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Patient management at any stage of disease

With more and more advanced measures available to treat a prostate tumor, anatomical information is often no longer sufficient to determine the most effective treatment plan for each patient. Additional information about the tumor’s metabolism and other physiological characteristics, as well as its aggressiveness, can be obtained from MR, bone scintigraphy, or PET·CT and MR-PET, which may help to better select the appropriate treatment.

Multiparametric MRI

MR diffusion-weighted imaging maps the motility of water molecules, thus visualizing areas of abnormal cell density.
Data courtesy of Nara Medical University Hospital, Nara, Japan

Next to T2- and T1-weighted images of tissue morphology, the following MRI contrasts offer additional physiological and metabolic information:

  • MR diffusion-weighted imaging maps cellular density.
  • Contrast-enhanced MRI allows the analysis of perfusion and vascular permeability.
  • MR spectroscopy imaging adds further specificity for tumor detection by imaging abnormal metabolism.

 

Bone scintigraphy

99mTc MDP bone SPECT•CT performed on a Symbia TM T scanner demonstrating vertebral metastases.
Data courtesy of Kliniken Maria Hilf GmbH, Moenchengladbach, Germany
  • With bone metastases being a common complication, routine bone scans utilizing SPECT or SPECT·CT are recommended for patients with a PSA >10 ng/mL1.
  • Integrated diagnostic CT performed as a part of the SPECT·CT bone procedure may help improve localization and lesion characterization. 

 

Unique hybrids for more precise molecular imaging

Hybrid imaging modalities, such as SPECT•CT, PET•CT and MR-PET, add the value of biological information to precise anatomical information - helping physicians to clearly understand tumor characteristics for more confident disease management.

Positron Emission Tomography – Computed Tomography (PET•CT)

18F-NaF PET·CT showing precise delineation of bone metastases resulting from prostate cancer.
Data courtesy of Northern California PET Imaging Center, Sacramento, CA, USA
  • PET•CT enables precise localization of the primary tumor and earlier visualization of metastatic disease.
  • Usefull for primary diagnosis and follow-up for high-risk patients and those with recurrent disease.
  • 18F-NaF PET•CT provides lesion detection through improved molecular resolution.
  • Potential new tracers may further expand the clinical use of PET•CT for prostate cancer.  

 

Molecular MR (MR-PET)

  • Siemens offers simultaneous acquisition of whole-body MR anatomical as well as functional data and PET metabolic information in a single image.
  • This unique modality helps to accurately identify and localize tumor relapse, involved lymph nodes, or distant metastases.
  • With already more than 30 installed systems worldwide, Biograph molecular MR (mMRTM) has become part of clinical routine. 

 

Computed Tomography (CT)

  • Used for tumor staging, e.g. searching for metastases, and evaluation of advanced disease or in high-risk patients.
  • Used for radiotherapeutical treatment planning (external beam therapy or brachytherapy)

1 S3-Guideline German Society Urology 9:2009; NCCN Guidelines Prostate Cancer Version 1.2011

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