Bone Scan Results

[naturephotog]

I've been diagnosed with prostate cancer and am unfavorable intermediate. I just had a bone scan and trying to interpret the results. The results said there is focal activity seen in the left medial acetabulum, and there is urinary contamination partially overlapping the left inferior pubic ramus. Wondering if the focal activity could be from arthritis or is it more likely from cancer that has spread? The test did say that I have some degenerative pattern of uptake in my knees and shoulder, but it didn't say that for the left medial acetabulum. I was also wondering about the second part of the results. Also, what sort of tests typically follow a bone scan? Lastly, what do they call "hot spots" in bone scan results? Thanks all. They don't have anyone to read the results with me until late next week and I don't have that kind of patience.

[Tall_Allen]

You are quite right to question the bone scan findings. As you know, a bone scan can only tell you that the bone has overgrown in that spot, but whether the overgrowth is a result of a previous injury, arthritis, or prostate cancer is unknown. That's why it is always done together with a CT scan or an MRI. The CT will enable the radiologist to more closely inspect the condition of the bone and make a more probable assessment. You have to wait for the full radiology report.

If it looks suspicious to the radiologist, you may want to get more definitive imaging with a NaF18 PET/CT (twice as sensitive for bone metastases compared to a PSMA PET scan), or, if you really need to be sure, you can have a biopsy done by an interventional radiologist.

If there are just one or two bone metastases, you will probably want to go ahead with prostate radiation:

prostatecancer.news/2018/09...

If there are no bone metastases, I recommend you consider this randomized clinical trials:

clinicaltrials.gov/ct2/show...

[naturephotog in reply to Tall_Allen]

Thanks Tall_Allen. I really appreciate the reply and feedback. That's great info to take with me to my radiologist appointment.

[Hidden]

There are a lot of in betweens in interpreting scans. If they didn’t use the word metastasis I think that’s a good sign. What is your PSA? Usually, but not always, bone metastasis has a higher PSA. The Impression paragraph usually has the conclusions. As in I recently had a DEXA bone scan and it said:

IMPRESSION:

Normal spine BMD.

Normal hip BMD.

[naturephotog in reply to Hidden]

Thanks Anomalous. That does make me feel better. My last PSA was about 9.4, which is high, but not crazy high. No doubt I have more scans in my future, but I am glad the report didn't mention metastasis specifically.

[doc1947g]

I am 75 y.o. and diagnosted as unfavorable intermediate.Dow you see approchement of the disease:

*Treatments*

*(2020/04/04). Casodex 50mgX30 jours.

ADT for 24weeks (2020/05/31)+(2020/08/24)Lupron Depot 22.5mg/12weeks X 2

VMAT-RT 3Gy X 20 fx (2020/06/08 - 2020/07/07)

*Testosterone*

*Testosterone 1 nmol/L - 28.8184 ng/dL, 15.40 nmol/L - 443.804ng/dL (3.0 à 27.4nmol/L 86.455 à 789.625ng/dL), Level under-castration = <0.7nmol/L - <20.189ng/dL

*Pre-ADT = 10.30nmol/L - 294.19ng/dL (2020/05/04), 15.2nmol/L - 438.04ng/dL (2020/05/27),

*Post-ADT = <0.2nmol/L - <5.768ng/dL(2020/07/29), <0.2nmol/L - <5.768ng/dL (2020/09/15), 0.3nmol/L - 8.6455ng/dL(2020/12/15), 0.4nmol/L - 11.356ng/dL (2021/02/11), 6.6nmol/L - 190.357ng/dL(2021/03/12), Testo Biodisponible 0.8nmol/L(3.5-15)(2021/05/28), 6.5nmol/L - 187.473NG/dL(2021/05/28), 4.0 nmol/L - 115.2737 ng/dL (2021/08/31), Testo-Free 42pmol/L (182.0 - 670.0 pmol/L)(2022/03/09),

*APS*

* APS μg/L = 4.23 (2001/07/18), 2.2 (2002/07/23), 1.8 (2006/07/04), 2.2 (2008/09/22), 2.4 (2009/05/20), 2.05 (2011/08/26), 2.25 (2012/08/13), 2.05 (2013/08/06), 2.77 (2014/07/28), 3.84 (2015/07/06), 1.97 (2016/06/30), 3.89 (2017/06/13), 6.8 (2019/09/10), 11.7 (2019/10/28), 13.7 (2020/01/08), Biopyes 12 (2020/01/29), (16.7 (2020/03/02),

*Per-ADT = 20.4 (2020/04/06), 1.76 (2020/05/04), 8.58(2020/05/27),

*Post-ADT = 0.18(2020/07/29), 0.03(2020/09/15), 0.01(2020/12/15), <0.01(2021/02/11), 0.04 (2021/05/28), 0.03 (2021/08/31), 0.03 - Free=0.01 (2022/03/09),