Imaging for recurrent prostate cancer

Imaging for recurrent prostate cancer following treatment with radical prostatectomy,radiation therapy, or cryosurgery has become an important determinant in the treatment options available to patients. Used in conjunction with clinical parameters such as tumor characteristic and posttreatment serum prostate-specific antigen (PSA), imaging tests are critical for determining whether recurrent disease is Limited to the prostate or prostatic fossa or whether disease has spread to distant sites. Several imaging modalities can be used to provide evidence for Limited local disease recurrence and thereby identify disease that is still potentially curable with adjuvant treatments. Likewise, imaging tests help not only to detect distant disease recurrence, but also to monitor response of such metastases to treatment. This article examines the imaging modalities currently used to detect prostate cancer recurrence and presents a general algorithm for surveillance of patients following definitive primary treatment of prostate cancer with prostatectomy, radiation therapy, or cryosurgery.