Peter L. Choyke, MD, FACR, ​chief, Molecular Imaging Branch, senior investigator, head, Imaging Section, National Cancer Institute, discusses recent developments in imaging for prostate cancer.

For a number of years, imaging ​modalities for prostate cancer weren't particularly intriguing diagnostic tool​s, Choyke says. ​Historically, bone scans and CT scans have been used, though both methods lacked the sensitivity needed to stage these patients.

Recently, however, numerous novel PET agents have dramatically improved the sensitivity for detecting ​metastatic or recurrent sites of prostate cancer, explains Choyke. It is now known that even in case​s of very low prostate-specific antigen recurrences, sites of disease can be reliably detect​ed using this modern method, Choyke concludes.

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Peter L. Choyke, MD, FACR, discusses recent developments in imaging for prostate cancer.

Dr. Choyke on Recent Developments in Imaging for Prostate Cancer

Peter Choyke, MD, FACR, chief of Molecular Imaging Program, National Cancer Institute, discusses the importance of multidisciplinary care in prostate cancer.

Discussing disgnosis and treatment strategies for a patient with the urologist, radiation oncologist, medical oncologist, pathologist, and radiologist, maybe be difficult to arrange, but it allows more questions to be answered and better decisions to be reached, says Choyke.

Dr. Choyke on the Importance of Multidisciplinary Care in Prostate Cancer

Peter Choyke, MD, FACR, chief of Molecular Imaging Program, National Cancer Institute, discusses the challenges with MRI in prostate cancer.

One of the biggest challenges, says Choyke, is how to perform an MRI for these patients.

The first thing to do is to establish the quality of the imaging, which means understanding what abnormalities look like, what is important to the urologist, and what are the limitations of the technique. From there, says Choyke, a knowledge of the Prostate Imaging Reporting and Data System (PI-RADS) must also be established consistently across the group using MRI.

Dr. Choyke Discusses the Challenges With MRI in Prostate Cancer

Peter Choyke, MD, FACR, chief of the Molecular Imaging Program, National Cancer Institute, discusses screening in prostate cancer.

Conducting random biopsies do not make any sense in a modern world, says Choyke. The best strategy to identify high-grade cancer is MRI, he adds.

In terms of when to operate or radiate, practitioners find that the answer is not perfect—there is a learning curve. A lot of this has to do with good communication between the urologist and radiologist, says Choyke.

Dr. Choyke Discusses Screening in Prostate Cancer

Peter Choyke, MD, FACR, chief of Molecular Imaging Program, National Cancer Institute, discusses developments being made in screening for patients with prostate cancer.

According to Choyke, the rise of genomics in prostate cancer is an important development. However, genomic testing is not likely to be able to stand on its own without imaging. Imaging provides better sampling of the tumor, which leads to more accurate genomics, states Choyke.

Peter Choyke, MD, FACR, chief of Molecular Imagine Program, National Cancer Institute, discusses developments being made in screening for patients with prostate cancer.

Dr. Choyke on Developments for the Screening of Prostate Cancer

Peter Choyke, MD, FACR, chief of Molecular Imagine Program, National Cancer Institute, discusses which patients with prostate cancer benefit from active surveillance.

There is very good long-term safety data for patients who are appropriately selected for active surveillance, says Choyke.

The patients who benefit from active surveillance have very low-risk cancer with a negative MRI.

Peter Choyke, MD, FACR, chief of Molecular Imaging Program, National Cancer Institute, discusses which patients with prostate cancer benefit from active surveillance. 

Peter Choyke, MD, FACR

Articles

Dr. Choyke on Recent Developments in Imaging for Prostate Cancer

Dr. Choyke on the Importance of Multidisciplinary Care in Prostate Cancer

Dr. Choyke Discusses the Challenges With MRI in Prostate Cancer

Dr. Choyke Discusses Screening in Prostate Cancer

Dr. Choyke on Developments for the Screening of Prostate Cancer

Dr. Choyke on Which Patients Benefit From Active Surveillance in Prostate Cancer