Whole-body low-dose CT can be of value in prostate cancer decision-making: a retrospective study on 601 patients

Abstract Objectives To evaluate the diagnostic value of whole-body low-dose computed tomography (CT) to detect bone metastasis in prostate cancer (PCa) patients and its possible utility therapeutic decision-making. Also, determine valuable CT features for lesion characterisation. Methods This IRB-approved retrospective study reviewed PCa who underwent 68 Ga-PSMA PET/CT our centre from March 2017 August 2022. Two board-certified radiologists one nuclear medicine specialist reported all scans separately, unaware Ga-PSMA-PET results. The per-lesion per-patient performances were calculated. significance was evaluated. Moreover, inter-observer agreement analysed. A two-tailed p < 0.05 considered significant. Results From 727 patients, 601 (mean age = 68.7 ± 8.1) found be eligible, including 211 (35.1%) referrals initial staging 390 (64.9%) evaluating extent disease after biochemical recurrence. Per-patient analysis three reviewers showed 81.0–89.4% sensitivity 96.6–98.5% specificity detecting osteo-metastasis. It able correctly high-burden based on both CHAARTED LATITUDE criteria. Regarding underlying features, size > 1 cm, ill-defined borders, presence soft-tissue component, cortical destruction statistically favour metastasis. Hu 900 benign entities with 93% specificity. Conclusions Although not as accurate PET/CT, might precisely classify considering Additionally, we proposed that could help better characterisation detected lesions. Critical relevance statement can clinical decision-making patients. modality may obviate performing multiple imaging sessions high-cost diagnosed disease. Graphical abstract