THE ROLE OF BONE SCINTIGRAPHY PERFORMED WITH TECHNETIUM-99m MDP IN THE MONITORING PATIENTS TREATED FOR PROSTATE CANCER

Karcinom prostate čini čak 60% koštanih metastaza u muškaraca. Scintigrafija pomaže u dijagnozi, ocjenjivanju i evaluaciji odgovora na kemoterapiju koštanih tumora. Scintigrafija kostiju se pokazala znatno superiornija u odnosu na radiograme i preciznije od određivanja kisele fosfataze u otkrivanju koštanih metastaza. Cilj istraživanja je ustvrditi ulogu scintigrafije skeleta u postupku dijagnostičke obrade i praćenja bolesnika s karcinomom prostate, usporediti PSA i Gleason score kod bolesnika bez patološkog nakupljanja, s onima s jednim patološkim fokusom i onima koji imaju više patoloških fokusa. Istraživanje je retrospektivno i obuhvaća muškarce s karcinomom prostate koji su imali podatke vrijednosti PSA i Gleason scorea tijekom 2018. god. Podaci su uzeti iz povijesti bolesti arhiviranih na Kliničkom zavodu za nuklearnu medicinu KBC-a Split. Istraživanje je provedeno na 101-om ispitaniku podijeljenom u tri skupine od kojih je jedna bez patološkog nakupljanja radiofarmaka, druga ima jedan patološki fokus, a treća ima više patoloških fokusa nakupljenog radiofarmaka u skeletu. Statističkom analizom utvrđeno je da postoji statistički značajna razlika u razini PSA i Gleason score-a kod bolesnika bez patološkog fokusa i onih bolesnika s patološkim fokusom, dok razlika u bolesnika s jednim patološkim fokusom i onih sa više patoloških fokusa nije statistički značajna. Uz prethodno dobivene rezultate, informacije o cijeni same pretrage usporedno sa drugim dijagnostičkim metodama scintigrafija skeleta je dobra metoda u praćenju tijeka bolesti. Scintigrafija skeleta nije opravdana u slučajevima bez simptoma bolesti, ali je dobar pokazatelj u procjeni koštanih presadnica zbog svoje visoke osjetljivosti, mogućnosti uvida u cijeli skelet u vrlo kratkom roku kod bolesnika koji imaju simptome bolesti ili laboratorijske pretrage ukazuju na to.Prostate cancer accounts for as much as 60% of bone metastases in men. Scintigraphy assists in the diagnosis, evaluation, and evaluation of responses to bone tumor chemotherapy. Bone scintigraphy proved to be significantly superior to radiographs and more accurate than acid phosphatase determination in the detection of bone metastases. The aim of the study is to establish the role of skeletal scintigraphy in the process of diagnostic processing and monitoring of prostate cancer patients, to compare PSA and Gleason score in patients without pathological accumulation, with those with one pathological focus and those with multiple pathological foci. The study is retrospective and includes men with prostate cancer who had PSA and Gleason score data during 2018. The data were taken from the history of diseases archived at the Clinical Institute of Nuclear Medicine of the Clinical Hospital Center Split. The study was conducted on 101 subjects divided into three groups, one of which had no pathological accumulation of radiopharmaceuticals, the second had one pathological focus, and the third had multiple pathological foci of the accumulated radiopharmaceutical in the skeleton. Statistical analysis showed that there was a statistically significant difference in the level of PSA and Gleason score in patients without pathological focus and those with pathological focus, while the difference in patients with single pathological focus and those with multiple pathological foci was not statistically significant. In addition to the previously obtained results, information on the cost of the examination itself, in comparison with other diagnostic methods, skeletal scintigraphy is a good method in monitoring the course of the disease. Skeletal scintigraphy is not justified in cases without symptoms of the disease, but is a good indicator in the assessment of bone grafts due to its high sensitivity, the possibility of insight into the entire skeleton in a very short time in patients with symptoms or laboratory tests indicate this