The crucial role of radiology in prostate cancer diagnosis and therapy
Urologist Arnulf Stenzl: "Imaging is the key to prostate cancer treatment"
Emphasising the crucial partnership of radiologists and urologists in the treatment of prostate cancer, Professor Arnulf Stenzl, Medical Director of Urology at the Tübingen University Hospital, explained that, throughout the phases of prostate cancer diagnosis and therapy - from primary diagnosis onward - imaging is indispensable.
If the biopsy provided a positive prostate cancer result, the next step is to determine whether the tumour is confined to the prostate or has spread to other tissue or organs. For this, MRI is preferred, which is also an important surgery planning tool, because MR images can show the amount of tissue that needs to be removed.
Prostate cancer frequently spreads to other body areas, particularly the lymph nodes and bones. Choline PET-CT, a system that combines diagnostic imaging and the visualization metabolic events, is used to detect metastases.
In addition, the tumour marker choline comes into play: as C11-choline, combined with radioactive carbon, the substance is intravenously injected into the body. PET/CT detectors catch signals emitted by the radioactive tumour marker for conversion into an image. ‘The intensity of the signals indicates where in the body’s metabolism choline is particularly active. We can thus localise cell growth caused by prostate cancer. Currently, this is the most sophisticated diagnostic method, but it needs further improvement,’ he said.
In the long term, Prof Stenzl predicts that super-precise MRI will replace computed tomography: ‘That’s the direction we urologists would like radiology to take. But the fact that we voice certain wishes will in no way belittle the enormous support we currently receive from imaging diagnostics.’
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