bone scan
article written by Dr. Hassan Khan
Bone is the commonest site of spread especially the bones of the
spine and pelvis. The most commonly used tool used to look for spread of prostate
cancer is the Radionuclide Scan commonly called the bone scan.
Patients with a PSA above 20ng/ml should have a bone scan. This is a very sensitive
test but recent bone injury or degenerative bone diseases may appear similar
to bone spread.
The incidence of bony spread in the PSA range 8-20ng/ml is very low and your
Urologist may not choose to do a bone scan especially if the Gleason
score is low.
CT SCAN
The CT scan is best used to determine if the cancer has spread to
the pelvic lymph nodes. The sensitivity of the CT Scanning is greatly
enhanced by using contrast and fine needle biopsy of the enlarged nodes.
MRI SCAN
This scan is also used to determine if the pelvic lymph nodes are enlarged
but does not allow for fine needle biopsy. The MRI is the most sensitive
in picking up spread of the cancer to the tissue surrounding the prostate gland.
There are no specific indications for the use of CT or MRI scan and they
are not more sensitive than a transrectal ultrasound performed by an
experienced ultrasonographer/radiologist.
The aim of staging of prostate cancer is to decide which form of
treatment is best suited for each patient. Age, pre-existing medical
problems, the PSA level, the Gleason Score and the results of the
above imaging techniques allows your Urologist to suggest the best
treatment option for you.