Imaging prostate cancer: Current and future applications

Various treatment options are available for adenocarcinoma of the prostate- the most common malignant neoplasm among men in the United States. To selec t an optimum management strategy, we must be able to identify an organ-conf ined disease tin which local therapy such as surgery or radiation may be be neficial) vs prostate cancer beyond the confines of the gland (for which ot her treatment approaches may be more appropriate). At present, no standard imaging modality can by itself reliably diagnose and/or stage adenocarcinom a of the prostate. Standard transrectal ultrasound, magnetic resonance imag ing (MRI), computed tomography, bone scans, and plain x-ray are not suffici ently reliable when used alone. Fortunately, advances in imaging technology have led to the development of several promising modalities. These modalit ies include color and power Doppler ultrasonography, ultrasound contrast ag ents, intermittent and harmonic ultrasound imaging, MR contrast imaging, MR I with fat suppression, MRI spectroscopy, three-dimensional MRI spectroscop y, elastography, and radioimmunoscintigraphy. These newer imaging technique s appear to improve the yield of prostate cancer detection and staging, but are limited in availability and thus require further validation. This arti cle reviews the status of current imaging modalities for prostate cancer an d identifies emerging imaging technologies that may improve the diagnosis a nd staging of this disease.