To determine the pattern of skeletal Metastases in prostate cancer patients using Radionuclide imaging

Prostate Cancer is a common disease which occurs all over the world, affecting males as young as those in their 40's and as many as 90% of those who are in their 90's. Skeletal metastasis is a common complication of ca prostate and is known to cause high morbidity and mortality.Scintigraphy is an imaging modality that is available and reveals the presence of disease prior to the appearance of any symptoms or structural expressions of the disease by providing information about the level of function within a body system unlike CT and plain radiography which provide structural information. Objectives: The aim of the study was to describe the distribution of skeletal metastases in patients with metastatic ca prostate. To determine the prevalence of bone metastases in patients with prostate cancer with no skeletal symptoms and to compare RNI findings with those of plain radiography in patients with bone metastases. Methods: A nine month cross-sectional descriptive study was carried out between May 2008 and January 2009 at MITC. All consecutive patients with a histological diagnosis of prostate cancer and evaluated using radiography and RNI for bone metastasis were included in the study after giving consent. Results: A total of 121 patients were recruited into the study over a period of one year. The age distribution of the patient was between 51 to 94 years with a mean age of 68.9 years. Majority were referred by the oncologist and surgeons. Using radionuclide it was established that the axial skeleton was the most commonly involved site in skeletal metastases at 80.9% of the cases while metastases to the appendicular skeleton were seen in 36.7% of the patients. Majority of the patients had multiple metastases. Conlusion: The study demonstrated that whole body mTc-MDP is a very effective way of determining the distribution of skeletal metastases in patients with prostate cancer. RNI should be included in the initial work-up of these patients. Plain radiography should be used to complement assessment areas of increased uptake. Primary health care providers should be sensitized about the potency of RNI as a modality during the management of ca prostate patients. Resources should also be mobilized to acquire gamma cameras to increase accessibility and reduce the cost of this crucial examination in the management of patients with prostate cancer.(author)