Bone scan use in the management of metastatic castration-resistant prostate cancer: Survey of practice patterns among Canadian radiation oncologists, medical oncologists, and urologists

The use of skeletal scintigraphy with technetium-99 methylene diphosphonate (hereafter referred to as a bone scan) for evaluating response to systemic treatment in men with metastatic castration-resistant prostate cancer (mCRPC) is an evolving paradigm in this era of advancing therapies and imaging techniques. Indeed, the interpretation of bone scans can be challenging, and there is a growing expectation that advanced imaging techniques such as prostate-specific membrane antigen positron emission tomography/computer tomography (PSMA PET/CT) may play a complementary role.1 The Prostate Cancer Working Group (PCWG) has outlined specific criteria to define disease progression with respect to bone scans performed as part of clinical trials.2 However, there is no high-level evidence for the scheduling and interpretation of bone scans during routine therapeutic interventions for mCRPC. Thus, patterns of bone scan use are variable and practice-dependent outside of clinical trials.