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Techniques for Diagnosis

BONE SCAN

article written by Dr. Hassan Khan

Bone is the commonest site of spread especially the bones of the spine and pelvis. The most commonly used tool used to look for spread of prostate cancer is the Radionuclide Scan commonly called the bone scan.

Patients with a PSA above 20ng/ml should have a bone scan. This is a very sensitive test but recent bone injury or degenerative bone diseases may appear similar to bone spread.

The incidence of bony spread in the PSA range 8-20ng/ml is very low and your Urologist may not choose to do a bone scan especially if the Gleason score is low.

CT SCAN

The CT scan is best used to determine if the cancer has spread to the pelvic lymph nodes. The sensitivity of the CT Scanning is greatly enhanced by using contrast and fine needle biopsy of the enlarged nodes.

MRI SCAN

This scan is also used to determine if the pelvic lymph nodes are enlarged but does not allow for fine needle biopsy. The MRI is the most sensitive in picking up spread of the cancer to the tissue surrounding the prostate gland.

There are no specific indications for the use of CT or MRI scan and they are not more sensitive than a transrectal ultrasound performed by an experienced ultrasonographer/radiologist.

The aim of staging of prostate cancer is to decide which form of treatment is best suited for each patient. Age, pre-existing medical problems, the PSA level, the Gleason Score and the results of the above imaging techniques allows your Urologist to suggest the best treatment option for you.

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