Medical Oncology

, 35:148 | Cite as

Imaging of distant metastases of prostate cancer

  • Filippo PesapaneEmail author
  • Marcin Czarniecki
  • Matteo Basilio Suter
  • Baris Turkbey
  • Geert Villeirs
Review Article


The detection of distant metastases at the initial diagnosis of prostate cancer (PCa) establishes the treatment approach and has a prognostic value, nevertheless it is not well established. Since proposed staging approaches often contradict each other, we aimed to compare the current imaging techniques for staging of advanced PCa, including future applications of the most innovative methods. Conventional imaging techniques, including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) have been employed for metastatic staging (both N and M staging) of men with high-risk PCa, but surgical pelvic dissection remains the gold standard for N staging. However, functional MRI by using diffusion-weighted imaging, MR lymphography (MRL) with ultra-small paramagnetic iron oxide particles (USPIO), and hybrid PET/MRI imaging showed both high sensitivity and high specificity for nodal staging and depicting metastases. The standard of practice for M staging in PCa includes the radionuclide bone scan and targeted X-ray film, but their performance has generally been poor. Recently, MRI showed promising results with applications in both local and distant staging. Finally, with the development of new PET tracers, PET/CT and PET/MRI offer a combination of excellent pharmacokinetic characteristics, functional information, and precise anatomic localization and morphological correlation of tumor lesions.


Prostate cancer staging Imaging staging Lymph node metastases Bone metastases Hybrid imaging 



The authors state that this work has not received any funding.

Compliance with ethical standards

Conflict of interest

All the authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Ethics approval and consent to participate to the study

Institutional Review Board approval was not required because the research does not involve human populations or animals.

Statistics and biometry

No complex statistical methods were necessary for this paper.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Health SciencesPostgraduation School of Radiodiagnostic of MilanMilanItaly
  2. 2.Molecular Imaging Program, National Cancer InstituteNational Institutes of HealthBethesdaUSA
  3. 3.Department of Medical OncologyASST Sette laghiVareseItaly
  4. 4.Department of RadiologyGhent University HospitalGhentBelgium

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