Imaging Techniques in the Diagnosis and Pelvic Staging of Prostatic Cancer

  • P. N. Bretan
  • R. D. Williams
Part of the Clinical Practice in Urology book series (PRACTICE UROLOG)


The initial diagnosis of prostatic cancer has typically relied on digital rectal examination which is, compared with other screening modalities, a noninvasive, cost effective, and highly reliable screening technique (Guinan et al. 1980; Chodak and Schoenberg 1984). Despite these advantages, over 50% of cases of prostatic cancer are diagnosed only after the disease has progressed beyond curability. Because earlier detection would allow institution of curative therapy, the search for imaging modalities capable of detecting intraprostatic lesions and delineating local extension has been extensive. This review focuses both on current imaging methods and on those likely to be useful in the future for the diagnosis and pelvic staging of prostatic cancer.


Magnetic Resonance Imaging Prostatic Cancer Benign Prostatic Hyperplasia Magnetic Resonance Spectroscopy Pelvic Lymph Node 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bartsch G, Egender G, Hubscher H et al. (1982) Sonometrics of the prostate. J Urol 127: 1119–1121PubMedGoogle Scholar
  2. Beaney RP (1984) Positron emission tomography in the study of human tumors. Semin Nucl Med 14: 324–341PubMedCrossRefGoogle Scholar
  3. Bottomley PA (1983) Nuclear magnetic resonance: beyond physical imaging. IEEE Spectrum 20 (2): 32–38Google Scholar
  4. Brasch RC, London DA, Wesbey GE et al. (1983) Work in progress: nuclear magnetic resonance study of a paramagnetic nitroxide contrast agent for enhancement of renal structures in experimental animals. Radiology 147: 773–779PubMedGoogle Scholar
  5. Brasch RC, Weinemann HJ, Wesbey GE (1984) Contrast-enhanced NMR imaging: animal studies using gadolinium-DTPA complex. AJR 142: 625–630PubMedGoogle Scholar
  6. Brooman PJC, Griffiths GJ, Roberts E (1981) Per rectal ultrasound in the investigation of prostatic disease. Clin Radiol 32: 669–676PubMedCrossRefGoogle Scholar
  7. Bryan PJ, Butler HE, Lipuma JP (1983) NMR scanning of the pelvis: initial experience with a 0.3T system. AJR 141: 1111–1118PubMedGoogle Scholar
  8. Bryan PH, Butler HE, Lipuma JP (1984) Magnetic resonance imaging of the pelvis. Radiol Clin North Am 22: 897–915PubMedGoogle Scholar
  9. Budinger TF, Lauterbur PC (1984) Nuclear magnetic resonance technology for medical studies. Science 226: 288–298PubMedCrossRefGoogle Scholar
  10. Buonocore E, Hesemann C, Pavlicek W, Montie (1984) Clinical and in vitro magnetic resonance imaging of prostatic carcinoma. AJR 143: 1267–1272Google Scholar
  11. Burks DD, Drolshogen LF, Fleischer AC et al. (1986) Transrectal sonography of benign and malignant prostatic lesions. AJR 146: 1187–1191PubMedGoogle Scholar
  12. Carpenter PJ, Schroder FH (1984) Transrectal ultrasonography in the followup of prostatic carcinoma patients: a new prognostic parameter. J Urol 131: 903–905Google Scholar
  13. Che TM, Kuriyama M, Johnson E et al. (1984) Circulating antibody to prostate antigen in patients with prostate cancer. Transplant Proc 16: 481–485Google Scholar
  14. Chodak GW, Schoenberg HW (1984) Early detection of prostate cancer by routine screening. JAMA 252: 3261–3264PubMedCrossRefGoogle Scholar
  15. Correa RJ, Kidd CR, Burnett L et al. (1981) Percutaneous pelvic lymph node aspiration in carcinoma of the prostate. J Urol 126: 190–191PubMedGoogle Scholar
  16. Dahnert WF, Hamper UM, Eggleston JC et al. (1986) Prostatic evolution by transrectal sonography with histopathologic correlation: the echopenic appearance of early carcinoma. Radiology 158: 97–102PubMedGoogle Scholar
  17. Demas BE, Hricak HH, Williams RD (1985) Magnetic resonance imaging in the evaluation of urologic malignancies. Semin Urol 3: 27–33PubMedGoogle Scholar
  18. Denkhaus H, Dierkopf W, Grabbe E (1983) Comparative study of suprapubic sonography and computed tomography for staging of prostatic carcinoma. Urol Rad. 5: 1–9CrossRefGoogle Scholar
  19. Dooms GC, Hricak HH, Crooks LE et al. (1984) Magnetic resonance imaging of the lymph nodes: comparison with CT. Radiology 153: 181–188Google Scholar
  20. Efrimidis SC, Dan SJ, Nieburgs H et al. (1981) Carcinoma of the prostate: lymph node aspiration for staging. AJR 136: 489–492Google Scholar
  21. Egender G, Rapf C, Feichtenger I et al. (1984) Comparative histopathologic and sonomorphological prostate studies. ROFO 140: 60–66PubMedCrossRefGoogle Scholar
  22. Ehman RL, Wesbey GE, Moon KL et al. (1985) Enhanced MRI of tumors utilizing a new nitroxyl spin label contrast agent. J MRI 3: 89–97CrossRefGoogle Scholar
  23. Emory TH, Reinke DB, Hill AL et al. (1983) Use of CT to reduce understaging in prostatic cancer: comparison with conventional staging techniques. AJR 141: 351–354PubMedGoogle Scholar
  24. Fair WR, Kadmon D (1983) Carcinoma of the prostate: diagnosis and staging. World J Urol 1: 3–11CrossRefGoogle Scholar
  25. Fornage BD, Touche DH, Deglaire M et al. (1983) Real-time ultrasound-guided prostatic biopsy using a new transrectal linear-array probe. Radiology 146: 547–550PubMedGoogle Scholar
  26. Fritzsche PJ, Axford PD, Ching VC, et al. (1983) Correlation of transrectal sonographic findings in patients with suspected and unsuspected prostatic disease. J Urol 130: 272–274PubMedGoogle Scholar
  27. Gammelguard J, Holm HH (1980) Transurethral and transrectal ultrasonic scanning in urology. J Urol 124: 863–868Google Scholar
  28. Golimbu M, Morales P, Al-Askori S et al. (1981) CAT scanning in staging of prostate cancer. Urology 18: 305–308PubMedCrossRefGoogle Scholar
  29. Gothlin JH, Hoien L (1980) Percutaneous fine-needle biopsy of radiographically normal lymph nodes in the staging of prostatic carcinoma. Radiology 141: 351–354Google Scholar
  30. Guinan P, Bush I, Ray V et al. (1980) The accuracy of rectal examination in the diagnosis of prostate carcinoma. N Engl J Med 303: 499–503PubMedCrossRefGoogle Scholar
  31. Harada K, Tanahashi Y, Igari D et al. (1980) Clinical evaluation of inside echo patterns in gray scale prostatic echography. J Urol 124: 216–220PubMedGoogle Scholar
  32. Holm HH, Juul N, Pederson JF (1983) Transperineal 125iodine seed implantation in prostatic cancer guided by transrectal ultrasonography. J Urol 130: 283–286PubMedGoogle Scholar
  33. Kadmon D, Mahle D, Heston WDW et al. (1985) Effect of estrogen and androgen administration on alpha DCMO-enhanced putrescine uptake by the rat prostate. Prostate 6: 343–349PubMedCrossRefGoogle Scholar
  34. Kidd R, Crane RD, Doil DH (1984) Lymphangiography and fine-needle aspiration biopsy: ineffective for staging early prostate cancer. AJR 142: 1007–1112PubMedGoogle Scholar
  35. Kohler G, Milstein C (1975) Continuous cultures of fused cells secreting antibody of predefined specificity. Nature 256: 495–497PubMedCrossRefGoogle Scholar
  36. Lee JKT, Heiken JP, Ling D et al. (1984) Magnetic resonance imaging of abdominal and pelvic lymphadenopathy. Radiology 153: 181–188PubMedGoogle Scholar
  37. Lee F, Gray JM, McCleary RD et al. (1986) Prostatic evolution by transrectal sonography: criteria of early diagnosis. Radiology 158: 91–95PubMedGoogle Scholar
  38. Levine MS, Arger PH, Coleman BG et al. (1981) Detecting lymphatic metastases from prostatic carcinoma: superiority of CT. AJR 137: 207–211PubMedGoogle Scholar
  39. Loening SA, Schmidt JD, Brown RC et al. (1977) A comparison between lymphangiography and pelvic node dissection in the staging of prostatic cancer. J Urol 117: 752–756PubMedGoogle Scholar
  40. Lowe DH, Handley HH, Schmidt J et al. (1984) A human monoclonal antibody reactive with human prostate. J Urol 132: 780–785PubMedGoogle Scholar
  41. McNeal JE (1968) Regional morphology and pathology of the prostate. Am J Clin Pathol 49: 347–357PubMedGoogle Scholar
  42. Merrin C, Wajsman Z, Baumgartner G et al. (1977) The clinical value of lymphangiography: Are the nodes surrounding the obturator nodes visualized? J Urol 117: 742–744Google Scholar
  43. Miller TR, Siegel BA, Fair WR et al. (1978) Imaging of canine tumors with uC-methyl-putrescine. Radiology 129: 221–223PubMedGoogle Scholar
  44. Morgan CJ, Hendee WR (1984) Magnetic resonsance spectroscopy. In: Morgan CJ, Hendee WR (eds) Introduction to magnetic resonance 9. Multimedia Publishing, Denver, p 125Google Scholar
  45. Morgan CL, Calkins RF, Cavalcanti EJ (1981) Computed tomography in the evaluation, staging and therapy of carcinoma of the bladder and prostate. Radiology 140: 751–761PubMedGoogle Scholar
  46. Moris JM, Evans AE, McLaughlin AC et al. (1985) 31P nuclear magnetic resonance spectroscopic investigation of human neuroblastoma in situ. N Engl J Med 312: 1500–1505Google Scholar
  47. Phelps ME, Mazziatta JC (1985) Positron emission tomography: human brain function and biochemistry. Science 228: 799–809PubMedCrossRefGoogle Scholar
  48. Pontes JE, Chu TM, Slack N et al. (1982) Serum prostatic antigen measurement in localized prostatic cancer: correlation with clinical course. J Urol 128: 1216–1218PubMedGoogle Scholar
  49. Poon PY, McCollum RW, Henkelman MM (1985) Magnetic resonance imaging of the prostate. Radiology 154: 143–149PubMedGoogle Scholar
  50. Prando A, Wallace S, Van Eschenbach AC et al. (1979) Lymphangiography in staging carcinoma of the prostate. Radiology 131: 641–645PubMedGoogle Scholar
  51. Pykett IL (1982) NMR imaging in medicine. Sci Am 246: 78–88PubMedCrossRefGoogle Scholar
  52. Rifkin MD, Kurtz AB, Goldberg BB (1983) Sonographically guided transperineal prostatic biopsy: preliminary experience with a longitudinal linear array transducer. AJR 140: 745–748PubMedGoogle Scholar
  53. Rifkin MD, Friedland GW, Shortliffe L (1986) Prostatic evaluation by transrectal endosonography: detection of carcinoma. Radiology 158: 85–90PubMedGoogle Scholar
  54. Ross B, Smith M, Marshall V et al. (1984) Monitoring responses to chemotherapy of intact human tumors by 31P nuclear magnetic resonance. Lancet 1: 641–646PubMedCrossRefGoogle Scholar
  55. Runge VM, Clanton JA, Herzer WA et al. (1984) Intravascular contrast agents suitable for magnetic resonance imaging. Radiology 153: 171–176PubMedGoogle Scholar
  56. Sawczuk IS, deVere White R, Gold R et al. (1983) Sensitivity of computed tomography in evaluation of pelvic lymph node metastases from carcinoma of bladder and prostate. Urology 21: 81–84PubMedCrossRefGoogle Scholar
  57. Shankagiri PG, Walsh JW, Hazra TA (1982) Role of computed tomography in the evaluation and management of carcinoma of the prostate. Int J Radiat Oncol Biol Phys 8: 283–287CrossRefGoogle Scholar
  58. Smith FW (1985) Nuclear magnetic resonance proton imaging in cancer. Eur J Clin Oncol 21: 379–387CrossRefGoogle Scholar
  59. Sobol RE, Dillman RO, Halpern S et al. (1983) Sero therapy and radio immunodetection of tumors with monoclonal antibodies. In: Molog PJ, Nicolson GL (eds) Cellular oncology—new approaches in biology, diagnosis and treatment. Praeger, New YorkGoogle Scholar
  60. Spirnak JP, Resnick MI (1984) Transrectal ultrasonography. Urology 23: 461–467PubMedCrossRefGoogle Scholar
  61. Steyn JH, Smith FW (1982) Nuclear magnetic resonance imaging of the prostate. Br J Urol 54: 726–728PubMedCrossRefGoogle Scholar
  62. Strand M, Scheinberg DA (1983) Monoclonal antibody conjugates for diagnostic imaging and therapy. In: Boss BD, Langman R, Towbridge I, Dulbecco R (eds) Monoclonal antibodies and cancer. Academic Press, New YorkGoogle Scholar
  63. Velthoven RV, Vandewalle JC, Lavieter-Nobre et al. (1984) Early diagnosis of prostatic carcinoma: advantages and limits of transrectal ultrasonic examinations. Abstract from 6th EAU Congress, CopenhagenGoogle Scholar
  64. Vessella RL, Chiou RK, Lange PH (1985) Monoclonal antibodies in urology: review of reactivities and applications in diagnosis, staging, and therapy. Semin Urol 3: 158–167PubMedGoogle Scholar
  65. Walsh JW, Amendola MA, Konerding KF et al. (1980) Computed tomographic detection of pelvic and inguinal lymph-node metastases from primary and recurrent pelvic malignant disease. Radiology 137: 157–166PubMedGoogle Scholar
  66. Watanabe H et al. (1968) Diagnostic application of the ultrasonotomography for the prostate. Jpn J Urol 59: 273–279Google Scholar
  67. Watanabe H, Saitoh M, Mishina T (1977) Mass screening program for prostatic disease with transrectal ultrasonotomography. J Urol 117: 746–748PubMedGoogle Scholar
  68. Weinerman PM, Arger PH, Pollack HM (1982) CT evaluation of bladder and prostate neoplasms. Urol Radiol 4: 105–114PubMedCrossRefGoogle Scholar
  69. Weinerman PM, Arger PH, Coleman BG et al. (1983) Pelvic adenopathy from bladder and prostate carcinoma: detection by rapid sequence computed tomography. AJR 140: 95–99PubMedGoogle Scholar
  70. Williams RD, Hricak HH (1984) Magnetic resonance imaging in urology. J Urol 132: 641–649PubMedGoogle Scholar
  71. Williams RD, Dunn V, Yousef MA, Brown RC (1986) Staging of pelvic malignancies by MRI. J Urol 135: 244AGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • P. N. Bretan
  • R. D. Williams

There are no affiliations available

Personalised recommendations