Patients who are at low risk of metastatic disease, defined by criteria based on prostate-specific antigen (PSA) and Gleason score, do not need a bone scan for staging. Bone scans may be useful if there are findings in the patient’s history or physical examination, which raise the suspicion of bony involvement.
Sources:
Abuzallouf S, et al. Baseline staging of newly diagnosed prostate cancer: a summary of the literature. J Urol. 2004 Jun;171(6 Pt 1):2122-7. PMID: 15126770.
Choosing Wisely. American Urological Association: Five Things Physicians and Patients Should Question [Internet]. 2013 Feb [cited 2015 Mar 16].
Eberhardt SC, et al. ACR Appropriateness Criteria prostate cancer–pretreatment detection, staging, and surveillance. J Am Coll Radiol. 2013 Feb;10(2):83-92. PMID: 23374687.
Heidenreich A, et al. EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 2014 Jan;65(1):124-37. PMID: 24207135.
Kim L, et al. Are staging investigations being overused in patients with low and intermediate risk prostate cancer? J Med Imaging Radiat Oncol. 2015 Feb;59(1):77-81. PMID: 25186469.
Makarov DV, et al. The population level prevalence and correlates of appropriate and inappropriate imaging to stage incident prostate cancer in the medicare population. J Urol. 2012 Jan;187(1):97-102. PMID: 22088337.
Wollin DA, et al. Guideline of Guidelines: Prostate Cancer Imaging. BJU Int. 2015 Feb 26. PMID: 25715887.