Radiofrequency Echographic Multi-Spectrometry for bone health assessment in prostate cancer patients receiving Androgen deprivation therapy: A prospective comparative observational study
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.