Advances in imaging in the postoperative patient with a rising prostate-specific antigen level.

Abstract:

:Imaging prostate cancer continues to represent a clinical challenge for both primary and recurrent disease. In the evaluation of the persistent/recurrent/metastatic prostate cancer, knowledge of cancer location (local v distant), size, and extent are essential in order to design a treatment, tailored to each patient's needs. There are evidence-based guidelines for the use of imaging in assessing the presence of distant spread of prostate cancer. Radionuclide bone scans and computed tomography (CT), magnetic resonance imaging (MRI), and/or positron emission tomography (PET) supplement clinical and biochemical evaluations (prostate-specific antigen [PSA]) for suspected metastatic disease to bones and lymph nodes. There is no consensus about the use of imaging in the evaluation of local tumor recurrence. The use of ultrasound has been limited to biopsy guidance of the prostatic bed, or percutaneous biopsy of enlarged lymph nodes detected on CT or MRI. The use of MRI is evolving. Recent studies indicate that the use of MRI provides valuable information in the evaluation of local tumor recurrence, and nodal and bony metastases. In a patient post-radiation therapy, the method of combining MRI anatomic information with MR spectroscopic metabolic information is evolving. Another modality offering information about anatomy and metabolism of the local disease is PET/CT. The value of PET/CT at present is controversial, but new studies exploring the role of PET/CT in aggressive prostate cancer are promising.

journal_name

Semin Oncol

journal_title

Seminars in oncology

authors

Hricak H,Schöder H,Pucar D,Lis E,Eberhardt SC,Onyebuchi CN,Scher HI

doi

10.1016/s0093-7754(03)00359-2

subject

Has Abstract

pub_date

2003-10-01 00:00:00

pages

616-34

issue

5

eissn

0093-7754

issn

1532-8708

pii

S0093775403003592

journal_volume

30

pub_type

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