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Prostate Cancer

Evaluation for Distant Disease: Imaging Tests

When prostate cancer spreads outside the prostate gland, it may not only involve nearby organs and structures such as the seminal vesicles or the bladder. It may also spread, or metastasize, to areas distant from the prostate gland. The most common areas of metastasis are pelvic or abdominal lymph nodes (bean-shaped collections of white blood cells that fight infection or disease) and the bones, especially of the pelvis, spine and ribs. Prostate cancer may also spread to the lungs.

Imaging tests take pictures of the inside of the body using various forms of energy. They are able to see whether cancer has spread outside the prostate gland and help determine the clinical stage of the cancer. Imaging tests are conducted only when metastasis is suspected. Otherwise, imaging tests are not recommended.

Several imaging tests are available:

  • Bone Scan
    A bone scan shows whether prostate cancer has spread to the bones. A tiny amount of low-level radioactive material is injected into the patient's bloodstream. This radioactive material attaches itself to diseased bone cells throughout the entire skeleton and shows up as "hot spots" on the bone scan. Hot spots may mean bone metastasis, but they can also indicate the presence of arthritis, an old injury, or other bone diseases. Additional testing may need to be done to distinguish among those conditions.

  • CT scan
    Computed tomography, more commonly known as a CT or CAT scan, is used to look for abnormally enlarged lymph nodes where cancer may have spread. The technique uses a rotating x-ray beam to create a series of pictures of the body from many angles. A computer combines the information from all these pictures to produce a detailed cross-sectional image.

  • Magnetic Resonance Imaging (MRI)
    Magnetic resonance imaging (MRI) is used to see abnormal areas of bone or lymph nodes where prostate cancer may have spread. An MRI is similar to a CT scan, except that magnetic fields are used instead of x-rays to create cross-sectional images of the body.

  • ProstaScint Scan
    A ProstaScint scan is similar to a bone scan, but with some important differences. Instead of looking only at bone, it can see whether the prostate cancer has spread to other organs and lymph nodes. In addition, a prostascint scan can distinguish prostate cancer from other cancers and benign disorders. A tiny amount of low-level radioactive material, called a monoclonal antibody, is injected into the bloodstream. This antibody attaches itself to prostate-specific membrane antigen, a substance found only in normal and cancerous prostate cells, turning up "hot spots" on the scan.

The Prostate Cancer pages of this Web site are part of the Comprehensive Prostate Cancer Awareness Program (CPCAP), a major regional effort to reduce the rates of death and illness caused by prostate cancer in southwestern Pennsylvania. Funding for CPCAP is provided by a grant from the Commonwealth of Pennsylvania.


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