<p><strong> </strong><strong>Clinicians should not routinely perform PSMA PET scan, cross-sectional imaging, or bone scan for nodal or metastatic staging in asymptomatic patients with low- or favorable intermediate-risk prostate cancer. <em>(Expert Opinion)</em></strong></p>
Discussion
Discussion
<p>Imaging studies are intended to define the local extent of disease as well as determine the presence of nodal and distant metastases and thereby inform management. Clinicians should use a risk-based approach to staging patients with newly diagnosed prostate cancer, considering the probability of the patient harboring metastatic disease as well as the sensitivity and specificity of the imaging modality. For asymptomatic patients with low- or favorable intermediate-risk prostate cancer, the probability of nodal or distant metastasis is low.<sup>88-90</sup> Therefore, molecular imaging (i.e., PSMA PET-CT scan), bone scan, or cross-sectional imaging (contrast-enhanced abdomino-pelvic computed tomography [CT] scan or MRI) for nodal and metastatic staging are unlikely to be helpful and should not be routinely obtained. However, even in the low- and favorable intermediate-risk patients, there may be instances in which symptoms, laboratory abnormalities, or disease characteristics warrant further investigation with imaging.</p>