Optimum Imaging Strategies for Advanced PCa: ASCO Guideline

Optimum Imaging Strategies for Advanced Prostate Cancer: ASCO Guideline [2020, Full Text]

"Abstract
PURPOSE
Provide evidence- and expert-based recommendations for optimal use of imaging in advanced prostate cancer. Due to increases in research and utilization of novel imaging for advanced prostate cancer, this guideline is intended to outline techniques available and provide recommendations on appropriate use of imaging for specified patient subgroups.

METHODS
An Expert Panel was convened with members from ASCO and the Society of Abdominal Radiology, American College of Radiology, Society of Nuclear Medicine and Molecular Imaging, American Urological Association, American Society for Radiation Oncology, and Society of Urologic Oncology to conduct a systematic review of the literature and develop an evidence-based guideline on the optimal use of imaging for advanced prostate cancer. Representative index cases of various prostate cancer disease states are presented, including suspected high-risk disease, newly diagnosed treatment-naïve metastatic disease, suspected recurrent disease after local treatment, and progressive disease while undergoing systemic treatment. A systematic review of the literature from 2013 to August 2018 identified fully published English-language systematic reviews with or without meta-analyses, reports of rigorously conducted phase III randomized controlled trials that compared ≥ 2 imaging modalities, and noncomparative studies that reported on the efficacy of a single imaging modality.

RESULTS
A total of 35 studies met inclusion criteria and form the evidence base, including 17 systematic reviews with or without meta-analysis and 18 primary research articles.

RECOMMENDATIONS
One or more of these imaging modalities should be used for patients with advanced prostate cancer: conventional imaging (defined as computed tomography [CT], bone scan, and/or prostate magnetic resonance imaging [MRI]) and/or next-generation imaging (NGI), positron emission tomography [PET], PET/CT, PET/MRI, or whole-body MRI) according to the clinical scenario."

(See the specific recommendations in the Bottom Line section in the Full Text. Near the bottom there is also a section with links to Related ASCO Guidelines)

Djin

Post Edited (DjinTonic) : 1/24/2020 6:50:27 AM (GMT-7)

Yes, there are studies on using advanced scanning for initial disease assessments, especially for high-risk after biopsy.. I think this application is too new for there to be recommendations. Clearly costs will enter the picture as well as studies showing how this imaging changes treatment decisions, as it is doing for recurrent disease.

Djin