What is the role of imaging studies in the workup of prostate cancer?

Updated: Jan 15, 2019
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Computed tomography (CT) scanning: To assess extension into the bladder and lymph nodes for staging the cancer or for considering pretreatment lymph node sampling

Endorectal magnetic resonance imaging (MRI): To localize cancer within the prostate and seminal vesicles; to help in local staging

Bone scanning: To evaluate bone metastasis

MRI: To determine the etiology of questionable lesions found on bone scans

Transrectal ultrasonography: To examine the prostate for hypoechoic areas, which are commonly associated with cancers but are not specific enough for diagnostic purposes

Men with PSA levels above 10 ng/mL, high-grade histology (Gleason score of ≥7), or physical findings suggesting stage T3 disease should probably undergo a staging CT scan and bone scan. Neither CT scanning nor MRI can be used to determine if lymph nodes are reactive or contain malignant deposits, unless the nodes are significantly enlarged and a percutaneous biopsy can be performed.

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