Bone Scan Is of Doubtful Value as a First Staging Test in the Primary Presentation of Prostate Cancer
Table 2
Analysis of patients classified in Group 4.
Age
PSA
Alkaline phosphatase
Gleason
Comments
(1)
75
7.3
68
3 + 4
Uptake in 1st left rib anteriorly, negative thorax X-ray, CT scan negative with 5 years of followup.
(2)
79
7.2
54
4 + 3
Uptake in 5th left rib anteriorly, negative CT scan of the chest.
(3)
78
29.7
189
3 + 3
Uptake noted in right shoulder joint/proximal humerus (suspicious), negative shoulder X-ray.
(4)
67
5.0
70
3 + 4
Focus of activity at the right posterior parietal region, negative skull X-ray.
(5)
72
9.7
107
3 + 4
Increased activity at the right superior aspect of the right mandible/right base of the skull. CT scan, X-ray, and MRI compatible with mastoiditis.
(6)
53
19.1
105
3 + 4
Uptake in 8th left rib posteriorly, negative thorax X-ray, stable on two-year followup.
(7)
72
23.5
73
3 + 4
Uptake in 6th left rib posteriorly, negative thorax CT scan, negative MRI.
(8)
78
43.6
87
Focally increased uptake at the lateral third of the left clavicle. Old fractures on X-ray.
(9)
79
15
406
4 + 5
Intense tracer uptake in T11 left side, and 12th rib. Normal CT scan of abdomen-pelvis, confirms Staghorn calculus.
(10)
85
601.2
129
4 + 5
Increased activity at the medial aspect of the right humerus head. No immediate images, negative shoulder X-ray four years later.
(11)
70
56.2
103
3 + 2
Diffuse rib uptake, normal CT and MRI.
(12)
78
11.5
45
4 + 3
Uptake in 8th left rib posteriorly, on review X-ray focal eccentric rib lesion. However treated by radical prostate radiotherapy with clinical response after 4 months (PSA nadir 0.1 ng/mL, 1.1 ng/mL after 4-year followup).
