Key Points
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Accurate prostate cancer diagnosis and staging is crucial to plan the most appropriate and tailored treatment
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Serum PSA level can identify disease, but not localize the site of local and distant disease
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Conventional morphological imaging modalities, such as transrectal ultrasonography (TRUS), CT, and MRI, are associated with some limitations in staging prostate cancer
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Morphofunctional imaging, such as PET–CT, which provides molecular characterization of prostate cancer, could overcome some of the limitations of conventional imaging modalities
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Choline-PET–CT represents the most established whole-body molecular imaging modality for prostate cancer diagnosis and staging
Abstract
An early and correct diagnosis together with accurate staging of prostate cancer is necessary in order to plan the most appropriate treatment strategy. Morphological imaging modalities such as transrectal ultrasonography (TRUS), CT, and MRI can have some limitations regarding their accuracy for primary diagnosis and staging of prostate cancer; for instance, they have limited specificity in differentiating cancer from benign prostatic conditions and, by using size as the only criterion to characterize lymph node metastases, they might not be accurate enough for tumour characterization. In this scenario, PET–CT with 11C-labelled or 18F-labelled choline derivatives provides morphological and functional characterization and could overcome the limitations of the conventional imaging techniques. PET–CT is one of the most investigated molecular imaging modalities for prostate cancer diagnosis and staging. Currently, the main investigations on the role of PET–CT in the diagnosis and staging of prostate cancer have been performed on a retrospective basis and this type of analysis might be one of the main reasons why different results regarding its diagnostic accuracy have been reported.
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Mapelli, P., Picchio, M. Initial prostate cancer diagnosis and disease staging—the role of choline-PET–CT. Nat Rev Urol 12, 510–518 (2015). https://doi.org/10.1038/nrurol.2015.191
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DOI: https://doi.org/10.1038/nrurol.2015.191
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