In castration-resistant prostate cancer (CRPC), early detection of metastases is essential for the selection of treatment, and prevention of bone complications. However detecting incipient metastases remains a challenge as the conventional radiological tests (bone scintigraphy or computerised tomography) lack sufficient sensitivity. Diagnostic imaging techniques are currently available that have greater sensitivity and specificity, but are little used due to shortfalls in the recommendations.
To create an algorithm that indicates the most suitable diagnostic imaging techniques for the different M0 CRPC patient profiles based on the scientific evidence.
Meetings were held with eight experts in Urology, Pathological Anatomy, Radiodiagnostics and Nuclear Medicine organised by the Andalusian Association of Urology, in which the recommendations and scientific evidence on each of the diagnostic imaging techniques were reviewed.
We present the current recommendations for the detection of metastasis in M0 CRPC patients, the patients that would benefit from early detection, and summarise the evidence to support the use of each of the new techniques.
Techniques such as 18F-Choline PET/CT or DWWB MRI and probably open MRI have been demonstrated to have good sensitivity and specificity for patients with low PSA (<10ng/ml). Their inclusion in routine clinical practice will help improve the early detection of metastasis in CRPC patients.
Actas urologicas espanolas. 2018 Aug 03 [Epub ahead of print]
A Juárez-Soto, J M Garín-Ferreira, A Rodríguez-Fernández, J L Tirado-Hospital, M T González-Serrano, J Moreno-Jiménez, R Medina-López, V Baena-González
Servicio de Urología, Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera, Cádiz, España. Electronic address: ., Servicio de Radiodiagnóstico, Hospital Universitario Carlos Haya, Málaga, España., Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España., Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España., Servicio de Anatomía Patológica, Hospital Universitario Reina Sofía, Córdoba, España., Servicio de Urología, Complejo Hospitalario de Jaén, Jaén, España., Servicio de Urología, Hospital Universitario Virgen del Rocío, Sevilla, España., Servicio de Urología, Hospital Universitario Carlos Haya, Málaga, España.