Bone Scan Index predicts outcome in patients with metastatic hormone-sensitive prostate cancer

2015 ◽  
Vol 117 (5) ◽  
pp. 748-753 ◽  
Author(s):  
Mads H. Poulsen ◽  
Janne Rasmussen ◽  
Lars Edenbrandt ◽  
Poul F. Høilund-Carlsen ◽  
Oke Gerke ◽  
...  
2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 225-225
Author(s):  
Yasuhide Miyoshi ◽  
Masato Yasui ◽  
Shuko Yoneyama ◽  
Koichi Uemura ◽  
Takashi Kawahara ◽  
...  

225 Background: Recently, the CHAARTED and STAMPEDE studies showed a survival benefit for docetaxel when started with androgen deprivation therapy (ADT) in men with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC). While GETUG-AFU 15 failed to demonstrate a survival benefit of early chemotherapy. New biomarker for select the candidate for early chemotherapy in mHSPC is warranted. The objective of this study is to evaluate the bone scan index (BSI) using computer-aided diagnosis system for bone scans for predictive factor in patients receiving ADT as first-line hormone therapy for mHSPC. Methods: We identified consecutive 85 mHSPC patients treated with maximum androgen blockade (MAB) as first-line hormone therapy. We analyzed the correlations between progression-free survival (PFS) of MAB and clinicopathological characteristics, including patients’ age, initial PSA levels, Gleason scores, clinical TNM stage, hemoglobin (Hb), lactase dehydrogenase (LDH), c-reactive protein (CRP), and bone scan index (BSI). Statistical analyses were assessed using cox proportional hazards regression models. Results: The median patients’ age was 73 and the median follow-up duration was 11.3months. The median initial PSA value was 270 ng/ml. Median BSI was 2.7 % (range: 0.0-14.6). Clinical or PSA progression occurred in 55 (64.7%) patients. The median time to progression was 12.9 months. In multivariate analysis, three significant risk factors for PFS were identified; patients’ age ( > 73 years old vs ≤ 73; HR 0.53, p = 0.038), initial PSA levels ( > 270 ng/mL vs ≤ 270; HR 0.53, p = 0.038), and BSI ( > 2.7 vs ≤ 2.7; HR 3.0, p < 0.000). We stratified the patients into two cohorts with low risk (0-1 risk factor present) and high risk (2-3 risk factors present). We found a significant difference in PFS among risk groups (median PFS 15.3 months vs 8.5, p < 0.000). Conclusions: Patients’ age, initial PSA levels, and bone scan index were the significant predictive factors for MAB as first-line hormone therapy in patients with mHSPC. These findings might support the decision-making of induction of early chemotherapy for mHSPC.


2017 ◽  
Vol 99 (4) ◽  
pp. 400-405 ◽  
Author(s):  
Yasuhide Miyoshi ◽  
Shuko Yoneyama ◽  
Takashi Kawahara ◽  
Yusuke Hattori ◽  
Jun-ichi Teranishi ◽  
...  

2019 ◽  
Vol 22 (4) ◽  
pp. 522-530 ◽  
Author(s):  
Jose Mauricio Mota ◽  
Andrew J. Armstrong ◽  
Steven M. Larson ◽  
Josef J. Fox ◽  
Michael J. Morris

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e16600-e16600
Author(s):  
Aseem Anand ◽  
Stephanie Daignault ◽  
Luke T. Nordquist ◽  
Jorge Ramos ◽  
Rohit K. Jain ◽  
...  

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. e639-e639
Author(s):  
Hiroshi Yaegashi ◽  
Atsushi Mizokami ◽  
Satoru Watanabe ◽  
Kenichi Nakajima ◽  
Natsuyo Noguchi ◽  
...  

e639 Background: Bone management is extremely important for maintaining QOL of prostate or renal cancer patients with bone metastasis. Physicians often administrate bone modifying agents (BMA), zoledronic acid or denosumab, to prevent skeletal-related event and bone pain for such patients. However, osteonecrosis of the jaw (ONJ) is one of sever adverse events of BMA (Medication-related ONJ; MRONJ). The early detection and follow-up of ONJ is extremely important issue. In order to achieve this issue, we utilized bone scintigraphy and a computer-aided diagnosis using a bone scan index (BSI). Methods: A total of 22 patients with either prostate cancer or renal cancer (27 lesions) diagnosed with MRONJ after treatment with BMA were investigated. Median age was 72.5 years (range 52-82 years). The primary disease was prostate cancer (81.8%), renal cancer (18.2%). Regarding the treatment, 86.4% of the patients were treated with bisphosphonate drugs, none in denosumab, and both in 13.6%, respectively. The median duration of medication was 33 months (range 7-70 months) by the time of MRONJ diagnosis. All patients underwent Tc-99m methylene diphosphonate bone scintigraphy. Bone uptake in the jaw was analyzed using BSI, which was calculated by BONENAVI (FUJIFILM RI Pharma, Japan; EXINIbone, EXINI Diagnostics, Sweden). Significant hot spots were manually selected according to both serial scintigraphic images and dental records, and the fraction of them to the entire skeleton was referred as BSI of the jaw (BSIJ). The level of BSIJ was evaluated in comparison with stage of ONJ and inflammation marker, C-reactive protein (CRP). Results: The median BSIJ of lesions was 0.14 (range 0.00-0.43) at the time of MRONJ diagnosis. If MRONJ is not treated appropriately, BSIJ tended to increase during treatment with BMA. When patients were classified according to their clinical stages of MRONJ, higher stage MRONJ lesions had significantly higher BSIJ (p < 0.01). In addition, BSIJ was correlated with CRP. Conclusions: Evaluation of BSIJ using BONENAVI on bone scintigraphy was helpful for early detection and follow-up of MRONJ. Furthermore, increased BSIJ on bone scintigraphy were related to CRP and stage of ONJ.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5068-5068 ◽  
Author(s):  
Aseem Anand ◽  
Glenn Heller ◽  
Howard I. Scher ◽  
Michael J. Morris

5068 Background: mCRPC is a bone dominant lethal disease. A validated endpoint in mCRPC trials is bone scan progression, which is semi-quantitative and rely on the appearance of new lesions as proposed by the PCWG. The validated automated bone scan index (BSI) quantifies the bone tumor burden as the fraction of total skeletal weight. To build on the current definition of disease progression, we sought to compare the association of time to progression with overall survival (OS) using PCWG criteria and BSI increase. Methods: mCRPC patients (pts) enrolled on trials of agents targeting androgen-receptor (AR) were assessed. Pts were required to have a raw bone scan image for BSI analysis concurrent with disease assessments. The EXINI automated computing platform generated the BSI values. Thresholds for the absolute and relative increase in BSI from 1st follow-up (≤12 weeks) were explored for the time to BSI progression. The association with survival time was computed for each threshold defined time to BSI progression. Kendall’s Tau, derived from the Clayton copula, was used to associate time to BSI progression with survival time, where both endpoints may be censored. Results: A total of 257 pts were assessed, of whom 169 had raw bone scans images needed for the BSI analysis. 90 pts (53%) met progression by PCWG criteria, the association between the time to PCWG progression and OS was 0.52. The association between time to BSI progression and OS was comparable to the PCWG progression when the absolute increase in BSI was 0.6 or more (table below). Conclusions: Progression in bone can be expressed as a single quantitative metric that describes the increase in total disease burden while retaining the same association that PCWG has with OS. These data represent the first steps to a quantitative expression of bone disease progression as a clinical trials endpoint. [Table: see text]


2017 ◽  
Vol 35 (6_suppl) ◽  
pp. e596-e596
Author(s):  
Suguru Kadomoto ◽  
Kouji Izumi ◽  
Takahiro Nohara ◽  
Konaka Hiroyuki ◽  
Yoshifumi Kadono ◽  
...  

e596 Background: It was ambiguous till now to evaluate the change of bone metastasis by various treatments. To quantify the change of bone metastases by enzalutamide, abiraterone, and docetaxel for the castration-resistant prostate cancer (CRPC) with bone metastases (bmCRPC), we employed Bone Scan Index (BSI) on bone scintigraphy. Methods: We retrospectively evaluated the change of PSA and bone metastases of CRPC patients who were treated with enzalutamide (Enz), abiraterone (Abi) and/or docetaxel (DOC) in our hospital. All patients underwent Tc-99m MDP bone scintigraphy. The degree of bone metastases was analyzed using BSI, which was calculated by BONENAVI (FUJIFILM RI Pharma, Japan; EXINIbone, EXINI Diagnostics, Sweden). 19 patients were treated with enzalutamide (8 cases: pre-docetaxel, 11 cases: post-docetaxel). The median PSA of patients treated with Enz was 12.64 ng/ml (1.63-199 ng/ml). And 11 patients were treated with abiraterone (5 cases: pre-docetaxel, 6 cases: post-docetaxel). The median PSA of patients treated with Abi was 26.37 ng/ml (2.29-199 ng/ml). Results: We observed decline of PSA in 18/30 cases (9 cases: pre-DOC, 9 cases: post-DOC). Decline of PSA to 50% or more was observed in 14 cases. In contrast, decline of BSI was observed in 53.3% (16/30) cases and decline of PSA to 25% or more was observed in only 6 cases. BSI decreased in 84.6% (11/13) of pre-DOC setting and in 29.4% (5/17) of post-DOC setting indicating that change of BSI was poor in post-DOC setting. However, DOC had already decreased BSI in 91.7% (11/12) before Abi or Enz treatment. Moreover, the average rate of BSI decline in the patients that BSI decreased by DOC was better than the patients that BSI decreased by Abi/Enz (-48.46% vs -28.56%). Finally, although the rate of BSI change by Enz was weakly correlated with the rate of PSA decline (y = 0.3906x + 25.35, R2 = 0.3423), BSI continued to increase in four cases in spite of PSA decline. Conclusions: BSI using BONENAVI on bone scintigraphy was helpful for evaluating the effectiveness of treatment and following-up of bmCRPC.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17507-e17507
Author(s):  
Vipal P. Durkal ◽  
Nicholas George Nickols ◽  
Matthew Rettig

e17507 Background: Prostate cancer commonly metastasizes to the bone and is associated with reduced survival, pathologic fractures and bone pain. The assessment of bone lesions is made with the technetium Tc99m(99mTc) bone scan, which relies on the subjective interpretation of radiologists and has a wide interobserver variability. There is an unmet need for a more objective and quantifiable measurement tool. Progenics Pharmaceuticals has introduced an automated bone scan index (aBSI), which employs artificial intelligence to quantify skeletal tumor burden. The automated bone scan index has been prospectively validated and is reproducible in large Phase III studies. The aBSI was validated by our study in the Veteran population at the West LA VA Medical Center. Methods: The first positive technetium 99 Tc99m bone scans of veterans diagnosed with metastatic, castration-sensitive prostate cancer were evaluated. Since 2011, a total of 107 evaluable patient bone scans were studied (n = 107). Patients with visceral metastases were excluded to evaluate only those with skeletal metastases. An automated bone scan index (aBSI) was generated for each scan using the Progenics Pharmaceuticals’ artificial intelligence platform. Multivariate analysis of aBSI with overall survival, prostate cancer specific survival, time from diagnosis to first positive bone scan, age at diagnosis, ethnicity, and Gleason score was assessed. Results: The study demonstrated a wide range of aBSI values (Range 0-16.84). Values calculated above the Median aBSI value (1.0) were prognostic for Overall Survival (p = 0.0009) and Prostate Cancer-Specific Survival (p = 0.0011). Patients in the highest quartile of aBSI values (range 5.2-16.84) showed a statistically significant Prostate Cancer-Specific Mortality (p = 0.0300) when compared to the lowest two quartiles (Range 0-1.07). The time from diagnosis to the first positive Tc99m bone scan statistically correlated with aBSI values (p = 0.0016). Multivariate analysis using Cox regression was utilized in the final statistical analysis of prostate cancer-specific mortality and overall survival. Conclusions: The automated Bone Scan Index provides a quantifiable and validated artificial intelligence biomarker to address an unmet need among metastatic prostate cancer patients. This tool was validated among Veterans, a pertinent population that is commonly affected by metastatic prostate cancer.


Sign in / Sign up

Export Citation Format

Share Document