Course Content
1. Introduction to Prostate Cancer
o Understanding the prostate gland o Overview of prostate cancer o Risk factors and epidemiology
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2. Signs and Symptoms
o Common signs and symptoms o When to seek medical attention o Diagnostic tests and screening guidelines
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3. Diagnosis and Staging
o Biopsy procedures and interpretation o Staging techniques (TNM system) o Imaging modalities for staging
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6. Nutrition and Lifestyle Considerations
o Diet and nutrition recommendations o Exercise and physical activity guidelines o Stress management techniques
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Understanding Prostate Cancer: Online Course for Patients & Caregivers
About Lesson

Introduction:

Imaging plays a critical role in staging prostate cancer by providing detailed information about the extent of the disease within the prostate gland and its spread to surrounding tissues or distant sites. Various imaging modalities are used in clinical practice to stage prostate cancer accurately.

Imaging Modalities:

  1. Transrectal Ultrasound (TRUS):

    • Transrectal ultrasound is commonly used to guide prostate biopsy procedures. While TRUS is not typically used for primary staging of prostate cancer, it can provide valuable information about the size and characteristics of prostate tumors and help guide biopsy needle placement.
  2. Multiparametric Magnetic Resonance Imaging (mpMRI):

    • Multiparametric MRI combines multiple imaging sequences to assess different aspects of prostate anatomy and pathology, including T2-weighted imaging, diffusion-weighted imaging, dynamic contrast-enhanced imaging, and spectroscopy.
    • mpMRI is highly sensitive for detecting and localizing prostate tumors, assessing tumor size and extent, and identifying extracapsular extension and seminal vesicle invasion.
    • mpMRI is increasingly used for pre-biopsy risk stratification, guiding targeted biopsies, and staging localized prostate cancer before definitive treatment.
  3. Computed Tomography (CT) Scan:

    • CT scans may be used in conjunction with other imaging modalities to evaluate the extent of prostate cancer spread, particularly to nearby lymph nodes or distant sites such as the bones.
    • CT scans are less sensitive than MRI for detecting prostate tumors but are useful for identifying enlarged lymph nodes or metastatic lesions in the pelvis or abdomen.
  4. Bone Scintigraphy (Bone Scan):

    • Bone scintigraphy is used to detect bone metastases in patients with advanced prostate cancer. Radioactive tracers are injected intravenously, and the distribution of the tracer in the bones is visualized using a gamma camera.
    • Bone scans are particularly valuable for detecting metastases to the bones, which are common in advanced prostate cancer and can impact treatment decisions and prognosis.

Additional Imaging Modalities:

  • Positron Emission Tomography (PET) Imaging: Emerging PET imaging techniques such as prostate-specific membrane antigen (PSMA) PET and fluciclovine (Axumin) PET are being increasingly used for detecting recurrent or metastatic prostate cancer with high sensitivity and specificity.
  • Pelvic MRI with Endorectal Coil: In some cases, pelvic MRI performed with an endorectal coil may provide additional detail and improve the accuracy of prostate cancer staging, particularly in cases of suspected extracapsular extension or seminal vesicle invasion.

Online Resources for Further Learning:

Explore the following online resources to learn more about imaging modalities for staging prostate cancer:

End of Topic Quiz:

  1. Which imaging modality is commonly used for guiding prostate biopsy procedures and assessing tumor size and characteristics within the prostate gland?

    • A) Transrectal Ultrasound (TRUS)
    • B) Multiparametric Magnetic Resonance Imaging (mpMRI)
    • C) Computed Tomography (CT) Scan
    • D) Bone Scintigraphy (Bone Scan)

    Answer: A) Transrectal Ultrasound (TRUS)

  2. Which imaging technique is particularly valuable for detecting bone metastases in patients with advanced prostate cancer?

    • A) Multiparametric Magnetic Resonance Imaging (mpMRI)
    • B) Computed Tomography (CT) Scan
    • C) Bone Scintigraphy (Bone Scan)
    • D) Positron Emission Tomography (PET) Imaging

    Answer: C) Bone Scintigraphy (Bone Scan)

Takeaway Assignment:

Divide students into groups and assign each group one imaging modality used in staging prostate cancer. Task them with creating a presentation or infographic detailing the principles of the imaging modality, its strengths and limitations in prostate cancer staging, and clinical scenarios where it is most useful. Encourage students to include visual examples or case studies to illustrate key points and facilitate understanding. This assignment will deepen students’ understanding of the role of imaging in prostate cancer staging and its clinical applications.

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