ArticleCancer diagnosis & prognosis
Predictive Value of Incidental Cross-Sectional Imaging for Prediction of Skeletal Events in Patients With Prostate Cancer.
Article in Cancer diagnosis & prognosis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background/Aim: Prostate cancer is linked to an elevated risk of osteoporotic fractures, which can lead to significant morbidity and even mortality. The optimal screening methods and frequency, particularly for patients with non-metastatic disease receiving androgen deprivation therapy (ADT), remain contentious. This study aimed to assess the utility of incidental cross-sectional imaging in the diagnosis of osteoporosis. Patients and Methods: We screened patients diagnosed with prostate cancer and followed-up at our tertiary cancer center between July 1, 2006, and December 31, 2023. For eligible patients, three cross-sectional images (computed tomography, alone or with positron-emission tomography) acquired at different times were evaluated to determine the mean attenuation of the L5 vertebral body. Results: A total of 66 patients were included, with 31 patients (47%) receiving adjuvant ADT. The median follow-up period was 45.2 months. Skeletal events were recorded in 15 patients (26.2%). The mean attenuation of the L5 vertebral body, expressed in Hounsfield units (HU), was measured across three consecutive imaging sessions. The median change in the overall cohort was -4.5, it was -5.7 in patients who received adjuvant ADT, -3.9 in patients with bone metastasis, -2.8 in patients who had skeletal events, and -1.65 in patients who received bone-modifying agents. No significant difference was observed between patient subgroups. Logistic and Bayesian regression analyses showed no relationship between skeletal events and changes in bone density (Bayesian Factor 01: 2.494-2.892, low causality). Conclusion: While computed tomography imaging can detect bone loss in this patient population, it does not appear to be of sufficient utility to predict skeletal events. This highlights the need for exploring new imaging techniques and their integration with nomograms, which are crucial research areas for improving the management of osteoporosis in patients with prostate cancer.
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