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Objective: Postoperative bone scintigraphies are not recommended at
PSA <20ng/ml. Our aim was to review our own practice in the last 3
years.
Materials and Methods: All patients who received a bone scintigraphy
between 2007 and 2010 as part of their workup before postoperative
radiotherapy were analysed. We retrospectively analysed the time since
operation, the PSA value at referral, the PSA dynamic from the last
measurement and the concurrent MRI scan for local or lymph node
abnormalities.
Results: Various reasons lead to bone scintigraphies even though this
typical criterion was not met in 13 patients. The reasons included: high
initial PSA, androgen suppression therapy, suspect lymph nodes on MRI,
large local recurrence, positive lymph nodes during operation, quick
PSA rise, over 5 years from last staging, high postoperative nadir and
high postoperative PSA. All bone scintigraphy scans were negative!
Conclusion: The reasons for performing a bone scintigraphy in these
situations were very heterogeneous. None of the analysed patients
fulfilled the previously mentioned criterion and all of their bone
scintigraphy scans were negative. Though the criteria were known,
intuition lead us to perform bone scintigraphies in selected cases. The
results of our small review demonstrate this to be an ineffective
approach. There is always room for individual decisions; however the
use of bone scintigraphies in the postoperative setting outside of typical
criteria should be used restrictively.