2016, Number 2
Diagnostic concordance between visual and digital methods in detecting metastasis by bone gammagraphy in prostate cancer
Zapote-Hernández B, Cruz-Santiago JC, González-Vargas E, Jaramillo-Núñez A
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Language: Spanish
References: 9
Page: 111-119
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ABSTRACT
Objetive: identify the degree of diagnostic concordance between visual and digital analyses in detection of bone metastasis by bone gammagraphy in prostate cancer.Introduction: prostate cancer is the malignant neoplasm with highest incidence in men over 65 years of age. In Mexico approximately 14,200 new cases are diagnosed each year, which represent 11.7% of all new malignant tumors; of those, approximately 70% will develop metastasis in the course of the disease. Bone gammagraphy has been accepted as a means to identify bone metastases associated with several types of cancer, and therefore it is necessary to increase its sensitivity and specificity to ensure accurate diagnoses. One way to standardize diagnosis using the bone gammagram is using computerassisted techniques. This article shows the results obtained on making a comparison between the traditional visual method and a software enhanced visual method.
Material and Methods: an observational and analytic study was conducted at Centro Médico Nacional La Raza, from January 1 through December 31, 2015, which included 138 patients with prostate cancer. Using bone gammagram we visually detected, by means of software and by tomography, the presence or absence of metastasis. A comparison between the three methods was made and the kappa index was used to quantify the degree of diagnostic concordance between them.
Results: the visual method identified 73.19% of patients without metastasis and 26.81% with metastasis. Likewise, using software we obtained 82.16% of cases without metastasis and 17.39% with positive result. Analysis by computed tomography identified 83.33% of patients without metastasis and 16.67% with metastasis. To calculate the kappa maindex, the number of findings obtained by visual observation with the aid of three specialists was considered standard. Findings using the software and by tomography were compared against that standard. The degree of diagnostic concordance between the visual and software-assisted methods was 73%.
Conclusion: we consider acceptable the degree of diagnostic concordance between the visual and software-assisted methods, considering that this is the first time software is used to find bone metastasis. The results could improve when we are better familiarized with the use of the software. As an additional conclusion on the investigation, we find that bone metastasis is closely related to the value of the prostate-specific antigen given that the higher it is the greater the probability that bone metastasis is present; we observed that the incidence of metastasis was higher in patients with more than 10 ng/mL, which is consistent with the findings reported in the specialized literature.
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