You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Value of Care: Cost and Outcomes Measures III1 Apr 2017PD32-09 DOWNSTREAM PROCEDURES FOLLOWING THE USE OF BONE SCAN IN THE STAGING OF MUSCLE-INVASIVE BLADDER CANCER Robert Turner II, Jonathan Yabes, Benjamin Davies, Dwight Heron, and Bruce Jacobs Robert Turner IIRobert Turner II More articles by this author , Jonathan YabesJonathan Yabes More articles by this author , Benjamin DaviesBenjamin Davies More articles by this author , Dwight HeronDwight Heron More articles by this author , and Bruce JacobsBruce Jacobs More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1400AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A bone scan may be considered prior to radical cystectomy to exclude bone metastases in high-risk patients. However, false positive bone scans can occur due to tracer uptake in benign bone lesions with reactive osteoblastic change, resulting in the need for additional procedures such as x-ray, computed tomography (CT), magnetic resonance imaging (MRI), and bone biopsy to further evaluate bone scan findings. The current burden of these downstream procedures is unknown. We aim to quantify the use of downstream procedures following staging bone scans in patients with muscle-invasive bladder cancer. METHODS Using Surveillance, Epidemiology, and End Results (SEER)- Medicare data, we identified 4404 patients diagnosed with muscle-invasive bladder cancer from 2004-2011. We further identified those who underwent a bone scan prior to treatment within 6 months of diagnosis. Using outpatient and carrier claims files, we determined the proportion of patients who underwent a subsequent x-ray, CT, MRI, and/or bone biopsy within 3 months of the bone scan and prior to treatment. RESULTS Among patients diagnosed with muscle-invasive bladder cancer during the study period, 1373 (31%) were identified as having completed a staging bone scan. Overall, 231 patients (17%) received downstream bone-specific x-rays, 340 patients (25%) received bone-specific CTs, and 103 patients (8%) received bone-specific MRIs. The use of bone biopsy was rare (n = 17; 1%). CONCLUSIONS Use of bone scan in the staging of muscle-invasive bladder cancer often results in the need for additional downstream imaging. The cost burden of this downstream imaging highlights a potential disadvantage of the routine use of this staging modality. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e591-e592 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Robert Turner II More articles by this author Jonathan Yabes More articles by this author Benjamin Davies More articles by this author Dwight Heron More articles by this author Bruce Jacobs More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...