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Dr. Castle on Staging Modalities for Men With High-Risk Prostate Cancer

Erik P. Castle, MD, professor of urology, Mayo Clinic, discusses traditional imaging modalities and newer counterparts that are used to detect prostate cancer.

Erik P. Castle, MD, professor of urology, Mayo Clinic, discusses traditional imaging modalities and newer counterparts that are used to detect prostate cancer.

Unless a patient with high-risk prostate cancer has a life expectancy of less than 5 to 10 years, they’re likely to undergo treatment, Castle says. For those patients, standard imaging like CT scans and bone imaging are used. However, physicians are slowly transitioning from classic technetium-99 bone scans to sodium-fluoride PET imaging.

There are other PET imaging modalities such as prostate-specific membrane antigen PET; this has yet to be fully FDA approved. Choline C-11 PET is available at Mayo Clinic for patients who have been treated for high-risk prostate cancer and have had a biochemical recurrence. There’s also 18F-Fluciclovine PET/CT.

Using these imaging studies to help better identify patients who are going to benefit from combined therapy with androgen-deprivation therapy (ADT), and the sequence of radiation, surgery, and ADT will become prominent over the course of the next few years.

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