Radiofrequency Echographic Multi-Spectrometry for bone health assessment in prostate cancer patients receiving Androgen deprivation therapy: A prospective comparative observational study
TL;DR
Radiofrequency Echographic Multi-Spectrometry-derived BMD at the lumbar spine and femoral neck in men with PCa receiving ADT and in age- and body mass index-matched healthy controls supports the potential role of REMS as a radiation-free tool for identifying reduced axial BMD in men with PCa undergoing ADT.
Abstract
Androgen deprivation therapy (ADT), used in selected patients with prostate cancer (PCa), is associated with accelerated bone loss and increased fragility fracture risk. Radiofrequency Echographic Multi-Spectrometry (REMS) is a non-ionizing ultrasound-based technique for axial bone mineral density (BMD) assessment. To evaluate REMS-derived BMD at the lumbar spine and femoral neck in men with PCa receiving ADT and in age- and body mass index-matched healthy controls. In this cross-sectional study, 143 Caucasian men were enrolled between October 2023 and October 2024: 83 patients with histologically confirmed PCa receiving ADT for at least 6 months and 60 healthy controls. REMS scans were performed at the lumbar spine and femoral neck. Between-group differences in BMD, T-score, and Z-score were assessed using an unpaired t -test. Compared with controls, patients receiving ADT showed lower REMS-derived BMD at the lumbar spine (0.885 ± 0.08 vs. 0.945 ± 0.11 g/cm²; p = 0.007), corresponding to a 6.3% difference. Femoral neck BMD was also lower in the PCa group (0.691 ± 0.08 vs. 0.715 ± 0.10 g/cm²; p = 0.01), corresponding to a 3.4% difference. These findings are consistent with the known skeletal effects of ADT and support the potential role of REMS as a radiation-free tool for identifying reduced axial BMD in men with PCa undergoing ADT. Longitudinal monitoring assessments are ongoing to clarify the temporal relationship between ADT exposure and progressive bone loss.