Prostate cancer bone metastases on staging prostate MRI: Prevalence and clinical features associated with their diagnosis Journal Article


Authors: Vargas, H. A.; Schor-Bardach, R.; Long, N.; Kirzner, A. N.; Cunningham, J. D.; Goldman, D. A.; Moskowitz, C. S.; Sosa, R. E.; Sala, E.; Panicek, D. M.; Hricak, H.
Article Title: Prostate cancer bone metastases on staging prostate MRI: Prevalence and clinical features associated with their diagnosis
Abstract: Purpose: Bone lesions on prostate MRI often raise concern about metastases. This study aimed to evaluate the prevalence of bone metastases on staging prostate MRI and evaluate associations between their MRI features and clinical/pathologic characteristics. Methods: Retrospective, IRB-approved study of 3765 patients undergoing prostate MRI for newly diagnosed PCa between 2000 and 2014. The reference standard to calculate the prevalence of bone metastases was bone biopsy and/or ≥1-year follow-up after MRI. In a subsample of 228 patients, the MRI characteristics of bone lesions were recorded by two radiologists independently. Associations between MRI and clinical/pathologic findings, including National Comprehensive Cancer Network (NCCN) risk categories, were calculated. Results: 57/3765 patients (1.5%, 95% CI 1.2–2.0%) had bone metastases. No patient with NCCN low-risk PCa (Gleason < 7, PSA < 10 ng/mL, cT1-2a) had bone metastases. In the subsample, ≥1 bone lesion was present on MRI in 74% (95% CI 0.67–0.79) and 72% (95% CI 0.66–0.78) of patients (R1 and R2). Larger lesion diameter (OR 1.33/1.19; p < 0.001 for both readers) and the absence of intralesional fat (OR 0.07/0.11; p = 0.004/0.002 for R1/R2) were significantly associated with bone metastases. Conclusion: Bone lesions are common in prostate MRI, but only rarely represent metastases. MRI should be interpreted in the context of clinical features that influence the likelihood of metastatic disease. © 2016, Springer Science+Business Media New York.
Keywords: staging; prostate cancer; imaging; detection; mri; bone metastases
Journal Title: Abdominal Radiology
Volume: 42
Issue: 1
ISSN: 2366-004X
Publisher: Springer  
Date Published: 2017-01-01
Start Page: 271
End Page: 277
Language: English
DOI: 10.1007/s00261-016-0851-3
PROVIDER: scopus
PMCID: PMC5247358
PUBMED: 27480976
DOI/URL:
Notes: Article -- Export Date: 2 February 2017 -- Source: Scopus
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MSK Authors
  1. Evis Sala
    94 Sala
  2. David M Panicek
    115 Panicek
  3. Chaya S. Moskowitz
    172 Moskowitz
  4. Hedvig Hricak
    330 Hricak
  5. Debra Alyssa Goldman
    92 Goldman
  6. Ramon Elias Sosa
    16 Sosa
  7. Niamh   Long
    11 Long