As opposed to Variants 1 and 2 in the setting of metastatic disease, chest CT becomes clinically relevant and is a first-line imaging modality for detection of pulmonary metastases. MRI Abdomen and Pelvis Local recurrence, even if present, becomes of lesser clinical importance in this setting, unless it is locally advanced and is causing urinary or bowel complications. MRI is capable of assessing response to metastatic nodal disease similar to CT based on size, with the addition of also being able to show functional changes. Post-ADT perfusion should greatly decrease with a positive response, and apparent diffusion coefficient values typically increase. Bone metastases can be followed for response by MRI as well in a similar way. In this clinical setting, the likelihood of metastatic disease outside the pelvis is increased. For example, liver metastases and nodal metastases in higher stations are most often seen in the setting of Variant 3. It is probable that coverage of the abdomen in addition to the pelvis would provide more benefit in this setting, but evidence is lacking. MRI Pelvis In this clinical setting, the likelihood of metastatic disease outside the pelvis is increased. For example, liver metastases and nodal metastases in higher stations are most often seen in the setting of Variant 3. It is probable that coverage of the abdomen in addition to the pelvis would provide more benefit, but evidence is lacking. Local recurrence, even if present, becomes of lesser clinical importance in this setting, unless it is locally advanced and is causing urinary or bowel complications. MRI-Targeted Biopsy Prostatectomy Bed Because local recurrence is of lesser clinical importance in the setting of metastatic prostate cancer, MRI-targeted biopsy of the prostate is not routinely used for evaluation.
Post Treatment Follow up of Prostate Cancer. As opposed to Variants 1 and 2 in the setting of metastatic disease, chest CT becomes clinically relevant and is a first-line imaging modality for detection of pulmonary metastases. MRI Abdomen and Pelvis Local recurrence, even if present, becomes of lesser clinical importance in this setting, unless it is locally advanced and is causing urinary or bowel complications. MRI is capable of assessing response to metastatic nodal disease similar to CT based on size, with the addition of also being able to show functional changes. Post-ADT perfusion should greatly decrease with a positive response, and apparent diffusion coefficient values typically increase. Bone metastases can be followed for response by MRI as well in a similar way. In this clinical setting, the likelihood of metastatic disease outside the pelvis is increased. For example, liver metastases and nodal metastases in higher stations are most often seen in the setting of Variant 3. It is probable that coverage of the abdomen in addition to the pelvis would provide more benefit in this setting, but evidence is lacking. MRI Pelvis In this clinical setting, the likelihood of metastatic disease outside the pelvis is increased. For example, liver metastases and nodal metastases in higher stations are most often seen in the setting of Variant 3. It is probable that coverage of the abdomen in addition to the pelvis would provide more benefit, but evidence is lacking. Local recurrence, even if present, becomes of lesser clinical importance in this setting, unless it is locally advanced and is causing urinary or bowel complications. MRI-Targeted Biopsy Prostatectomy Bed Because local recurrence is of lesser clinical importance in the setting of metastatic prostate cancer, MRI-targeted biopsy of the prostate is not routinely used for evaluation.