Preliminary Diagnosis: Prostate Cancer
I. What imaging technique is first-line for this diagnosis?
Prostatic ultrasound.
II. Describe the advantages and disadvantages of this technique for diagnosing prostate cancer.
Advantages
- Moderately sensitive and specific in detecting, detailing, and characterizing prostate abnormalities, such as cancer.
- May help guide biopsy.
- Highly specific in characterizing the vascularity of a neoplastic process.
- Does not expose patients to ionizing radiation.
Disadvantages
- Less adept in detailing the extent of soft tissue infiltration and extension.
- Highly operator dependent.
III. What are the contraindications for the first-line imaging technique?
No specific contraindications to ultrasound exist.
IV. What alternative imaging techniques are available?
- MRI with IV contrast.
- CT imaging with IV contrast.
V. Describe the advantages and disadvantages of the alternative techniques for diagnosing prostate cancer.
MRI with IV contrast
Advantages
- Gold standard in detecting, detailing, and characterizing prostate neoplasm and extension of neoplasm.
- Does not expose patients to ionizing radiation.
- Offers exquisite detail of the surrounding soft tissues and the zones of the prostate gland (central, peripheral, and transitional zone).
- Contrasted MR imaging helps evaluate for any secondary complications.
Disadvantages
- May be subject to motion and susceptibility weighted artifact, degrading image quality.
- Less sensitive and specific for detailing the osseous structures.
- Expensive.
- Time consuming.
CT imaging with IV contrast
Advantages
- Quick and relatively inexpensive imaging modality as compared to MR imaging.
- May help guide percutaneous biopsy and treatment.
- Moderately sensitive and specific in characterizing the surrounding soft tissues and extension of tumors.
- Highly sensitive and specific in characterizing the surrounding osseous and mineralized structures.
Disadvantages
- Exposes patients to ionizing radiation.
- Contrasted CT imaging helps evaluate for any secondary complications.
VI. What are the contraindications for the alternative imaging techniques?
MRI with IV contrast
May be contraindicated in patients with non-MR compatible hardware.
Continue Reading
CT imaging with IV contrast
May be contraindicated in patients who are pregnant.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.