Evaluation of two-dimensional total bone uptake (2D-TBU) and bone scan index (BSI) extracted from active bone metastatic burden on the bone scintigraphy in patients with radium-223 treatment

IF 2.5 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Shohei Fukai, Hiromitsu Daisaki, Takuro Umeda, Naoki Shimada, Takashi Terauchi, Mitsuru Koizumi
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Abstract

Objective

Radium-223 is a first alpha-emitting radionuclide treatment for metastatic castration-resistant prostate cancer (mCRPC) patients with bone metastases. Although the spread-based bone scan index (BSI) and novel index of the intensity-based two-dimensional total bone uptake (2D-TBU) from bone scintigraphy may provide useful input in radium-223 treatment, they have not been evaluated in detail yet. This study aimed to fill this gap by evaluating BSI and 2D-TBU in patients treated with radium-223.

Methods

Twenty-seven Japanese patients with mCRPC treated with radium-223 were retrospectively analyzed. The patients were evaluated via blood tests and bone scans at baseline and 3 cycles intervals of treatment. BSI and 2D-TBU were analyzed via VSBONE BSI in terms of correlations, response to radium-223 treatment, association with treatment completion, and the Kaplan–Meier survival analysis was performed.

Results

Nineteen patients (70.4%) completed six cycles of radium-223 treatment, whereas eight patients (29.6%) did not complete the treatment regimen. A significant difference in baseline BSI and 2D-TBU was observed between these groups of patients. Both BSI and 2D-TBU were highly correlated (r = 0.96, p < 0.001). Univariate analysis showed an association between radium-223 completion in median BSI and 2D-TBU values (p = 0.015) and completion percentage differences (91.7% vs. 45.5%; p = 0.027). The Kaplan–Meier product limit estimator showed that the median overall survival was 25.2 months (95% CI 14.0–33.6 months) in the completion group and 7.5 months (95% CI 3.3–14.2 months) in the without completion group (p < 0.001). The overall survival based on median cutoff levels showed a significant difference in 2D-TBU (p = 0.007), but not in BSI (p = 0.15).

Conclusions

The 2D-TBU may offer advantages over BSI in classifying patients towards radium-223 treatment based on the degree of progression of bone metastases. This study supports the importance of preliminary assessment of bone metastasis status using BSI and 2D-TBU extracted from VSBONE BSI for radium-223 treatment decisions.

Abstract Image

Abstract Image

评估镭-223治疗患者骨闪烁扫描中的二维总骨摄取量(2D-TBU)和从活动性骨转移负荷中提取的骨扫描指数(BSI)。
目的:镭-223是治疗骨转移的转移性抗性前列腺癌(mCRPC)患者的第一种α放射性核素。尽管基于扩散的骨扫描指数(BSI)和基于强度的二维骨摄取总量(2D-TBU)的骨闪烁扫描新指数可为镭-223治疗提供有用的信息,但尚未对它们进行详细评估。本研究旨在通过评估镭-223 治疗患者的 BSI 和 2D-TBU 来填补这一空白:回顾性分析了27名接受镭-223治疗的日本mCRPC患者。在基线和三个治疗周期之间,通过血液检测和骨扫描对患者进行评估。通过 VSBONE BSI 分析了 BSI 和 2D-TBU 的相关性、对镭-223 治疗的反应、与治疗完成的关系,并进行了 Kaplan-Meier 生存分析:19名患者(70.4%)完成了6个周期的镭-223治疗,8名患者(29.6%)未完成治疗方案。这两组患者的基线 BSI 和 2D-TBU 存在明显差异。BSI 和 2D-TBU 都高度相关(r = 0.96,p 结论:BSI 和 2D-TBU 的相关性很高:在根据骨转移灶的进展程度对患者进行镭-223 治疗分类方面,2D-TBU 可能比 BSI 更有优势。这项研究支持使用 BSI 和从 VSBONE BSI 中提取的 2D-TBU 初步评估骨转移状态对镭-223 治疗决策的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Nuclear Medicine
Annals of Nuclear Medicine 医学-核医学
CiteScore
4.90
自引率
7.70%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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