[Imaging of prostate cancer by diagnostic radiology and nuclear medicine]

The diagnostic methods in radiology and nuclear medicine for the imaging of prostate cancer as well as for the detection of locoregional recurrent disease and positive lymph nodes have progressed dramatically over the past years. Regarding technical advances in magnetic resonance imaging (MRI) and the new tracers used in nuclear medicine, an increase in sensitivity up to 85-90% and in specificity up to 75-90% has been achieved. Especially in MRI, efforts had been made to implement multiparametric imaging using the diagnostic methods of spectroscopy and diffusion-weighted sequences and by including dynamic contrast enhancement studies. In addition, by the use of dedicated, lymph-node specific contrast media, "ultrasmall paramagnetic iron particles" (USPIO), up to 100% of all pathological lymph nodes were detected in the published studies. Also in the field of nuclear medicine there have been relevant advances such as the development of specific tracer substances, which can be coupled to 18fluorine, a nuclide that is characterised by a longer half-life time than 11C and is therefore usable even in sites without an in-house cyclotron. Using this nuclide, the sensitivity and specificity rates in the detection of primary prostate cancer as well as in locoregional recurrences have been increased to values between 85 and 95%.