Magnetic Resonance or Computed Tomography and Bone Scan for Staging Metastatic Hormone-Sensitive Prostate Cancer.

Area of Science:

• Oncology
• Radiology
• Prostate Cancer Research

Background:

• Computed tomography with bone scans (CT-B) is standard for staging metastatic hormone-sensitive prostate cancer (mHSPC).
• Whole-body magnetic resonance imaging (WB-MRI) is emerging as a potentially superior staging modality.
• Direct comparison of WB-MRI and CT-B in mHSPC staging and outcomes is needed.

Purpose of the Study:

• To compare the efficacy of WB-MRI versus CT-B in detecting metastatic sites in mHSPC.
• To evaluate the impact of WB-MRI and CT-B on disease classification using CHAARTED and LATITUDE criteria.
• To assess the influence of imaging modality on treatment outcomes and survival in mHSPC.

Main Methods:

• Retrospective analysis of 203 mHSPC patients from two UK hospitals (February 2017 - August 2023).
• Patients underwent baseline staging with either WB-MRI (n=120) or CT-B (n=83).
• Demographic, disease extent, treatment data, and survival outcomes were analyzed; CHAARTED and LATITUDE criteria were applied.

Main Results:

• WB-MRI detected significantly higher rates of bone-only disease, high-volume, high-risk, and de novo metastatic disease compared to CT-B.
• WB-MRI identified fewer lymph node-only metastases and less prior radical treatment.
• Both CHAARTED and LATITUDE classifications independently predicted overall survival, with significant volume/risk differences more pronounced in the WB-MRI group.

Conclusions:

• WB-MRI demonstrates enhanced accuracy in staging and risk stratification for mHSPC compared to CT-B.
• Findings suggest WB-MRI may optimize treatment decisions and patient management in mHSPC.
• Further prospective studies are warranted to validate these findings.