Imaging for recurrent prostate cancer

Imaging for recurrent prostate cancer following treatment with radical pros tatectomy,radiation therapy, or cryosurgery has become an important determi nant in the treatment options available to patients. Used in conjunction wi th clinical parameters such as tumor characteristic and posttreatment serum prostate-specific antigen (PSA), imaging tests are critical for determinin g whether recurrent disease is Limited to the prostate or prostatic fossa o r whether disease has spread to distant sites. Several imaging modalities c an be used to provide evidence for Limited local disease recurrence and the reby identify disease that is still potentially curable with adjuvant treat ments. Likewise, imaging tests help not only to detect distant disease recu rrence, but also to monitor response of such metastases to treatment. This article examines the imaging modalities currently used to detect prostate c ancer recurrence and presents a general algorithm for surveillance of patie nts following definitive primary treatment of prostate cancer with prostate ctomy, radiation therapy, or cryosurgery.