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Challenges in Clinical Prostate Cancer: Role of Imaging

¹ Division of Cancer Treatment and Diagnosis, Cancer Imaging Program, National Institutes of Health, National Cancer Institute, 6130 Executive Blvd., EPN Rm. 6058, Bethesda, MD 20852.
² Molecular Imaging Program, National Institutes of Health, National Cancer Institute, Bethesda, MD.
³ Department of Urology, Johns Hopkins University, Baltimore, MD.

OBJECTIVE. This article reviews a recent 2-day workshop on prostate cancer and imaging technology that was conducted by the Cancer Imaging Program of the National Cancer Institute. The workshop dealt with research trends and avenues for improving imaging and applications across the clinical spectrum of the disease.

CONCLUSION. After a summary of prostate cancer incidence and mortality, four main clinical challenges in prostate cancer treatment and management—diagnostic accuracy; risk stratification, initial staging, active surveillance, and focal therapy; prostate-specific antigen relapse after radiation therapy or radical prostatectomy; and assessing response to therapy in advanced disease—were discussed by the 55-member panel. The overarching issue in prostate cancer is distinguishing lethal from nonlethal disease. New technologies and fresh uses for established procedures make imaging effective in both assessing and treating prostate cancer.

Keywords: diffusion-weighted MRI • dynamic contrast-enhanced MRI • FDG PET imaging • functional imaging • high-intensity focused ultrasound imaging • MRI • prostate cancer imaging • SPECT

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