Abstract: |
The imaging of prostate cancer at different disease states has undergone a series of quantum leaps in the past decade. Imaging in prostate cancer serves, in part, the purpose of staging and risk-stratifying patients to formulate the most effective treatment plan with the least adverse side effects. However, traditional imaging techniques could only serve this role with significant limitations. Computed tomography (CT), for instance, has a size criterion of 1 cm for lymph nodes as threshold of raising suspicion for malignancy, which would not detect sub-centimeter or microscopic nodal disease often encountered on pathologic specimens. Traditional Tc-99 m methylene diphosphonate (MDP) bone scan limited by inherent single photon emission scintigraphic spatial resolution in the 1 cm range would fall short of delineating early bone metastases. Magnetic resonance imaging (MRI), despite its exquisite soft tissue resolution, faces challenges in identifying malignant lymph nodes in sub-centimeter range. The new paradigm of molecular imaging allows for detection of disease at a molecular level, at a stage where often no macroscopic structural abnormality can be demonstrated. It holds the promise of answering questions not sufficiently answered by conventional imaging and better characterizes prostate cancer at it different stages. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. |