IndicationOrganizationYearWordingPopulationGleasonPSAT stageOther
Initial stagingAUA, ASTRO, SUO2017“Should consider staging with bone scan” (expert opinion)Intermediate-risk7 or10–20 orT2b–T2c
“Should stage with bone scan” (clinical principle)High-risk≥8 or>20 orT3–T4
NCCN2018“Staging work-up with bone scan if”Intermediate-risk>10 andT2
“Staging work-up with bone scan if”High-risk≥8 or>20 orT3–T4
“Staging work-up with bone scan if”Bone symptom
ACR2017“May be appropriate”Intermediate-risk>10 andT2
“Usually appropriate”High-risk≥8 or>20 orT3–T4
“Usually appropriate”Bone symptom
SNMMI2017“May be appropriate”Low-riskElevated PAL
“May be appropriate”Intermediate-risk7 or10–20 orT2b–T2c
“Appropriate”Intermediate-risk7 and10–20 andT2b–T2c
“Appropriate”High-risk≥8 or>20 orT3–T4
“Appropriate”Bone symptom
Biochemical recurrence localization, restaging, posttreatment follow-upAUA, ASTRO2013“Restaging may be considered (Option; Grade C)”After radical prostatectomy
NCCN2018“Consider restaging with bone imaging”After radical prostatectomy
“Restaging with bone imaging if”After definitive radiation therapy
“Monitoring with bone scan every 6–12 mo if”Localized under observationBone symptom
“Monitoring with bone scan every 6–12 mo if”N1/M1 under systemic therapyBone symptom
ACR2017“May be appropriate”After radical prostatectomy
2017“May be appropriate”After nonsurgical treatment
“Usually appropriate”N1/M1 under systemic therapy
SNMMI2017“Appropriate”Treatment change is planned
“Appropriate”Bone symptom
“Appropriate”Before bone RNT
“Appropriate”Equivocal imaging findings
  • SNMMI = Society of Nuclear Medicine and Molecular Imaging; ACR = American College of Radiology; SUO = Society of Urologic Oncology; AUA =American Urological Association; ASTRO = American Society for Radiation Oncology; PAL = phosphatase alkaline; RNT = radionuclide therapy.