Despite the frequent statement that "most men die with prostate cancer, not of it," the reality is that prostate cancer is second only to lung cancer as a cause of death from malignancy in American men. The primary goal during baseline evaluation of prostate cancer is disease characterization, that is, establishing disease presence, extent (local and distant), and aggressiveness. Prostate cancer is usually diagnosed after the finding of a suspicious serum prostate-specific antigen level or digital rectal examination. Tissue diagnosis may be obtained by transrectal ultrasound-guided biopsy or MRI-targeted biopsy. The latter requires a preliminary multiparametric MRI, which has emerged as a powerful and relatively accurate tool for the local evaluation of prostate cancer over the last few decades. Bone scintigraphy and CT are primarily used to detect bone and nodal metastases in patients found to have intermediate- or high-risk disease at biopsy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Journal of the American College of Radiology : JACR. 2017 May [Epub]
Expert Panel on Urologic Imaging: , Fergus V Coakley, Aytekin Oto, Lauren F Alexander, Brian C Allen, Brian J Davis, Adam T Froemming, Pat F Fulgham, Keyanoosh Hosseinzadeh, Christopher Porter, V Anik Sahni, David M Schuster, Timothy N Showalter, Aradhana M Venkatesan, Sadhna Verma, Carolyn L Wang, Erick M Remer, Steven C Eberhardt
Principal Author, Oregon Health & Science University, Portland, Oregon. Electronic address: ., Panel Vice-Chair, University of Chicago, Chicago, Illinois., Emory University Hospital, Atlanta, Georgia., Duke University Medical Center, Durham, North Carolina., Mayo Clinic, Rochester, Minnesota., Urology Clinics of North Texas, Dallas, Texas; American Urological Association., Wake Forest University School of Medicine, Winston Salem, North Carolina., Virginia Mason Medical Center, Seattle, Washington; American Urological Association., Brigham & Women's Hospital, Boston, Massachusetts., University of Virginia, Charlottesville, Virginia., University of Texas MD Anderson Cancer Center, Houston, Texas., University of Cincinnati Medical Center, Cincinnati, Ohio., University of Washington, Seattle Cancer Care Alliance, Seattle, Washington., Specialty Chair, Cleveland Clinic, Cleveland, Ohio., Panel Chair, University of New Mexico, Albuquerque, New Mexico.