Prostate cancer is second leading cause of death from malignancy after lung cancer in American men. The primary goal during pretreatment evaluation of prostate cancer is disease detection, localization, establishing disease extent (both local and distant), and evaluating aggressiveness, which are the driving factors of patient outcomes such as recurrence and survival. Prostate cancer is typically diagnosed after the recognizing elevated serum prostate-specific antigen level or abnormal digital rectal examination. Tissue diagnosis is obtained by transrectal ultrasound-guided biopsy or MRI-targeted biopsy, commonly with multiparametric MRI without or with intravenous contrast, which has recently been established as standard of care for detecting, localizing, and assessing local extent of prostate cancer. Although bone scintigraphy and CT are still typically used to detect bone and nodal metastases in patients with intermediate- or high-risk prostate cancer, novel advanced imaging modalities including prostatespecific membrane antigen PET/CT and whole-body MRI are being more frequently utilized for this purpose with improved detection rates. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
Journal of the American College of Radiology : JACR. 2023 May [Epub]
Expert Panel on Urological Imaging , Oguz Akin, Sungmin Woo, Aytekin Oto, Brian C Allen, Ryan Avery, Samantha J Barker, Marielia Gerena, David J Halpern, Lori Mankowski Gettle, Seth A Rosenthal, Samir S Taneja, Baris Turkbey, Pat Whitworth, Paul Nikolaidis
Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: ., Research Author, Memorial Sloan Kettering Cancer Center, New York, New York., Panel Chair, University of Chicago, Chicago, Illinois., Panel Vice-Chair, Duke University Medical Center, Durham, North Carolina., Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Commission on Nuclear Medicine and Molecular Imaging., University of Minnesota, Minneapolis, Minnesota; Director of Ultrasound M Health Fairview., St. Luke's Health System, Boise, Idaho., Duke University Medical Center, Durham, North Carolina, Primary care physician., University of Wisconsin, Madison, Wisconsin., Sutter Medical Group, Sacramento, California; Commission on Radiation Oncology; Member, RTOG Foundation Board of Directors., NYU Clinical Cancer Center, New York, New York; American Urological Association., National Cancer Institute, National Institutes of Health, Bethesda, Maryland., Thomas F. Frist, Jr College of Medicine, Belmont University, Nashville, Tennessee., Specialty Chair, Northwestern University, Chicago, Illinois.