Good Framework for Diagnostic Imaging in Advanced Prostate Cancer - ASCO Reading Room - 02.05.2020 - MedPage Today

[cujoe]

Newly released ASCP guidelines for diagnostic imaging in Advance Prostate Cancer diagnostics and treatment. Since these reflect the newer scan technologies, they should be useful to our APCa patient community. This article is from the MedPageToday's ASCO Reading Room.

Good Framework for Diagnostic Imaging in Advanced Prostate Cancer

Important to remember, though, that each patient case is unique

by David Hermel, MD

ASCO's recently published multidisciplinary, evidence-based imaging guidelines for advanced prostate cancer provide a framework for the appropriate use of diagnostic imaging in the clinical workup of high-risk, progressive, recurrent, and newly diagnosed metastatic prostate cancer.

The recommendations are based on 35 studies filtered after a systemic review of the literature from 2013 to 2018. In prostate cancer, conventional standard imaging includes a 99mTc-MDP bone scan and computerized tomography or magnetic resonance imaging to detect metastatic disease; however, these modalities have limited diagnostic accuracy when compared with next-generation imaging (NGI) modalities, which rely on radiopharmaceuticals coupled to prostate cancer specific targets, such as prostate-specific membrane antigen.

While these new imaging techniques are more specific, there are notable downsides to their use, including cost, increased risk of false-positive results, and a lack of prior precedent for their use in the staging of prostate cancer.

In the context of uncertainty, these guidelines provide recommendations for incorporating NGI into specific clinical scenarios where they could provide important clinical information (i.e., clinical high-risk localized disease, suspected or confirmed metastatic disease, recurrent or progressive disease with rising prostate-specific antigen levels, etc.).

Ultimately, however, while these guidelines provide an appropriate framework for thinking about the diagnostic workup of advanced prostate cancer, each patient case is unique, and, in each scenario consideration must be given to how certain diagnostics will change clinical management in the context of a patient's care plan.

David Hermel, MD, is an oncology/hematology fellow at Scripps Clinic in La Jolla, California.

Here is a link to the full ASCO guideline:

ascopubs.org/doi/full/10.12...

Be Well - Captain K9

[cujoe]

Here is an additional short interview with Edouard Trabulsi, MD, (co-director of the Multidisciplinary Genitourinary Oncology Center and the Prostate Diagnostic Center at Thomas Jefferson University in Philadelphia) on these new ASCO guidelines that cuts to the chase about the importance of them in oncology practice.

Edouard Trabulsi, MD, on Optimum Imaging Strategies for Advanced Prostate Cancer

New ASCO guidelines emphasize next-generation techniques

medpagetoday.com/reading-ro...

Maybe one day, the new scans will be more widely available and at a cost that does not prohibit their use for all patients that can benefit from their use.

Be Well - K9

[NPfisherman]

The work done by ASCO continues to drive us forward toward Chronic Disease State/Status for those diagnosed with PCa... The hunt continues on what is the best approach for diagnostic studies, treatment protocols, etc... Watching the Ga68 FAPI scan trials--diagnostic-- and the PEACE-1 trials--treatment --with great interest...

Fish