Percentage of the positive area of bone metastasis is an independent predictor of disease death in advanced prostate cancer

Br J Cancer. 2003 Jan 27;88(2):195-201. doi: 10.1038/sj.bjc.6600715.


We addressed in this study whether quantifying the extent of disease on bone scans can predict the disease death of patients with advanced prostate cancer using computer-assisted image analysis. Pretreatment radionuclide bone scans were reviewed in 56 patients with bone metastases from prostate cancer, and the percentage of the positive area on a bone scan (%PABS) was quantified automatically using a personal computer with the NIH Image program for estimation of the accurate extent of metastatic bone lesions on a bone scan. The significance of the %PABS as well as the other known prognostic factors was evaluated using univariate and multivariate Cox proportional hazards analysis. In univariate regression analysis, the %PABS (P=0.0155), serum alkaline phosphatase (P=0.0272), the tumour grade based on biopsy (P=0.044) and the number of bone lesions on bone scans (P=0.0388) were well associated with disease-specific survival. In multivariate analysis, the %PABS (P=0.0155, relative risk ratio 2.603), but not the other factors, was the independent predictor of the disease death. These results suggest that the %PABS is a novel parameter for predicting the prognosis of patients with advanced prostatic cancer.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / metabolism
  • Adenocarcinoma / mortality*
  • Adenocarcinoma / secondary
  • Aged
  • Alkaline Phosphatase / metabolism
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / metabolism
  • Bone Neoplasms / mortality*
  • Bone Neoplasms / secondary
  • Humans
  • Male
  • Prognosis
  • Prostate-Specific Antigen / metabolism
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / metabolism
  • Prostatic Neoplasms / mortality*
  • Prostatic Neoplasms / pathology
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Tomography, Emission-Computed


  • Alkaline Phosphatase
  • Prostate-Specific Antigen