PURPOSE OF REVIEW: High-risk prostate cancers (PCa), that is, those with prostate-specific antigen greater than 20 ng/dl, Gleason Score of at least 8, or extraprostatic spread, are nowadays commonly treated by surgery and radiotherapy combined with a fixed period of systemic treatment.
Implementing these strategies requires an exhaustive assessment of metastatic spread. This review addresses the latest development in integrated imaging techniques.
RECENT FINDINGS: In contrast to the progress that has been made in PCa treatment, diagnostic strategies have not much evolved. Most guidelines still recognize Tc bone scintigraphy and computed tomography (CT) as cornerstone modalities to assess metastatic spread in bones and lymph nodes. Therefore, modern imaging techniques should primarily focus on these two targets. PET with various tracers, including 11C or 18F-choline and 18F-sodium fluoride, and MRI with or without diffusion-weighted imaging are competing to supplant bone scan and CT scan as reference imaging techniques. This review focuses on the latest development of these techniques and analyses their potential impact in everyday urology practice.
SUMMARY: Although certain hurdles remain, PET and whole-body MRI have the ability to supplant Tc bone scan and CT as upfront test to assess metastatic spread in high-risk PCa.
Lecouvet FE, Lhommel R, Pasoglou V, Larbi A, Jamar F, Tombal B. Are you the author?
Radiology Department bNuclear Medicine Division cUrology Division, Cliniques universitaires Saint Luc, Institut de Recherche Clinique (IREC), Centre du Cancer, Université Catholique de Louvain, Brussels, Belgium.
Reference: Curr Opin Urol. 2013 Apr 24. Epub ahead of print.