Detection of Prostate Cancer Metastasis by Whole Body Magnetic Resonance Imaging Combined with Bone Scintigraphy and PSA Levels.

BACKGROUND/AIMS: The combined role of whole-body magnetic resonance imaging (WB-MRI), bone scintigraphy and prostate specific antigen (PSA) were considered in predicting metastases and prognosis of prostate cancer (PCa).

METHODS: Totally 38 PCa patients underwent WB-MRI, bone scintigraphy and PSA detections, and 34 benign prostate hyperplasia (BPH) patients were checked with PSA. Pearson correlations were performed to determine associations among PSA, apparent diffusion coefficient (ADC) and Gleason scoring. Specificity and sensitivity were for comparison of diagnostic accuracies. Patients' baseline PSA, PSA nadir and time to the prostate-specific antigen nadir (TTPN) were analyzed, and Kaplan-Meier survival curves were also established.

RESULTS: ADC values were negatively correlated with PSA levels (rs = -0.389, P = 0.016) and Gleason scores (rs = -0.432, P = 0.006), while PSA levels were positively correlated with Gleason scoring (rs = 0.493, P = 0.002). Diagnostic efficacy of whole body-diffusion weighted imaging (WB-DWI) combined with PSA seemed the most favorable, and bone scintigraphy was advantageous in identifying bone metastasis. PSA levels (> 61.60 µg/L), Gleason scores (> 6) and ADC (< 0.81 × 10-3 mm2/s) could all predict pessimistic prognosis (HR = 7.65; HR = 6.09; HR = 7.28). Smaller PSA nadir (≤ 1.0 µg/L) and longer TTPN (> 3 months) were associated with increased 5-year survival rate (P < 0.05).

CONCLUSIONS: The combined efficacies of WB-MRI, bone scintigraphy and PSA levels were desired in identifying PCa lesions and prognosis.