Osseous scintigraphy in prostate cancer:results of a national inquiry

A national inquiry has been conducted in order to establish precise methodology of realization, criteria of image interpretation and indications of osseous scintigraphy in the initial examination and surveillance of prostate cancers. A questionnaire was formulated by a group of 5 nuclear medicine specialists and afterwards addressed to all the concerned services. Each regional official representative of the 'Societe Francaise de Medicine Nucleaire' was charged to sort out the answers, to draw up a synthesis and to address it to the 5 national 'experts'. In the framework of a national gathering these experts have reported the analysis of answers what allowed, after discussions, to prepare recommendations. Seventy percent of answers were received and 50% of answers were evaluable. In France around 10% of the osseous scintigraphies are performed in the frame of prostate cancer investigations. Discrepancies exist concerning the examination methodology. Concerning the interpretation of images the answers are more homogeneous. The recommendations adopted concerned the sweeping speed, the interest for certain pictures, the particular incidences for urinary bladder, taking in charge the patients, etc. The second part of questionnaire regards the osseous scintigraphy in the initial state evaluation and in the patients' follow-up. Not in all regions the initial examination is systematic. A consensus was not yet established but the scintigraphy appears to be largely advisable in the initial state evaluation. In contrast, in the surveillance the osseous scintigraphy must not be systematic; it is achieved only as a new clinical element or if the serum concentration of the PSA increases. The result could originate in a therapeutic adaptation