By Dr Fergus Macbeth (Dir)

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Knudson G, Grinis G, Lopez-Majano V, Sansi P, Targonski P, Rubenstein M, Sharifi R & Guinan P (1991) Bone scan as a stratification variable in advanced prostate cancer. Cancer, 68: 316–320. Krejcarek SC, Chen MH, Renshaw AA, Loffredo M, Sussman B & D'Amico AV (2007) Prediagnostic prostate-specific antigen velocity and probability of detecting high-grade prostate cancer. Urology, 69: 515–519. Lin K, Szabo Z, Chin BB & Civelek AC (1999) The value of a baseline bone scan in patients with newly diagnosed prostate cancer.

0 ng/ml and an initially negative biopsy. J Urol, 174: 500–504. Eichler K, Hempel S, Wilby J, Myers L, Bachmann LM & Kleijnen J (2006) Diagnostic value of systematic biopsy methods in the investigation of prostate cancer: a systematic review. [Review] [42 refs]. J Urol, 175: 1605–1612. Engelbrecht MR, Jager GJ, Laheij RJ, Verbeek AL, van Lier HJ & Barentsz JO (2002) Local staging of prostate cancer using magnetic resonance imaging: a meta-analysis. , 12: 2294–2302. Fowler JE, Bigler SA, Miles D & Yalkut DA (2000) Predictors of first repeat biopsy cancer detection with suspected local stage prostate cancer.

Clinical Evidence Two systematic reviews (Abuzallouf et al. 2004 and NICE ‘Improving outcomes in urological cancers’ service guidance, 2002) looked at the role of radioisotope bone scans in the staging of men with newly diagnosed prostate cancer. Abuzallouf and co-workers summarised bone scan results by serum PSA level in men with newly diagnosed prostate cancer. Serum PSA level and risk of a positive bone scan were strongly correlated. The other review (NICE, 2002) concluded that PSA level was the best means of identifying those at risk of a positive bone scan and that men with PSA less than 10 ng/ml were unlikely to have a positive bone scan.

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