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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
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Characterising potential bone scan overuse amongst men treated with radical prostatectomy
Peter S Kirk1, Tudor Borza1, Megan E V Caram2,3
1Dow Division of Health Services Research, Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA.
BJU International
|September 25, 2018
Summary
Bone scans are frequently used after radical prostatectomy (RP), often with low prostate-specific antigen (PSA) levels. More careful use of bone scans is recommended following RP to avoid unnecessary imaging.
Area of Science:
- Urology
- Radiology
- Oncology
Background:
- Overuse of medical imaging is a concern in cancer care.
- The persistence of imaging overuse after radical prostatectomy (RP) for prostate cancer is not well understood.
Purpose of the Study:
- To evaluate the utilization and potential overuse of bone scans after radical prostatectomy (RP).
- To identify factors associated with bone scan use in the post-RP setting.
Main Methods:
- Analysis of data from 12,269 patients treated with RP between 2005-2008.
- Examination of bone scan rates, prostate-specific antigen (PSA) levels, and receipt of adjuvant therapy.
- Multivariable logistic regression to identify predictors of post-RP bone scan use.
Main Results:
- 22% of patients underwent a bone scan after RP, with a median PSA of 0.2 ng/mL.
- 48% of bone scans were performed in patients not receiving further treatment.
- Bone scan use was associated with prior bone scans, positive surgical margins, preoperative PSA, ethnicity, race, and D'Amico risk category.
Conclusions:
- A significant rate of bone scan utilization exists after RP.
- Many scans are performed at low PSA levels (<1 ng/mL), where positive results are unlikely.
- Judicious use of bone scans is warranted in the post-RP setting to optimize resource allocation and patient care.
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