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Diagnostics 2018, 8(1), 9;

Reporting and Handling of Indeterminate Bone Scan Results in the Staging of Prostate Cancer: A Systematic Review

Department of Nuclear Medicine, Clinical Cancer Research Centre, Aalborg University Hospital, DK-9000 Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, DK-9100 Aalborg, Denmark
The Medical Library, Aalborg University Hospital, DK-9000 Aalborg, Denmark
Unit of Clinical Biostatistics, Aalborg University Hospital, DK-9000 Aalborg, Denmark
Author to whom correspondence should be addressed.
Received: 29 December 2017 / Revised: 10 January 2018 / Accepted: 12 January 2018 / Published: 16 January 2018
(This article belongs to the Special Issue Imaging of Bone Metastases in Oncology)
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Bone scintigraphy is key in imaging skeletal metastases in newly diagnosed prostate cancer. Unfortunately, a notable proportion of scans are not readily classified as positive or negative but deemed indeterminate. The extent of reporting of indeterminate bone scans and how such scans are handled in clinical trials are not known. A systematic review was conducted using electronic databases up to October 2016. The main outcome of interest was the reporting of indeterminate bone scans, analyses of how such scans were managed, and exploratory analyses of the association of study characteristics and the reporting of indeterminate bone scan results. Seventy-four eligible clinical trials were identified. The trials were mostly retrospective (85%), observational (95%), large trials (median 195 patients) from five continents published over four decades. The majority of studies had university affiliation (72%), and an author with imaging background (685). Forty-five studies (61%) reported an indeterminate option for the bone scan and 23 studies reported the proportion of indeterminate scans (median 11.4%). Most trials (44/45, 98%) reported how to handle indeterminate scans. Most trials (n = 39) used add-on supplementary imaging, follow-up bone scans, or both. Exploratory analyses showed a significant association of reporting of indeterminate results and number of patients in the study (p = 0.024) but failed to reach statistical significance with other variables tested. Indeterminate bone scan for staging of prostate cancer was insufficiently reported in clinical trials. In the case of indeterminate scans, most studies provided adequate measures to obtain the final status of the patients. View Full-Text
Keywords: bone neoplasms; classification; diagnosis; prostatic neoplasms; radionuclide imaging bone neoplasms; classification; diagnosis; prostatic neoplasms; radionuclide imaging

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Petersen, L.J.; Strandberg, J.; Stenholt, L.; Johansen, M.B.; Zacho, H.D. Reporting and Handling of Indeterminate Bone Scan Results in the Staging of Prostate Cancer: A Systematic Review. Diagnostics 2018, 8, 9.

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