Choline PET/MRI Skull Base to Mid-Thigh Choline PET/MRI is less commonly used than choline PET/CT but can be considered in the pretreatment assessment of prostate cancer based on the same principles that it better detects nodal and distant metastases than CT and bone scan [96,98-100]. For example, in a study of 48 patients with intermediate- and high-risk disease, choline PET/CT showed a higher sensitivity (46.2% versus 69.2%) with identical specificity (92.3%) for detecting nodal metastases [99]. In a prospective study specifically assessing choline PET/MRI in 58 patients, it was superior to CT and bone scan for detecting distant metastases (100% versus 63.6%, respectively) [101]. CT Abdomen and Pelvis With IV Contrast CT abdomen and pelvis with IV contrast for nodal staging is generally useful in intermediate-risk patients because the a priori risk of nodal disease exceeds 10% [20]. CT Abdomen and Pelvis Without and With IV Contrast There is limited evidence to support the use of CT abdomen and pelvis without and with IV contrast because obtaining CT with both techniques does not provide additional benefit in terms of detecting nodal and distant metastases. Pretreatment Detection of Prostate Cancer CT Abdomen and Pelvis Without IV Contrast CT abdomen and pelvis without IV contrast can be a viable option as an alternative for using IV contrast for nodal staging because it is generally useful in intermediate-risk patients because the a priori risk of nodal disease exceeds 10% [20]. However, it should be recognized that without using IV contrast there is possibility of less optimal detection of metastases to visceral organs. CT Chest, Abdomen, and Pelvis With IV Contrast CT chest, abdomen, and pelvis with IV contrast for nodal staging is generally useful in intermediate-risk patients because the a priori risk of nodal disease exceeds 10% [20].
Pretreatment Detection Surveillance and Staging of Prostate Cancer. Choline PET/MRI Skull Base to Mid-Thigh Choline PET/MRI is less commonly used than choline PET/CT but can be considered in the pretreatment assessment of prostate cancer based on the same principles that it better detects nodal and distant metastases than CT and bone scan [96,98-100]. For example, in a study of 48 patients with intermediate- and high-risk disease, choline PET/CT showed a higher sensitivity (46.2% versus 69.2%) with identical specificity (92.3%) for detecting nodal metastases [99]. In a prospective study specifically assessing choline PET/MRI in 58 patients, it was superior to CT and bone scan for detecting distant metastases (100% versus 63.6%, respectively) [101]. CT Abdomen and Pelvis With IV Contrast CT abdomen and pelvis with IV contrast for nodal staging is generally useful in intermediate-risk patients because the a priori risk of nodal disease exceeds 10% [20]. CT Abdomen and Pelvis Without and With IV Contrast There is limited evidence to support the use of CT abdomen and pelvis without and with IV contrast because obtaining CT with both techniques does not provide additional benefit in terms of detecting nodal and distant metastases. Pretreatment Detection of Prostate Cancer CT Abdomen and Pelvis Without IV Contrast CT abdomen and pelvis without IV contrast can be a viable option as an alternative for using IV contrast for nodal staging because it is generally useful in intermediate-risk patients because the a priori risk of nodal disease exceeds 10% [20]. However, it should be recognized that without using IV contrast there is possibility of less optimal detection of metastases to visceral organs. CT Chest, Abdomen, and Pelvis With IV Contrast CT chest, abdomen, and pelvis with IV contrast for nodal staging is generally useful in intermediate-risk patients because the a priori risk of nodal disease exceeds 10% [20].