Abstract
BackgroundThe 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.MethodsWe 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.ResultsA 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).ConclusionsThe 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.
Highlights
The Bone Scan Index (BSI) is used to quantitatively assess the total tumour burden in bone scans of patients with metastatic prostate cancer
The current methods used in clinical routine are based on traditional visual analysis, which is qualitative and mainly focuses on merely whether or not metastatic lesions are present in the bone [4]
Patients The study participants were recruited from all prostate cancer patients who underwent bone scintigraphy at Sahlgrenska University Hospital in Gothenburg, Sweden, from March to October 2015 and at Skåne University Hospital, Sweden, from November 2015 to March 2016
Summary
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. 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. Bone scan examination remains the most widely used and recommended method for assessing metastatic spread to the bone when progression of the disease is suspected in patients with prostate cancer [4]. Automatic quantitative analysis of the images could be useful for reducing intra- and inter-observer variability [6]
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