Approximately 15% of men with newly diagnosed prostate cancer have high-risk disease. Imaging is critically important for the diagnosis and staging of these patients, and also for the selection of management.
While established prostate cancer staging guidelines have increased the appropriate use of imaging, underuse for high-risk prostate cancer remains substantial. Several factors affect the utility of initial diagnostic imaging, including the variable definition of high-risk prostate cancer, variable guideline recommendations, poor accuracy of existing imaging tests, and the difficulty in validating imaging findings. Conventional imaging modalities, including CT and radionuclide bone scan, have been employed for local and metastatic staging, but their performance characteristics have generally been poor. Emerging modalities including multiparametricMRI, positron emission tomography (PET)-CT, and PET-MRI have shown increased diagnostic accuracy and could improve accuracy in staging patients with high-risk prostate cancer.
Nature reviews. Urology. 2015 Oct 20 [Epub ahead of print]
Marc A Bjurlin, Andrew B Rosenkrantz, Luis S Beltran, Roy A Raad, Samir S Taneja
Division of Urologic Oncology, Department of Urology, New York University Langone Medical Center, New York, NY 10016, USA. , Department of Radiology, New York University Langone Medical Center, New York, NY 10016, USA. , Department of Radiology, New York University Langone Medical Center, New York, NY 10016, USA. , Department of Radiology, New York University Langone Medical Center, New York, NY 10016, USA. , Division of Urologic Oncology, Department of Urology, New York University Langone Medical Center, New York, NY 10016, USA.