From Conventional to Advanced Imaging in Advanced Prostate Cancer

Welcome back to another Urology Times Peers & Perspectives. In this episode titled, ‘From Conventional to Advanced Imaging in Advanced Prostate Cancer,’ the expert faculty reviews the historical reliance on conventional imaging modalities, such as CT, MRI, ultrasound, and bone scans, for diagnosing and staging advanced prostate cancer. While these approaches remain guideline-supported, they are limited by suboptimal sensitivity and specificity, often resulting in false positives or missed disease. Clinicians noted particular frustration with bone scans, where suspected metastases frequently do not represent true disease. These limitations have driven a clear unmet clinical need for more accurate staging tools, especially in patients with unfavorable intermediate- and high-risk disease or biochemical recurrence. The discussion also highlights growing confidence in advanced imaging technologies, which are enabling clinicians to consider imaging at earlier PSA thresholds and potentially reconsider traditional definitions of recurrence.

In the next episode ‘Multidisciplinary Use of PSMA PET in Advanced Prostate Cancer,’ the experts examine how PSMA PET imaging is ordered, interpreted, and incorporated into care through multidisciplinary collaboration. It underscores the importance of coordinated communication among specialties, particularly in complex or discordant cases, as practices increasingly rely on PSMA PET over conventional imaging.