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Foto på Mattias Ohlsson

Mattias Ohlsson


Foto på Mattias Ohlsson

Bone Scan Index as an Imaging Biomarker in Metastatic Castration-resistant Prostate Cancer : A Multicentre Study Based on Patients Treated with Abiraterone Acetate (Zytiga) in Clinical Practice


  • Mariana Reza Felix
  • Mattias Ohlsson
  • Reza Kaboteh
  • Aseem Anand
  • Ingela Franck Lissbrant
  • Jan-Erik Damber
  • Anders Widmark
  • Camilla Thellenberg-Karlsson
  • Lars Budäus
  • Thomas Steuber
  • Till Eichenauer
  • Per Wollmer
  • Lars Edenbrandt
  • Elin Trägårdh
  • Anders Bjartell

Summary, in English

Background Abiraterone acetate (AA) prolongs survival in metastatic castration-resistant prostate cancer (mCRPC) patients. To measure treatment response accurately in bone, quantitative methods are needed. The Bone Scan Index (BSI), a prognostic imaging biomarker, reflects the tumour burden in bone as a percentage of the total skeletal mass calculated from bone scintigraphy. Objective To evaluate the value of BSI as a biomarker for outcome evaluation in mCRPC patients on treatment with AA according to clinical routine. Design, setting, and participants We retrospectively studied 104 mCRPC patients who received AA following disease progression after chemotherapy. All patients underwent whole-body bone scintigraphy before and during AA treatment. Baseline and follow-up BSI data were obtained using EXINI BoneBSI software (EXINI Diagnostics AB, Lund, Sweden). Outcome measurements and statistical analysis Associations between change in BSI, clinical parameters at follow-up, and overall survival (OS) were evaluated using the Cox proportional hazards regression models and Kaplan-Meier estimates. Discrimination between variables was assessed using the concordance index (C-index). Results and limitations Patients with an increase in BSI at follow-up of at most 0.30 (n = 54) had a significantly longer median survival time than those with an increase of BSI >0.30 (n = 50) (median: 16 vs 10 mo; p = 0.001). BSI change was also associated with OS in a multivariate Cox analysis including commonly used clinical parameters for prognosis (C-index = 0.7; hazard ratio: 1.1; p = 0.03). The retrospective design was a limitation. Conclusions Change in BSI was significantly associated with OS in mCRPC patients undergoing AA treatment following disease progression in a postchemotherapy setting. BSI may be a useful imaging biomarker for outcome evaluation in this group of patients, and it could be a valuable complementary tool in monitoring patients with mCRPC on second-line therapies. Patient summary Bone Scan Index (BSI) change is related to survival time in metastatic castration-resistant prostate cancer (mCRPC) patients on abiraterone acetate. BSI may be a valuable complementary decision-making tool supporting physicians monitoring patients with mCRPC on second-line therapies.


  • Nuklearmedicin, Malmö
  • Institutionen för astronomi och teoretisk fysik - Har omorganiserats
  • Urologisk cancerforskning, Malmö
  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
  • EpiHealth: Epidemiology for Health








European Urology Focus






Artikel i tidskrift




  • Cancer and Oncology
  • Urology and Nephrology


  • Abiraterone acetate
  • Bone metastasis
  • Bone Scan Index
  • Castration-resistant prostate cancer




  • Nuclear medicine, Malmö
  • Urological cancer, Malmö


  • ISSN: 2405-4569