In asymptomatic patients with unfavorable intermediate risk prostate cancer and a PSA <10, how helpful/reliable and clinically useful is bone imaging?  

Bone scans amazingly are still something we discuss, and I imagine when we look back in 5 years at this question (at least I hope), people would think it is unthinkable to order a bone scan for intermediate risk with PSA <10 (let alone in localized PCa) instead of MRI and/or PSMA PET/CT.10 years ...

I agree with Dr. @Spratt. The incidence of finding metastatic cancer to bone in a patient with a Gleason score less than 8 and a PSA less than 10 is too low to warrant obtaining a bone scan routinely in this patient population. The incidence of bone scan positivity in patients with Gleason scores le...