Évaluation de la stratégie optimale d’imagerie osseuse scintigraphique dans le bilan d’extension initial des patients avec un adénocarcinome prostatique à risque métastatique intermédiaire ou élevé

Abstract

Bone scintigraphy is indicated for first extension work-up in prostatic adenocarcinoma with intermediate or high metastatic risk according to d’Amico classification. Since February 2014, Haguenau Hospital nuclear medicine team systematically performs a double-field SPECT/CT to carry out the extension work-up of adenocarcinoma of prostate. The aim of this study was to assess incremental value of this method. Patients referred for initial staging of prostate cancer between February 2014 and July 2015 were retrospectively included. Planar and SPECT/CT imaging were evaluated by regions of interest with a diagnosis score, based on interpretation of radiotracer uptake. Data from the results of planar imaging, simple-field and double-field SPECT/CT were compared. A total of 201 patients were retrospectively included. SPECT/CT imaging allowed to reclassify 81.4% of inconclusive planar imaging. Only 2.4% of exams would have been be falsely negative without a systematic double-bed SPECT/CT. Three percent of study population showed suspicious uptake on planar imaging located outside of double-field SPECT/CT. Our study confirmed that a double-field SPECT/CT systematically undertaken is interesting to evaluate bone metastases in prostatic adenocarcinoma with intermediate or high metastatic risk.