Contribution of alkaline phosphatase in the detection of “Superscan” finding in bone scintigraphy


ERTÜRK S. A.

ANNALS OF CLINICAL AND ANALYTICAL MEDICINE, vol.14, no.10, pp.939-942, 2023 (ESCI) identifier

Abstract

Aim: Distant osteoblastic bone metastases are frequent manifestations of prostate cancer. Widespread bone metastases can occasionally give rise to uniform distribution of "Tc99m methylene diphosphonate" resulting in a nearly normal appearance on the bone scintigraphy. This situaition is defined as superscan, a finding that can be seen in some malignancies and some metabolic diseases. We think that alkaline phosphatase values, may be a parameter that can prevent erroneous evaluation in prostate cancer patients with extensive bone metastasis,"superscan" finding that can cause an appearance similar to normal bone scintigraphy. This study aimed to investigate the relationship between alkaline phosphatase levels and the superscan finding during the evaluation of bone scintigraphy images.Material and Methods: Prostate cancer patients who underwent bone scintigraphy in our unit between 2014 and 2022 were retrospectively scanned and those reported as "superscan" were selected. The relationship between serum ALP levels and the "Superscan" finding was evaluated and ROC analysis was performed. Results: When the bone scintigraphy images of the patients were evaluated, 12 had normal scintigraphy and 12 had superscan findings. While the mean ALP levels of the patients with superscan appearance in the bone scintigraphy were 515.17 +/- 476.71, the mean ALP levels of the patients whose bone scintigraphy was reported as normal were calculated as 83.58 +/- 25.41 (p=0.005). Discussion: ALP levels in patients who were reported as superscan during bone scintigraphy were found to be statistically significantly higher than in patients whose bone scintigraphy was reported as normal. Therefore, evaluation of ALP levels while reporting bone scintigraphy examinations by nuclear medicine specialists can greatly prevent false negative results in patients.