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EJNMMI Research

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Open Access 01-12-2014 | Original research

Bone Scan Index as a prognostic imaging biomarker during androgen deprivation therapy

Authors: Mariana Reza, Anders Bjartell, Mattias Ohlsson, Reza Kaboteh, Per Wollmer, Lars Edenbrandt, Elin Trägårdh

Published in: EJNMMI Research | Issue 1/2014

Abstract

Background

Bone Scan Index (BSI) is a quantitative measurement of tumour burden in the skeleton calculated from bone scan images. When analysed at the time of diagnosis,it has been shown to provide prognostic information on survival in men with metastatic prostate cancer (PCa). In this study, we evaluated the prognostic value of BSI during androgen deprivation therapy (ADT).

Methods

Prostate cancer patients who were at high risk of a poor outcome and who had undergone bone scan at the time of diagnosis and during ADT were recruited from two university hospitals for a retrospective study. BSI at baseline and follow-up were calculated using an automated software package (EXINIbone^bsi).Associations between BSI, other prognostic biomarkers and overall survival (OS)were evaluated using a Cox proportional hazards regression model.

Results

One hundred forty-six PCa patients were included in the study. A total of 102patient deaths were registered, with a median survival time after the follow-up bone scan of 2.4 years (interquartile range (IQR) =0.8 to 4.4). Both at baseline and during ADT, BSI was significantly associated with OS in univariate and multivariate analyses. When BSI was added to a prognostic base model including age, prostate-specific antigen, clinical tumour stage and Gleason score, the concordance index increased from 0.73 to 0.77 (p =0.0005) at baseline and from 0.77 to 0.82 (p <0.0001) during ADT.

Conclusions

Automated BSI during ADT is an independent prognostic indicator of OS in PCa patients with bone metastasis. It represents an emerging imaging biomarker that can be used in a prognostic model for risk stratification of PCa patients at the time of diagnosis and at later stages of the disease. BSI could then help physicians identify patients who could benefit from more aggressive therapies.

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Bastian PJ, Boorjian SA, Bossi A, Briganti A, Heidenreich A, Freedland SJ, Montorsi F, Roach M III, Schröder F, van Poppel H, Stief CG, Stephenson AJ, Zelefsky MJ: High-risk prostate cancer: from definition to contemporary management. Eur Urol 2012, 61: 1096–1106. 10.1016/j.eururo.2012.02.031CrossRefPubMed

Nørgaard M, Jensen AØ, Jacobsen JB, Cetin K, Fryzek JP, Sørensen HT: Skeletal related events, bone metastasis and survival of prostate cancer: a population based cohort study in Denmark (1999 to 2007). J Urology 2010, 184(1):162–167. 10.1016/j.juro.2010.03.034CrossRef

Rigaud J, Tiguert R, Le Normand L, Karam G, Glemain P, Buzelin JM, Bouchot O: Prognostic value of bone scan in patients with metastatic prostate cancer treated initially with androgen deprivation therapy. J Urol 2002, 168(4):1423–1426. 10.1016/S0022-5347(05)64465-5CrossRefPubMed

Thoreson GR, Gayed BA, Chung PH, Raj GV: Emerging therapies in castration-resistant prostate cancer. Can J Urol 2014, 21(2 Suppl 1):98–105.PubMed

Briganti A, Passoni N, Ferrari M, Capitanio U, Suardi N, Gallina A, Da Pozzo LF, Picchio M, Di Girolamo V, Salonia A, Gianolli L, Messa C, Rigatti P, Montorsi F: When to perform bone scan in patients with newly diagnosed prostate cancer:external validation of the currently available guidelines and proposal of a novel risk stratification tool. Eur Urol 2010, 57(4):551–558. 10.1016/j.eururo.2009.12.023CrossRefPubMed

Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T, Mason M, Matveev V, Wiegel T, Zattoni F, Mottet N: EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent—update 2013. Eur Urol 2014, 65(1):124–137. 10.1016/j.eururo.2013.09.046CrossRefPubMed

Imbriaco M, Larson SM, Yeung HW, Mawlawi OR, Erdi Y, Venkatraman ES, Scher HI: A new parameter for measuring metastatic bone involvement by prostate cancer: the Bone Scan Index. Clin Cancer Res 1998, 4(7):1765–1772.PubMed

Dennis ER, Jia X, Mezheritskiy IS, Stephenson RD, Schoder H, Fox JJ, Heller G, Scher HI, Larson AM, Morris MJ: Bone Scan Index: a quantitative treatment response biomarker for castration-resistant metastatic prostate cancer. J Clin Oncol 2012, 30(5):519–524. 10.1200/JCO.2011.36.5791PubMedCentralCrossRefPubMed

Ulmert D, Kaboteh R, Fox JJ, Savage C, Evans MJ, Lilja H, Abrahamsson PA, Björk T, Gerdtsson A, Bjartell A, Gjertsson P, Höglund P, Lomsky M, Ohlsson M, Richter J, Sadik M, Morris MJ, Scher HI, Sjöstrand K, Yu A, Suurküla M, Edenbrandt L, Larson SM: A novel automated platform for quantifying the extent of skeletal tumor involvement in prostate cancer patients using Bone Scan Index. Eur Urol 2012, 62(1):78–84. 10.1016/j.eururo.2012.01.037PubMedCentralCrossRefPubMed

10.

Kaboteh R, Damber JE, Gjertsson P, Höglund P, Lomsky M, Ohlsson M, Edenbrandt L: Bone Scan Index: a prognostic imaging biomarker for high-risk prostate cancer patients receiving primary hormonal therapy. EJNMMI Res 2013, 3(1):9. 10.1186/2191-219X-3-9PubMedCentralCrossRefPubMed

11.

Ulmert D, O'Brien MF, Bjartell AS, Lilja H: Prostate kallikrein markers in diagnosis, risk stratification and prognosis. Nat Rev Urol 2009, 6: 384–391. 10.1038/nrurol.2009.123PubMedCentralCrossRefPubMed

12.

Haibe-Kains B, Desmedt C, Sotiriou C, Bontempi G: A comparative study of survival models for breast cancer prognostication based on microarray data: does a single gene beat them all? Bioinformatics 2008, 24: 2200–2208. 10.1093/bioinformatics/btn374PubMedCentralCrossRefPubMed

13.

Scher HI, Halabi S, Tannock I, Morris M, Sternberg CN, Carducci MA, Eisenberger MA, Higano C, Bubley GJ, Dreicer R, Petrylak D, Kantoff P, Basch E, Kelly WK, Figg WD, Small EJ, Beer TM, Wilding G, Martin A, Hussain M: Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol 2008, 26(7):1148–1159. 10.1200/JCO.2007.12.4487PubMedCentralCrossRefPubMed

14.

Kaboteh R, Gjertsson P, Leek H, Lomsky M, Ohlsson M, Sjöstrand K, Edenbrandt L: Progression of bone metastases in patients with prostate cancer - automated detection of new lesions and calculation of bone scan index. EJNMMI Res 2013, 3(1):64. 10.1186/2191-219X-3-64PubMedCentralCrossRefPubMed

15.

Mitsui Y, Shiina H, Yamamoto Y, Haramoto M, Arichi N, Yasumoto H, Kitagaki H, Igawa M: Prediction of survival benefit using an automated bone scan index in patients with castration-resistant prostate cancer. BJU Int 2012, 110: 628–634. 10.1111/j.1464-410X.2012.11355.xCrossRef

Title: Bone Scan Index as a prognostic imaging biomarker during androgen deprivation therapy
Authors: Mariana Reza
Anders Bjartell
Mattias Ohlsson
Reza Kaboteh
Per Wollmer
Lars Edenbrandt
Elin Trägårdh
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: EJNMMI Research / Issue 1/2014
Electronic ISSN: 2191-219X
DOI: https://doi.org/10.1186/s13550-014-0058-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Bone Scan Index as a prognostic imaging biomarker during androgen deprivation therapy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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