Comparison of whole-body bone scintigraphy with axial skeleton magnetic resonance imaging in the skeletal evaluation of carcinoma prostate

Abstract

Introduction: Whole-body bone scintigraphy (WBBS) is considered to be the standard of care in the initial skeletal evaluation of patients with carcinoma prostate. Magnetic resonance imaging (MRI) is a potential alternative technique for detecting bone metastasis. The objective of this study was to compare the diagnostic performance of WBBS with a single-photon emission computed tomography–computed tomography (SPECT-CT) correlation of the suspicious WBBS lesions to the axial skeleton (AS)-MRI in diagnosing bone metastasis in patients with carcinoma prostate. Methods: WBBS and AS-MRI were both performed during the initial skeletal evaluation in 35 patients of carcinoma prostate with the prostate-specific antigen (PSA) in the range of 10–50 ng/ml. Suspicious lesions on the WBBS were correlated on SPECT CT. The presence or absence of metastasis was determined by best valuable comparator. The validity parameters of WBBS and AS-MRI were computed and compared. Results: The sensitivity, specificity, positive predictive value, and negative predictive value of WBBS and AS-MRI for detecting patients with bone metastasis were 55.6%, 88.5%, 62.5%, 85.2% and 100.0%, 96.2%, 90.0%, 100%, respectively. The kappa value and the accuracy of WBBS were 0.457 and 80.0%, respectively. The kappa value and accuracy of AS-MRI were 0.928 and 97.1%, respectively. Conclusions: The diagnostic performance of AS-MRI in detecting patients with bone metastasis due to carcinoma prostate is superior to that of WBBS with SPECT-CT correlation of the suspicious lesions in the PSA range of 10–50 ng/ml.