early imaging

Dave,

I think the problem is the size of what you are trying to scan. It takes a significant cluster of PC cells to make the PSA number change. So no matter what scan technique we use, it is extremely difficult to pick out a small tumor or met. Scan images make it hard to differentiate between a very small point of reaction to just background noise.

Sonny has been to the government labs in DC where they used the most recent scan techniques, and even with a High PSA, they could not find any mets.

I guess it is the old needle in a haystack thing.

Dave,
I think you are referring to scans of the prostate and not full scans like PET.
CDU or multiparametric MRIs can be useful in deciding what treatment option to pursue. A very good radiologist can tell the difference between prostatitis and cancer with the scans. If you are proven to have cancer via biopsy then the scans can determine if you are a good candidate for surgery or would be better served by radiation due to the size and location of the tumor.
I really don't understand the question you are asking. If a man has had 1 or 2 negative biopsies and a continuing rising psa than a scan would be worthwhile, but it must be accompanied by a biopsy to confirm the presence of cancer.

I am not an expert by any means but can give you my experience.

It's a little different scenario since I already had bone mets confirmed by bone scans three months apart.

After a change in radiation oncologists due to former one relocating, the new RO ordered MRIs of the thoracic spine and of the pelvis. This was somewhat to appease my frustration with very general CYA bone scan reports.

The bone scan in March used terms like multiple thoracic bodies and right posterior ribs without quantifying. Neither of my urologists can read bone scans and relied too much on the wording and assuming my whole body was riddled with stage IV cancer.

Then the second comparison bone scan in July said there was improvement, again too vague for a metrics guy like me. Is that 1% improvement or 50% improvement, but I digress.

The MRI of spine actually downgraded my metastasis in that area to "mild" if there is such an animal because the area that glowed so much in T7-T8 ended up being benign due a previously undiagnosed herniated disc with spinal compression (fortunately no pain). There were confirmed bony mets in T4 and T9.

The MRI Being more specific than bone scan but not as good at overall detection pendulum swings both ways. On the pelvic MRI, what appeared to only be a non symmetric dot on bone scan right side versus left side turned out to be what RO referred to as classic prostate metastasis to bone in sacroiliac ALA and femoral necks.

I think you are getting ahead of yourself with high powered diagnostics, but if you get to point of bone scan showing mets, I would recommend a complementary MRI as way of distinguishing benign glows due to herniated disc with spinal compression versus probably malignant glows due to prostate cancer that has spread to the bone.

LupronJim