Study of the Usefulness of Bone Scan Index Calculated From 99m-Technetium-Hydroxymethylene Diphosphonate (99mtc-HMDP) Bone Scintigraphy for Bone Metastases from Prostate Cancer Using Deep Learning Algorithms

2020 ◽  
Vol 16 ◽  
Author(s):  
Shigeaki Higashiyama ◽  
Atsushi Yoshida ◽  
Joji Kawabe
Keyword(s):  
Prostate Cancer ◽  
Deep Learning ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Bone Scan ◽  
Learning Algorithms ◽  
Bone Imaging ◽  
Bone Scan Index ◽  
Metabolic Biomarkers

Background: BSI calculated from bone scintigraphy using 99mtechnetium-methylene diphosphonate (99mTc-MDP) is used as a quantitative indicator of metastatic bone involvement in bone metastasis diagnosis, therapeutic effect assessment, and prognosis prediction. However, the BONE NAVI, which calculates BSI, only supports bone scintigraphy using 99mTc-MDP. Aims: We developed a method in collaboration with the Tokyo University of Agriculture and Technology to calculate bone scan index (BSI) employing deep learning algorithms with bone scintigraphy images using 99mtechnetiumhydroxymethylene diphosphonate (99mTc-HMDP). We used a convolutional neural network (CNN) enabling the simultaneous processing of anterior and posterior bone scintigraphy images named CNNapis. Objectives: The purpose of this study is to investigate the usefulness of the BSI calculated by CNNapis as bone imaging and bone metabolic biomarkers in patients with bone metastases from prostate cancer. Methods: At our hospital, 121 bone scintigraphy scans using 99mTc-HMDP were performed and analyzed to examine bone metastases from prostate cancer, revealing the abnormal accumulation of radioisotope (RI) at bone metastasis sites. Blood tests for serum prostate-specific antigen (PSA) and alkaline phosphatase (ALP) were performed concurrently. BSI values calculated by CNNapis were used to quantify the metastatic bone tumor involvement. Correlations between BSI and PSA and between BSI and ALP were calculated. Subjects were divided into four groups by BSI values (Group 1, 0 to <1; Group 2, 1 to <3; Group 3, 3 to <10; Group 4, >10), and the PSA and ALP values in each group were statistically compared. Results: Patients diagnosed with bone metastases after bone scintigraphy were also diagnosed with bone metastases using CNNapis. BSI corresponding to the range of abnormal RI accumulation was calculated. PSA and BSI (r = 0.2791) and ALP and BSI (r = 0.6814) correlated positively. Significant intergroup differences in PSA between Groups 1 and 2, Groups 1 and 4, Groups 2 and 3, and Groups 3 and 4 and in ALP between Groups 1 and 4, Groups 2 and 4, and Groups 3 and 4 were found. Conclusion : BSI calculated using CNNapis correlated with ALP and PSA values and is useful as bone imaging and bone metabolic biomarkers, indicative of the activity and spread of bone metastases from prostate cancer.

Evaluation of bone metastasis of castration-resistant prostate cancer after enzalutamide and abiraterone using Bone Scan Index on bone scintigraphy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. e596-e596
Author(s):  
Suguru Kadomoto ◽  
Kouji Izumi ◽  
Takahiro Nohara ◽  
Konaka Hiroyuki ◽  
Yoshifumi Kadono ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastasis ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Bone Scan ◽  
Average Rate ◽  
Castration Resistant Prostate Cancer ◽  
Bone Scan Index ◽  
Castration Resistant ◽  
Better Than

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.

scholarly journals Bone scan index on bone scintigraphy and radiation therapy for bone metastases from cancers other than prostate and breast cancers: a retrospective observational study

2020 ◽  
Author(s):  
Naoya Ishibashi ◽  
Toshiya Maebayashi ◽  
Yuki Kimura ◽  
Masahiro Okada
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Bone Scan ◽  
Whole Body ◽  
Study Cohort ◽  
Breast Cancers ◽  
Bone Scan Index

Abstract Background A low bone scan index that is associated with a better prognosis in patients with bone metastases from prostate or breast cancer, the former often being osteolytic, has been established. In this study we aimed to use new automatic analysis software (VSBONE BSI; Nihon Medi-Physics, Tokyo, Japan) to investigate whether the pre-radiation therapy bone scan index, derived from bone scintigraphy images, is a prognostic indicator in patients undergoing radiation therapy for bone metastases from cancers other than breast or prostate cancer. Methods In this retrospective single institution study, we analyzed data of 51 patients who had undergone whole-body scintigraphy before receiving radiation therapy for bone metastases from cancers other than breast and prostate cancer between 2013 and 2019. Their bone metastases were classified as osteoblastic, osteolytic, or mixed and their pre-radiation bone scan indexes were automatically calculated using newly developed software (VSBONE BSI; Nihon Medi-Physics, Tokyo, Japan). Univariate and multivariate analyses were performed to identify associations between selected clinical variables and overall survival. Results We did not find a significant association between BSI and overall survival, possibly because osteolytic lesions may be underestimated by bone scan indexes. However, we did find that younger patients (aged less than the median of 66 years at the time of bone scintigraphy or of diagnosis of bone metastases) had significantly better overall survivals than older patients (P = 0.016 and P = 0.036, respectively). Additionally, bone scan indexes were significantly lower in patient with solitary or osteolytic bone metastases than in those with osteoblastic or mixed bone metastases (P = 0.035 and P = <0.001, respectively), and significantly higher in those with lung cancer than in those with other types of cancer (mean BSI 3.26% vs. 1.97%; P = 0.009). Conclusions The only significant association with survival identified in this study was for age at the time of bone scintigraphy and at time of diagnosis of bone metastases. In particular, we found no association between bone scan index and survival in the whole study cohort.

Relationship of bone scan index and progression-free survival after docetaxel treatment for CRPC patients with bone metastases.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 280-280
Author(s):  
Atsushi Mizokami ◽  
Kouji Izumi ◽  
Satoru Ueno ◽  
Yoshifumi Kadono ◽  
Hiroshi Wakabayashi ◽  
...  
Keyword(s):  
Bone Metastasis ◽  
Bone Metastases ◽  
Bone Scintigraphy ◽  
Bone Scan ◽  
Progression Free Survival ◽  
Type I ◽  
Bone Scan Index ◽  
Free Survival ◽  
Significant Difference ◽  
Docetaxel Treatment

280 Background: A computer-aided diagnosis system for bone scintigraphy using semiquantitative index [Bone Scan Index (BSI)] has been used to measure the tumor burden of bone metastases. We examined relationships of BSI, bone turnover marker, and prostate-specific antigen (PSA)-progression free survival (PFS) after docetaxel-treatment for castration resistant prostate cancer (CRPC) with bone metastasis. Methods: Sixteen CRPC patients with bone metastases (median age 72, range 52 to 82) were treated with docetaxel. We evaluated bone metastasis by bone scintigraphy before or around six months after docetaxel-treatment retrospectively. BSI was automatically calculated by BONENAVI software version 1 (FUJIFILM RI Pharma, Co. Ltd., Tokyo, Japan; Exini Bone, Exini Diagnostics, Sweden). Serum PSA, bone alkaline phosphatase (BAP), carboxyterminal telopeptide of type I collagen (I-CTP) were examined every months. PSA-PFS was evaluated after docetaxel-treatment and compared with baseline of BSI, BAP, I-CTP, and change of these value after treatment. Overall survival (OS) was also evaluated by these markers. The rate of patients with PFS and OS was estimated by the Kaplan-Meier method. Results: Baseline of BSI, the serum BAP, and I-CTP before docetaxel-treatment did not affect PFS. The change of BAP and I-CTP by the docetaxel-treatment also did not affect PFS. Only the change of BSI affected PFS and the median PFS of CRPC patients with increased BSI and decreased BSI was 5.5 months and 10 months, respectively (p=0.026). Although OS showed a longer tendency in CRPC patients with decreased BSI than with increased BSI, there was not the significant difference (p=0.12). Conclusions: The change of BSI affected PFS in CRPC patients with bone metastases. Bone scan and its evaluation with BONENAVI was effective to monitor the clinical course during chemotherapy.

scholarly journals Lesion-Based Bone Metastasis Detection in Chest Bone Scintigraphy Images of Prostate Cancer Patients Using Pre-Train, Negative Mining, and Deep Learning

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 518
Author(s):  
Da-Chuan Cheng ◽  
Te-Chun Hsieh ◽  
Kuo-Yang Yen ◽  
Chia-Hung Kao
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Deep Learning ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Bone Scintigraphy ◽  
Breast Cancer Patients ◽  
Location Detection ◽  
The Mean ◽  
Mean Sensitivity

This study aimed to explore efficient ways to diagnose bone metastasis early using bone scintigraphy images through negative mining, pre-training, the convolutional neural network, and deep learning. We studied 205 prostate cancer patients and 371 breast cancer patients and used bone scintigraphy data from breast cancer patients to pre-train a YOLO v4 with a false-positive reduction strategy. With the pre-trained model, transferred learning was applied to prostate cancer patients to build a model to detect and identify metastasis locations using bone scintigraphy. Ten-fold cross validation was conducted. The mean sensitivity and precision rates for bone metastasis location detection and classification (lesion-based) in the chests of prostate patients were 0.72 ± 0.04 and 0.90 ± 0.04, respectively. The mean sensitivity and specificity rates for bone metastasis classification (patient-based) in the chests of prostate patients were 0.94 ± 0.09 and 0.92 ± 0.09, respectively. The developed system has the potential to provide pre-diagnostic reports to aid in physicians’ final decisions.

Diagnosis and semiquantification of osteonecrosis of the jaw by bone scan index on bone scintigraphy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. e639-e639
Author(s):  
Hiroshi Yaegashi ◽  
Atsushi Mizokami ◽  
Satoru Watanabe ◽  
Kenichi Nakajima ◽  
Natsuyo Noguchi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Early Detection ◽  
Bone Scintigraphy ◽  
Renal Cancer ◽  
Bone Scan ◽  
Osteonecrosis Of The Jaw ◽  
Bone Scan Index ◽  
Reactive Protein ◽  
Skeletal Related Event

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.

scholarly journals Progression of bone metastases in patients with prostate cancer - automated detection of new lesions and calculation of bone scan index

2013 ◽  
Vol 3 (1) ◽  
pp. 64 ◽  
Author(s):  
Reza Kaboteh ◽  
Peter Gjertsson ◽  
Håkan Leek ◽  
Milan Lomsky ◽  
Mattias Ohlsson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Bone Scan ◽  
Automated Detection ◽  
Bone Scan Index

A new parameter of bone scintigraphy: Relation between bone scan index and bone metabolic markers in prostate cancer patients with bone metastases.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16072-e16072
Author(s):  
Hiroshi Wakabayashi ◽  
Kenichi Nakajima ◽  
Atsushi Mizokami ◽  
Mikio Namiki ◽  
Anri Inaki ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Bone Scan ◽  
Bone Metabolic Markers ◽  
Bone Scan Index ◽  
Metabolic Markers ◽  
Trap 5B ◽  
Group A ◽  
Group B ◽  
Group D

e16072 Background: A computer-aided diagnosis system for bone scan with semiquantitative index of Bone Scan Index (BSI) may be used to quantify the spread of bone metastases. This retrospective study aimed to examine associations between BSI, bone metabolic markers, and prostate specific antigen (PSA) in prostate cancer patients with bone metastases. Methods: A total of 158 scintigraphy of 52 patients (mean examinations/person 3, range 1-8; mean age 71 years, range 46 to 86) were studied. The intervals between bone scan and blood examinations were 0 to 16 days (median 0 day). Subjects were divided into 4 groups according to BSI; Group A: 0 - <2, Group B: 2 - <4, Group C: 4 - <8, and Group D: 8<. The markers of PSA, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (1-CTP), bone alkaline phosphatase (BAP), and tartate resistant acid phosphatase-5b (TRAP-5b) were examined. As the values of PSA, BAP, and TRAP-5b covered a large range of scales, we also used the logarithms of the variables. BSI, which corresponded amount of metastatic lesions, was automatically calculated by BONENAVI software (FUJIFILM RIPharma, Co. Ltd., Tokyo, Japan; Exini Bone, Exini Diagnostics, Sweden). Results: All scans showed increased uptake at bone metastases. BSI correlated significantly with 1-CTP, BAP, logBAP, TRAP-5b, logTRAP-5b, and logPSA (r=0.39, 0.66, 0.71, 0.69, 0.61 and 0.41, respectively). Statistical F value was 11 in 1-CTP, 31 in BAP, 29 in logBAP, 19 in TRAP-5b, 14 in logTRAP-5b, 3 in PSA, and 9 in logPSA by ANOVA, respectively. Comparison by Dunnett’s test showed significantly higher values in Group D for all bone metabolic markers and logPSA, Group C for BAP, logBAP, TRAP-5b, and logTRAP-5b, and Group B for logTRAP-5b compared with Group A, respectively. However, PSA did not correlate significantly with extent of bone metastases as assessed by BSI. Conclusions: The changes in BSI showed close relationship with all bone metabolic markers but not with PSA. The BSI reflected the activity and extent of bone metastases, and might be used as an imaging biomarker.

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