involvement. Correlations between BSI and PSA and between BSI and ALP were calculated. Subjects were divided into four groups by BSI values (Group 1, 0 to 10), and the PSA and ALP values in each group were statistically compared. Results: Patients diagnosed with bone metastases after bone scintigraphy were also diagnosed with bone metastases using CNNapis. BSI corresponding to the range of abnormal RI accumulation was calculated. PSA and BSI (r = 0.2791) and ALP and BSI (r = 0.6814) correlated positively. Significant intergroup differences in PSA between Groups 1 and 2, Groups 1 and 4, Groups 2 and 3, and Groups 3 and 4 and in ALP between Groups 1 and 4, Groups 2 and 4, and Groups 3 and 4 were found. Conclusion: BSI calculated using CNNapis correlated with ALP and PSA values and is useful as bone imaging and bone metabolic biomarkers, indicative of the activity and spread of bone metastases from prostate cancer.
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- 2021
36. Assessment of Bone Metastases in Patients with Prostate Cancer--A Comparison between 99mTc-Bone-Scintigraphy and [68Ga]Ga-PSMA PET/CT.
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Thomas, Lena, Balmus, Caroline, Ahmadzadehfar, Hojjat, Essler, Markus, Strunk, Holger, and Bundschuh, Ralph A.
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BONE metastasis , *PROSTATE cancer patients , *POSITRON emission tomography , *PROSTATE-specific antigen , *BLAND-Altman plot , *ALKALINE phosphatase , *DIAGNOSIS - Abstract
Purpose: Bone scintigraphy is the standard of reference in bone metastases in prostate cancer patients. However, new radiotracers employed in prostate-specific membrane antigen (PSMA)-ligands has led to the growing importance of PET/CT as diagnostic tool. The aim of our study was to investigate the difference between bone scan and PSMA-PET/CT for the detection of bone metastases in prostate cancer. Methods: Thirty patients with bone metastases originating from prostate cancer were examined by 99mTc-MDP bone scan and 68Ga-PSMA-PET/CT within an average of 21 days. Bone scans were analyzed visually according to the number of lesions and using the software package ExiniBONE by Exini Diagnostics. PET/CT data was analyzed visually. Numbers of detected lesions were compared for the different methods for the whole patient and for different regions. In addition, results were compared to serum prostate-specific antigen (PSA), alkaline phosphatase (ALP), bone alkaline phosphatase (bALP), pro gastrin releasing peptide (pGRP) and eastern cooperative oncology group (ECOG) performance status. Results: In the bone scans, visual and semiautomatic lesion detection showed similar results with an average of 19.4 and 17.8 detected bone lesion per patient. However, in PSMA-PET/CT, on average double the numbers of lesions (40.0) were detected. The largest differences were found in the thorax and pelvis, which can be explained by the advantages of tomographic imaging. Bland-Altman analysis showed greater differences in patients with large numbers of bone metastases. Conclusion: No significant difference was found when using semiautomatic analysis compared to visual reading for bone scans. Fewer bone metastases were detected in bone scans than in PSMA-PET/CT. However, in none of our patients would the difference have led to clinical consequences. Therefore, it seems that for patients undergoing PSMA-PET/CT, there is no need to perform additional bone scans if the appropriate PET/CT protocols are applied. [ABSTRACT FROM AUTHOR]
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- 2017
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37. Prospective evaluation of computer-assisted analysis of skeletal lesions for the staging of prostate cancer.
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Petersen, Lars J., Mortensen, Jesper C., Bertelsen, Henrik, and Zacho, Helle D.
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DIAGNOSIS ,PROSTATE cancer ,BONE metastasis ,PROSTATE-specific antigen ,DIAGNOSTIC imaging ,RADIONUCLIDE imaging - Abstract
Background: The purpose of this study was to compare the agreement of the bone scan index (BSI) using EXINI BoneBSI versus experts' readings in the initial staging for bone metastasis in prostate cancer. In addition, the diagnostic outcome was assessed in a large subset of patients where a true reference for metastases could be determined based on clinical and biochemical follow-up and/or supplementary imaging. Methods: A total of 342 patients had a bone scintigraphy as part of routine staging for prostate cancer. Supplementary imaging was obtained at the discretion of the referring urologist. After full recruitment, the BSI and the number of malignant lesions were calculated using EXINI Bone
BSI , and three imaging experts independently classified bone status by a dichotomous outcome (M1 for bone metastasis, M0 for no bone metastasis). A true reference was available in a subset of the patients based on post-operative prostate-specific antigen responses after radical prostatectomy and/or supplementary imaging. Results: Software analysis with a BSI > 0 as the cut-off for metastasis showed excellent agreement with expert classification for M1 disease (96% of the patients) but modest agreement for M0 disease (38%). With a BSI > 1, the agreement was 58% for M1 and 98% for M0. Software analyses based on individual European Association of Urology risk classification did not improve the diagnostic performance. Among patients with a true reference, the software showed metastasis in 64% of the M0 patients but correctly classified metastases in all M1 patients. The sensitivity was 100%, the specificity was 36%, the positive predictive value was 12.6% and the negative predictive value was 100% with a BSI >0 compared with 66.7%, 97.8%, 72.7%, and 97.0% with a BSI > 1. Conclusion: The diagnostic value of using EXINI Bone for the BSI in the staging of newly diagnosed prostate cancer is limited. [ABSTRACT FROM AUTHOR]- Published
- 2017
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38. Association between bone scan index and activities of daily living in patients with advanced non-small cell lung cancer.
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Ito, Ikuno, Ito, Kimiteru, Takahashi, Shinichi, Horibe, Mitsuko, Karita, Rui, Nishizaka, Chika, Nagai, Takako, Hamada, Kohei, Sato, Hiroyuki, and Shindo, Naoko
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LUNG cancer patients , *RETROSPECTIVE studies , *DIAGNOSTIC use of tumor markers , *BARTHEL Index , *RADIONUCLIDE imaging , *LUNG cancer treatment , *TREATMENT of lung tumors , *ACTIVITIES of daily living , *BONES , *BONE tumors , *LUNG cancer , *LUNG tumors , *CROSS-sectional method , *PSYCHOLOGY - Abstract
Purpose: The aim of this retrospective cross-sectional study was to investigate the association between the bone scan index (BSI) and activities of daily living (ADL) in patients with advanced non-small cell lung cancer (NSCLC).Methods: Among patients with advanced NSCLC, subjects who underwent bone scintigraphy were recruited from this study. Clinical information about patients, including the Barthel Index of ADL, was extracted from their medical charts. Variables including the age, sex, BSI, presence/absence skeletal-related events (SREs), diagnostic state (initial vs. relapse), and history of use of certain medications (e.g. opiates) were evaluated as factors possibly associated with the Barthel Index. In Addition, associations between these factors, including the Barthel Index, with the overall survival were also assessed.Results: A total of 111 patients with bone metastases were selected. The BSI and Barthel Index of the patients were 1.59 ± 2.25 and 69.7 ± 19.6, respectively. Multivariable analysis identified age (≥70 years), a high BSI (≥1.0), and presence of SREs were as factors statistically significantly associated with lower values of the Barthel Index (<75). On the other hand, Cox proportional hazards analysis identified low values of the Barthel Index (<75), use of opiates, and male sex as significant factors associated with a shorter overall survival; the BSI was not associated with the overall survival in the patients with advanced NSCLC in this study.Conclusion: The results suggest that a high BSI (≥1.0) is an independent predictor of poor ADL in patients with NSCLC, while showing no correlation with the overall survival. [ABSTRACT FROM AUTHOR]- Published
- 2017
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39. 3D skeletal uptake of F sodium fluoride in PET/CT images is associated with overall survival in patients with prostate cancer.
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Lindgren Belal, Sarah, Sadik, May, Kaboteh, Reza, Hasani, Nezar, Enqvist, Olof, Svärm, Linus, Kahl, Fredrik, Simonsen, Jane, Poulsen, Mads, Ohlsson, Mattias, Høilund-Carlsen, Poul, Edenbrandt, Lars, and Trägårdh, Elin
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DIAGNOSIS , *PROSTATE cancer , *THREE-dimensional imaging , *POSITRON emission tomography , *SODIUM fluoride , *PROSTATE cancer patients - Abstract
Background: Sodium fluoride (NaF) positron emission tomography combined with computer tomography (PET/CT) has shown to be more sensitive than the whole-body bone scan in the detection of skeletal uptake due to metastases in prostate cancer. We aimed to calculate a 3D index for NaF PET/CT and investigate its correlation to the bone scan index (BSI) and overall survival (OS) in a group of patients with prostate cancer. Methods: NaF PET/CT and bone scans were studied in 48 patients with prostate cancer. Automated segmentation of the thoracic and lumbar spines, sacrum, pelvis, ribs, scapulae, clavicles, and sternum were made in the CT images. Hotspots in the PET images were selected using both a manual and an automated method. The volume of each hotspot localized in the skeleton in the corresponding CT image was calculated. Two PET/CT indices, based on manual (manual PET index) and automatic segmenting using a threshold of SUV 15 (automated PET index), were calculated by dividing the sum of all hotspot volumes with the volume of all segmented bones. BSI values were obtained using a software for automated calculations. Results: BSI, manual PET index, and automated PET index were all significantly associated with OS and concordance indices were 0.68, 0.69, and 0.70, respectively. The median BSI was 0.39 and patients with a BSI >0.39 had a significantly shorter median survival time than patients with a BSI <0.39 (2.3 years vs not reached after 5 years of follow-up [ p = 0.01]). The median manual PET index was 0.53 and patients with a manual PET index >0.53 had a significantly shorter median survival time than patients with a manual PET index <0.53 (2.5 years vs not reached after 5 years of follow-up [ p < 0.001]). The median automated PET index was 0.11 and patients with an automated PET index >0.11 had a significantly shorter median survival time than patients with an automated PET index <0.11 (2.3 years vs not reached after 5 years of follow-up [ p < 0.001]). Conclusions: PET/CT indices based on NaF PET/CT are correlated to BSI and significantly associated with overall survival in patients with prostate cancer. [ABSTRACT FROM AUTHOR]
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- 2017
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40. Prognostic value of automated bone scan index for predicting overall survival among bone metastatic castration resistant prostate cancer patients treated with radium‐223
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Narihiko Hayashi, Shuko Yoneyama, Sohgo Tsutsumi, Hiroji Uemura, Yasuhide Miyoshi, Masahiro Yao, Yumiko Yokomizo, Koichi Uemura, Takashi Kawahara, and Masato Yasui
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Radium-223 ,medicine.medical_specialty ,business.industry ,Urology ,General Medicine ,Castration resistant ,medicine.disease ,Bone scan index ,Prostate cancer ,medicine ,Overall survival ,business ,Value (mathematics) ,medicine.drug - Abstract
The objective of this study was to evaluate automated bone scan index (aBSI) as a prognostic biomarker for overall survival (OS) in bone-metastatic, castration-resistant prostate cancer (mCRPC) patients treated with radium-223 (Ra-223).We identified 42 men treated with Ra-223 for mCRPC. We investigated aBSI as an independent prognostic factor by multivariate analysis. Moreover, we evaluated the prognostic value of the aBSI after 12 weeks after the first cycle of Ra-223 administration and aBSI change from baseline to after 12 weeks (ΔBSI).Median baseline PSA and aBSI were 42.8 ng/mL and 1.5%, respectively. Median OS was 20.7 months. Multivariate analysis showed that baseline aBSI was a significant prognostic factor for OS. The aBSI at 12 weeks after first Ra-223 administration also exhibited significant prognostic value for OS, while we found no evidence of prognostic value for ΔBSI.Baseline aBSI may be a significant prognostic factor for OS in bone-metastatic CRPC patients treated with Ra-223.
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- 2020
41. Prognostic value of the bone scan index in patients with metastatic castration-resistant prostate cancer: a systematic review and meta-analysis
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Peng Xiang, Hualin Song, Shuai Hu, Jie Jin, and Song Jin
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Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,030232 urology & nephrology ,Bone Neoplasms ,Subgroup analysis ,Castration resistant ,BSI ,lcsh:RC254-282 ,White People ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Asian People ,Surgical oncology ,Internal medicine ,Genetics ,medicine ,Humans ,In patient ,business.industry ,Hazard ratio ,mCRPC ,Prognosis ,medicine.disease ,bacterial infections and mycoses ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Survival Analysis ,Bone scan index ,Metastatic castration-resistant prostate cancer ,Radiography ,Prostatic Neoplasms, Castration-Resistant ,Meta-analysis ,030220 oncology & carcinogenesis ,Disease Progression ,business ,human activities ,Research Article - Abstract
Background Many studies have reported the prognostic significance of the bone scan index (BSI) for metastatic castration-resistant prostate cancer (mCRPC); however, these reports are controversial. This study investigated the BSI in mCRPC and its relationship with prognosis. Methods The PubMed, Cochrane, and Embase databases were searched systematically for relevant articles published before September 1, 2019. Hazard ratios (HRs) were used to investigate the prognostic value. Results This study finally identified 9 eligible studies. The results suggested that high baseline BSI predicted poor OS (HR = 1.331, 95% CI: 1.081–1.640) and that elevated ΔBSI also predicted poor OS (HR = 1.220, 95% CI: 1.015–1.467). The subgroup analysis stratified by ethnicity showed that the baseline BSI and ΔBSI predicted poor OS in the Asian population but not in the Caucasian population. We also performed a subgroup analysis based on the different cut-off values of baseline BSI. The subgroup of ≤1 showed a significant association with OS in mCRPC patients. Conclusion Our study demonstrated that high baseline BSI and elevated ΔBSI predicted poor OS in patients with mCRPC. Hence, the BSI can serve as a prognostic indicator for mCRPC patients and may therefore guide clinical treatment in the future.
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- 2020
42. Automated measurement of bone scan index from a whole-body bone scintigram
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Kazuhiro Nishikawa, Hayato Wakabayashi, Takumi Kanamori, Atsushi Saito, Akinobu Shimizu, Joji Kawabe, Hiromitsu Daisaki, and Shigeaki Higashiyama
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Metastatic lesions ,Computer science ,Biomedical Engineering ,Health Informatics ,Residual ,030218 nuclear medicine & medical imaging ,Metastatic lesion ,03 medical and health sciences ,0302 clinical medicine ,Radiology, Nuclear Medicine and imaging ,Segmentation ,Bone scintigram ,Deep learning ,General Medicine ,Computer Graphics and Computer-Aided Design ,Skeleton (computer programming) ,Bone scan index ,Computer Science Applications ,030220 oncology & carcinogenesis ,Residual Blocks ,Bone metastatic lesion ,Surgery ,Original Article ,Computer Vision and Pattern Recognition ,Computer-aided interpretation ,Whole body ,Biomedical engineering - Abstract
Purpose We propose a deep learning-based image interpretation system for skeleton segmentation and extraction of hot spots of bone metastatic lesion from a whole-body bone scintigram followed by automated measurement of a bone scan index (BSI), which will be clinically useful. Methods The proposed system employs butterfly-type networks (BtrflyNets) for skeleton segmentation and extraction of hot spots of bone metastatic lesions, in which a pair of anterior and posterior images are processed simultaneously. BSI is then measured using the segmented bones and extracted hot spots. To further improve the networks, deep supervision (DSV) and residual learning technologies were introduced. Results We evaluated the performance of the proposed system using 246 bone scintigrams of prostate cancer in terms of accuracy of skeleton segmentation, hot spot extraction, and BSI measurement, as well as computational cost. In a threefold cross-validation experiment, the best performance was achieved by BtrflyNet with DSV for skeleton segmentation and BtrflyNet with residual blocks. The cross-correlation between the measured and true BSI was 0.9337, and the computational time for a case was 112.0 s. Conclusion We proposed a deep learning-based BSI measurement system for a whole-body bone scintigram and proved its effectiveness by threefold cross-validation study using 246 whole-body bone scintigrams. The automatically measured BSI and computational time for a case are deemed clinically acceptable and reliable.
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- 2019
43. Scintigraphic Load of Bone Disease Evaluated by DASciS Software as a Survival Predictor in Metastatic Castration-resistant Prostate Cancer Patients Candidates to 223RaCl Treatment
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Mirco Colosi, Viviana Frantellizzi, Irvin Aloise, Alessio Farcomeni, C. Polito, Maria Dea Ippoliti, Arianna Pani, Roberto Pani, and Giuseppe De Vincentis
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Oncology ,Male ,medicine.medical_specialty ,Bone disease ,DASciS software ,overall survival ,R895-920 ,Bone Neoplasms ,Disease ,Castration resistant ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,Medical physics. Medical radiology. Nuclear medicine ,0302 clinical medicine ,Internal medicine ,medicine ,Overall survival ,Image Processing, Computer-Assisted ,Humans ,Radiology, Nuclear Medicine and imaging ,radium223 dichloride ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,bone disease ,bone scan index ,mCRPC ,Bone metastasis ,Single parameter ,Middle Aged ,medicine.disease ,Survival Analysis ,Bone scan index ,Prostatic Neoplasms, Castration-Resistant ,030220 oncology & carcinogenesis ,business ,Settore SECS-S/01 ,Software ,Research Article ,Radium - Abstract
Background Aim of our study was to assess the load of bone disease at starting and during Ra-223 treatment as an overall survival (OS) predictor in metastatic castration-resistant prostate cancer (mCRPC) patients. Bone scan index (BSI) is defined as the percentage of total amount of bone metastasis on whole-body scintigraphic images. We present a specific software (DASciS) developed by an engineering team of “Sapienza” University of Rome for BSI calculation. Patients and methods 127 mCRPC patients bone scan images were processed with DASciS software, and BSI was tested as OS predictor. Results 546 bone scans were analyzed revealing that the extension of disease is a predictor of OS (0–3% = 28 months of median survival (MoMS]; 3%–5% = 11 MoMS, > 5% = 5 MoMS). BSI has been analyzed as a single parameter for OS, determining an 88% AUC. Moreover, the composition between the BSI and the 3-PS (3-variable prognostic score) determines a remarkable improvement of the AUC (91%), defining these two parameters as the best OS predictors. Conclusions This study suggests that OS is inversely correlated with the load of bone disease in mCRPC Ra-223-treated subjects. DASciS software appears a promising tool in identifying mCRPC patients that more likely take advantage from Ra-223 treatment. BSI is proposed as a predictive variable for OS and included to a multidimensional clinical evaluation permits to approach the patients’ enrollment in a rational way, allowing to enhance the treatment effectiveness together with cost optimization.
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- 2019
44. Quantitative bone scan imaging using BSI and BUV: an approach to evaluate ARONJ early
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Sachiyo Mitsunaga, Ayumi Horikawa, Hiroaki Kurihara, Yayoi Yamamoto, and Ayako Hino
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Male ,Early detection ,Bone Neoplasms ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Spect imaging ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Radionuclide Imaging ,Aged ,Retrospective Studies ,Bone Density Conservation Agents ,medicine.diagnostic_test ,business.industry ,Osteonecrosis ,Bone metastasis ,General Medicine ,medicine.disease ,Cad system ,Bone scan index ,Jaw ,Bone scintigraphy ,030220 oncology & carcinogenesis ,Female ,Osteonecrosis of the jaw ,business ,Nuclear medicine ,Semi quantitative ,Jaw Diseases - Abstract
The usefulness of bone scan index (BSI), a quantitative metric of the area of uptake in computer-aided diagnosis in bone scintigraphy, has been reported for the diagnosis of anti-resorptive-agent-related osteonecrosis of the jaw (ARONJ). The aim of this study is to validate the diagnostic ability of BSI for the early detection of ARONJ. In addition, the Bone uptake value (BUV), another quantitative index obtained from bone scintigraphy that indicates the degree of radioisotope (RI) accumulation, was used to improve the diagnostic ability for early detection of ARONJ. A total of 34 patients (11 with ARONJ, 23 without ARONJ) who were administered anti-resorptive-agents for bone metastasis and had incidentally consulted a dental surgeon within 3 months after regular whole-body bone scintigraphy were retrospectively included in the study. The bone scintigraphy data were subjected to semiquantitative analysis of uptake in the jaw using BONENAVI (FUJIFILM Toyama Chemical, Co. Ltd., Tokyo, Japan; EXINI Diagnostics AB, Lund, Sweden) and BUV software (Technical Society for Quantitative Bone Scintigraphy and Fujifilm Toyama Chemical Co., Ltd. Tokyo, Japan). The ROI was set semi-automatically on mandibular hotspots, and the regional BSI was termed BSIJ. Planar anterior and posterior images were then sent to BUV software, with the ROI set manually as for BSI, and the regional BUV was termed BUVJ. Mean BSIJ values for the ARONJ positive and ARONJ negative groups were 0.17 ± 0.83 and 0.03 ± 0.50%, respectively. Mean BUVJ values for the ARONJ positive and ARONJ negative groups were 0.47 ± 0.17 and 0.19 ± 0.11, respectively. BSIJ × BUVJ values for the ARONJ positive versus ARONJ negative groups were 0.088 ± 0.067 vs. 0.007 ± 0.010. The AUC for BSIJ, BUVJ and BSIJ × BUVJ was 0.949, 0.951 and 0.988, respectively. The BSI metric of a CAD system for bone scintigraphy was useful for the early detection of ARONJ. Accuracy was improved with the additional use of BUVJ data. We recommend that SPECT imaging be performed when bone scintigraphy reveals focal or diffuse uptake in the mandible with high BSIJ and BUVJ.
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- 2019
45. Assessing Radiographic Response to 223Ra with an Automated Bone Scan Index in Metastatic Castration-Resistant Prostate Cancer Patients
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Lars Edenbrandt, Camilla Thellenberg, Aseem Anand, Jon Kindblom, Jan Henry Svensson, Anders Widmark, Anders Ullén, Anders Bjartell, Elin Trägårdh, and Lars Beckman
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medicine.medical_specialty ,Imaging biomarker ,business.industry ,Radiography ,Urology ,Retrospective cohort study ,medicine.disease ,Bone scan index ,030218 nuclear medicine & medical imaging ,Discontinuation ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Interquartile range ,030220 oncology & carcinogenesis ,medicine ,Biomarker (medicine) ,Radiology, Nuclear Medicine and imaging ,business - Abstract
For effective clinical management of patients being treated with 223Ra, there is a need for radiographic response biomarkers to minimize disease progression and to stratify patients for subsequent treatment options. The objective of this study was to evaluate an automated bone scan index (aBSI) as a quantitative assessment of bone scans for radiographic response in patients with metastatic castration-resistant prostate cancer (mCRPC). Methods: In a multicenter retrospective study, bone scans from patients with mCRPC treated with monthly injections of 223Ra were collected from 7 hospitals in Sweden. Patients with available bone scans before treatment with 223Ra and at treatment discontinuation were eligible for the study. The aBSI was generated at baseline and at treatment discontinuation. The Spearman rank correlation was used to correlate aBSI with the baseline covariates: alkaline phosphatase (ALP) and prostate-specific antigen (PSA). The Cox proportional-hazards model and Kaplan-Meier curve were used to evaluate the association of covariates at baseline and their change at treatment discontinuation with overall survival (OS). The concordance index (C-index) was used to evaluate the discriminating strength of covariates in predicting OS. Results: Bone scan images at baseline were available from 156 patients, and 67 patients had both a baseline and a treatment discontinuation bone scan (median, 5 doses; interquartile range, 3-6 doses). Baseline aBSI (median, 4.5; interquartile range, 2.4-6.5) was moderately correlated with ALP (r = 0.60, P < 0.0001) and with PSA (r = 0.38, P = 0.003). Among baseline covariates, aBSI (P = 0.01) and ALP (P = 0.001) were significantly associated with OS, whereas PSA values were not (P = 0.059). After treatment discontinuation, 36% (24/67), 80% (54/67), and 13% (9/67) of patients demonstrated a decline in aBSI, ALP, and PSA, respectively. As a continuous variable, the relative change in aBSI after treatment, compared with baseline, was significantly associated with OS (P < 0.0001), with a C-index of 0.67. Median OS in patients with both aBSI and ALP decline (median, 134 wk) was significantly longer than in patients with ALP decline only (median, 77 wk; P = 0.029). Conclusion: Both aBSI at baseline and its change at treatment discontinuation were significant parameters associated with OS. The study warrants prospective validation of aBSI as a quantitative imaging response biomarker to predict OS in patients with mCRPC treated with 223Ra.
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- 2019
46. Evaluation of Bone Scan Index as a Prognostic Tool in Breast Cancer Patients with Bone Metastasis.
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De Feo MS, Frantellizzi V, Di Rocco A, Farcomeni A, Matto A, Marongiu A, Nuvoli S, Spanu A, and De Vincentis G
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- Male, Humans, Prognosis, Retrospective Studies, Radiopharmaceuticals, Breast Neoplasms diagnostic imaging, Bone Neoplasms diagnostic imaging
- Abstract
Background: Bone metastatic involvement represents a leading cause of death in patients with advanced breast cancer (BC). At present, it is not clear whether the bone metastatic load might impact Overall Survival (OS) in patients with bone metastatic BC at diagnosis. For this purpose, we used the Bone Scan Index (BSI), which is a reproducible and quantitative expression of tumor load observed at bone scintigraphy., Objective: The aim of this study was to associate BSI with OS in bone metastatic BC patients., Methods: In this retrospective study, we enrolled BC patients with bone metastases at the scintigraphic bone scan performed for staging purposes. The BSI was calculated through the DASciS software, and statistical analysis was carried out. Other clinical variables relevant to OS analysis were taken into account., Results: Of a total of 94 patients, 32% died. In most cases, the histotype was ductal infiltrating carcinoma. The median OS from diagnosis was 72 months (CI 95%: 62-NA). The univariate analysis with COX regression showed that only hormone therapy significantly correlates with OS (HR 0.417, CI 95%: 0.174-0.997, p < 0.049). As concerning BSI, the statistical analysis showed that it does not predict OS in BC patients (HR 0.960, 95% CI: 0.416-2.216, p < 0.924)., Conclusion: Although the BSI significantly predicts OS in prostate cancer and in other tumors, we observed that the metastatic load of bone disease has not a key role in prognostic stratification in our population., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2023
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47. Bone Scan Index predicts skeletal-related events in patients with metastatic breast cancer.
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Idota, Ai, Sawaki, Masataka, Yoshimura, Akiyo, Hattori, Masaya, Inaba, Yoshitaka, Oze, Isao, Kikumori, Toyone, Kodera, Yasuhiro, and Iwata, Hiroji
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BREAST cancer patients , *BONE metastasis , *PROPORTIONAL hazards models , *QUALITY of life , *DISEASE incidence - Abstract
Background: Bone Scan Index (BSI) expresses tumor burden in bone as a percentage of total skeletal mass, but its significance for metastatic breast cancer patients is unknown. We investigated whether baseline BSI is associated with skeletal-related events (SREs) or survival and identified the cut-off BSI score for predicting SREs in metastatic breast cancer patients. Methods: We retrospectively reviewed 144 patients with bone metastatic breast cancer. Bone scan examinations were performed and BSI was calculated using the Bonenavi automated method. All patients received standard medical treatment for metastatic breast cancer. For bone metastasis prophylaxis, bisphosphonates were infused initially with analgesics as needed. We defined SRE as either bony, requiring intervention (surgery and/or radiotherapy) for pain or prevention of fracture, or spinal cord compression. The rates of SRE and overall survival (OS) were evaluated according to baseline BSI, and the cut-off score of BSI for predicting SRE in metastatic breast cancer patients was identified. Results: Thirty-three patients (25.6 %) had SREs. The median BSI was 1.08 % (inter-quartile range 0.50-3.23 %). To identify the cut-off BSI score for predicting SRE, we performed sensitivity analysis to check P-value at every 0.1 BSI interval (0.4-2.4) by multiple-variable proportional hazard analysis. A BSI cut-off point of 1.4 % showed the lowest P value. Patients with BSI scores ≥1.4 had a significantly higher rate of SRE than those with lower BSI ( P = 0.022). However there was no significant difference in OS. Conclusion: BSI may predict SRE in patients with metastatic breast cancer. A high BSI value (≥1.4) at diagnosis of bone metastasis may be a predictor of SREs in bone metastatic breast cancer patients. [ABSTRACT FROM AUTHOR]
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- 2016
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48. Bone Scan Index predicts outcome in patients with metastatic hormone-sensitive prostate cancer.
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Poulsen, Mads H., Rasmussen, Janne, Edenbrandt, Lars, Høilund‐Carlsen, Poul F., Gerke, Oke, Johansen, Allan, and Lund, Lars
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- *
PROSTATE cancer treatment , *PROGRESSION-free survival , *BONE metastasis , *PROSTATE cancer prognosis , *PROSTATE-specific antigen - Abstract
Objective To evaluate the Bone Scan Index ( BSI) for prediction of castration resistance and prostate cancer-specific survival ( PCSS). In this retrospective study, we used novel computer-assisted 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 Methods In all, 88 patients with prostate cancer awaiting initiation of androgen-deprivation therapy due to metastases were included. WBS was performed using a two-headed γ-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). Results The 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) from prostate cancer. In multivariate analysis including PSA level, Gleason score and BSI, only prediction by BSI was statistically significant. This was true both for time to CRPC (hazard ratio [ HR] 1.45, 95% confidence interval [ CI] 1.22-1.74; C-index increase from 0.49 to 0.69) and for PCSS ( HR 1.34, 95% CI 1.07-1.67; C-index increase from 0.76 to 0.95). Conclusion BSI 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. [ABSTRACT FROM AUTHOR]
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- 2016
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49. Prognostic value of the bone scan index using a computer-aided diagnosis system for bone scans in hormone-naive prostate cancer patients with bone metastases.
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Yasuhide Miyoshi, Shuko Yoneyama, Takashi Kawahara, Yusuke Hattori, Jun-ichi Teranishi, Keiichi Kondo, Masatoshi Moriyama, Shigeo Takebayashi, Yumiko Yokomizo, Masahiro Yao, Hiroji Uemura, Kazumi Noguchi, Miyoshi, Yasuhide, Yoneyama, Shuko, Kawahara, Takashi, Hattori, Yusuke, Teranishi, Jun-Ichi, Kondo, Keiichi, Moriyama, Masatoshi, and Takebayashi, Shigeo
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PROSTATE cancer patients , *BONE metastasis , *GLEASON grading system , *PROPORTIONAL hazards models , *DOCETAXEL , *DIAGNOSIS , *ANTINEOPLASTIC agents , *HYDROCARBONS , *BONES , *BONE tumors , *PROGNOSIS , *PROSTATE tumors , *SURVIVAL analysis (Biometry) , *PROSTATE-specific antigen , *RETROSPECTIVE studies , *COMPUTER-aided diagnosis , *THERAPEUTICS - Abstract
Background: The bone scan index (BSI) using a computer-aided diagnosis system for bone scans is expected to be an objective and quantitative clinical tool for evaluating bone metastatic prostate cancer. This study aimed to evaluate the pretreatment BSI as a prognostic factor in hormone-naive prostate cancer patients with bone metastases.Methods: The study included 60 patients with hormone-naive, bone metastatic prostate cancer that was initially treated with combined androgen blockade therapy. The BONENAVI system was used for calculating the BSI. We evaluated the correlation between overall survival (OS) and pretreatment clinicopathological characteristics, including patients' age, initial prostate-specific antigen (PSA) value, Gleason scores, clinical TNM stage, and the BSI. Cox proportional hazards regression models were used for statistical analysis.Results: The median follow-up duration was 21.4 months. Clinical or PSA progression occurred in 37 (61.7%) patients and 18 (30.0%) received docetaxel. Death occurred in 16 (26.7%) patients. Of these deaths, 15 (25.0%) were due to prostate cancer. The median OS was not reached. In multivariate analysis, age and the BSI were independent prognostic factors for OS. We evaluated the discriminatory ability of our models, including or excluding BSI by quantifying the C-index. The BSI improved the C-index from 0.751 to 0.801 for OS. Median OS was not reached in patients with a BSI ≤ 1.9 and median OS was 34.8 months in patients with a BSI >1.9 (p = 0.039).Conclusions: The pretreatment BSI and patients' age are independent prognostic factors for patients with hormone-naive, bone metastatic prostate cancer. [ABSTRACT FROM AUTHOR]- Published
- 2016
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50. Prognostic value of a computer-aided diagnosis system involving bone scans among men treated with docetaxel for metastatic castration-resistant prostate cancer.
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Koichi Uemura, Yasuhide Miyoshi, Takashi Kawahara, Shuko Yoneyama, Yusuke Hattori, Jun-ichi Teranishi, Keiichi Kondo, Masatoshi Moriyama, Shigeo Takebayashi, Yumiko Yokomizo, Masahiro Yao, Hiroji Uemura, Kazumi Noguchi, Uemura, Koichi, Miyoshi, Yasuhide, Kawahara, Takashi, Yoneyama, Shuko, Hattori, Yusuke, Teranishi, Jun-Ichi, and Kondo, Keiichi
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DOCETAXEL , *BONE metastasis , *PROSTATE cancer prognosis , *PROSTATE cancer treatment , *MULTIVARIATE analysis , *PROPORTIONAL hazards models , *DIAGNOSIS , *ANTINEOPLASTIC agents , *HYDROCARBONS , *BONES , *BONE tumors , *PROGNOSIS , *PREDICTIVE tests , *PROSTATE tumors , *RETROSPECTIVE studies , *KAPLAN-Meier estimator , *COMPUTER-aided diagnosis , *THERAPEUTICS - Abstract
Background: The bone scan index (BSI), which is obtained using a computer-aided bone scan evaluation system, is anticipated to become an objective and quantitative clinical tool for evaluating bone metastases in prostate cancer. Here, we assessed the usefulness of the BSI as a prognostic factor in patients with metastatic castration-resistant prostate cancer (mCRPC) treated using docetaxel.Methods: We analyzed 41 patients who received docetaxel for mCRPC. The Bonenavi system was used as the calculation program for the BSI. The utility of the BSI as a predictor of overall survival (OS) after docetaxel was evaluated. The Cox proportional hazards model was used to investigate the association between clinical variables obtained at docetaxel treatment, namely PSA, patient age, liver metastasis, local therapy, hemoglobin (Hb), lactase dehydrogenase (LDH), albumin (Alb), PSA doubling time, and BSI and OS.Results: The median OS after docetaxel therapy was 17.7 months. Death occurred in 22 (53.7%) patients; all deaths were caused by prostate cancer. In multivariate analysis, three factors were identified as significant independent prognostic biomarkers for OS after docetaxel; these were liver metastases (yes vs no; HR, 3.681; p = 0.026), Alb (<3.9 vs ≥ 3.9; HR, 3.776; p = 0.020), and BSI (>1% vs ≤ 1%; HR, 3.356; p = 0.037). We evaluated the discriminatory ability of our models including or excluding the BSI by quantifying the c-index. The BSI improved the c-index from 0.758 to 0.769 for OS after docetaxel. CRPC patients with a BSI >1 had a significantly shorter OS than patients with a BSI ≤ 1 (p = 0.029).Conclusions: The BSI, liver metastases and Alb were independent prognostic factors for OS after docetaxel. The BSI might be a useful tool for risk stratification of mCRPC patients undergoing docetaxel treatment. [ABSTRACT FROM AUTHOR]- Published
- 2016
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