In addition, because a majority of the distant metastases occur (at least in the pretreatment setting) in the axial skeleton and it is rare to harbor isolated bone metastases without simultaneously harboring metastases in the pelvic and lumbosacral vertebral bones, MRI abdomen and pelvis is usually sufficient to detect the presence of bone metastasis at the patient level [113]. MRI Abdomen and Pelvis Without IV Contrast Because the main purpose for imaging the abdomen and pelvis would be to identify nodal and distant metastases, MRI abdomen and pelvis without IV contrast is a viable option as an alternative to that using IV contrast [109-113]. However, it should be recognized that without using IV contrast there is the possibility of less optimal detection of metastases to visceral organs. MRI Whole Body Without IV Contrast Because the main purpose for imaging the whole body would be to identify nodal and distant metastases, MRI whole body without IV contrast is a viable option as an alternative to that using IV contrast [49,96,108-112,114- 117]. However, it should be recognized that without using IV contrast there is the possibility of less optimal detection of metastases to visceral organs. Pretreatment Detection of Prostate Cancer PSMA PET/CT Skull Base to Mid-Thigh The literature indicates PSMA PET/CT is useful in patients with intermediate- and high-risk disease. PSMA PET, which can be used with CT or MRI (PET/CT and PET/MRI, respectively), is one of the newer imaging modalities, which has been primarily investigated in the setting of biochemical recurrence and biochemical failure, where, because of its superior capability to detect recurrent disease, has shown to substantially change management [118].
Pretreatment Detection Surveillance and Staging of Prostate Cancer. In addition, because a majority of the distant metastases occur (at least in the pretreatment setting) in the axial skeleton and it is rare to harbor isolated bone metastases without simultaneously harboring metastases in the pelvic and lumbosacral vertebral bones, MRI abdomen and pelvis is usually sufficient to detect the presence of bone metastasis at the patient level [113]. MRI Abdomen and Pelvis Without IV Contrast Because the main purpose for imaging the abdomen and pelvis would be to identify nodal and distant metastases, MRI abdomen and pelvis without IV contrast is a viable option as an alternative to that using IV contrast [109-113]. However, it should be recognized that without using IV contrast there is the possibility of less optimal detection of metastases to visceral organs. MRI Whole Body Without IV Contrast Because the main purpose for imaging the whole body would be to identify nodal and distant metastases, MRI whole body without IV contrast is a viable option as an alternative to that using IV contrast [49,96,108-112,114- 117]. However, it should be recognized that without using IV contrast there is the possibility of less optimal detection of metastases to visceral organs. Pretreatment Detection of Prostate Cancer PSMA PET/CT Skull Base to Mid-Thigh The literature indicates PSMA PET/CT is useful in patients with intermediate- and high-risk disease. PSMA PET, which can be used with CT or MRI (PET/CT and PET/MRI, respectively), is one of the newer imaging modalities, which has been primarily investigated in the setting of biochemical recurrence and biochemical failure, where, because of its superior capability to detect recurrent disease, has shown to substantially change management [118].