New prostate cancer imaging techniques and their use in clinical practice

An article by Vapiwala et al., just published in the Journal of Clinical Oncology, is a “must read” for patients who are trying to understand how new types of imaging technology are being applied in the diagnosis, work-up, and monitoring of men with various stages of prostate cancer. The full text of this article (“Strategies for evaluation of novel imaging in prostate cancer: putting the horse back before the cart“) is accessible on line.

In their article, Vapiwala et al. lay out concerns related to the risks and the benefits of the current use of new imaging techniques and the lack — for a variety of reasons — of a well-coordinated process for understanding how best to use these techniques.

We should be clear that everyone agrees that these new techniques are providing all sorts of useful and valuable new insights into the evaluation of patients, the staging of their cancers, and the consequent opportunities for prognosis and treatment. However, what is a good deal less clear is how to use these new techniques to the best advantage for the majority of patients; whether certain types of information that can be generated by the novel scanning methods should lead to changes in treatment or not; and similar matters.

This is all complicated by regulatory and commercial issues that can vary from country to country.

Table 1 in this article sets out a whole spectrum of currently unresolved questions and ongoing or essential clinical trials needed to resolve the relevant issues.

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