NCCN Guidelines for Patients
: Prostate Cancer
Part 3: Treatment planning
3.3 Imaging tests
Imaging tests make pictures (images) of the insides of
your body. They can help show if the cancer has spread
to the lymph nodes or bones. If your life expectancy
is more than 5 years or you have cancer symptoms,
testing for metastases may help with treatment planning.
Signs of metastases are listed in the chart below. If you
have these signs, you may get a 1) bone scan or 2) CT
omography) or MRI (
imaging) scan of your pelvis. Results of these tests may
change the stage of the cancer.
Signs of metastases
Bone scan if you have a:
• T1 tumor and your PSA
level is >20 ng/mL,
• T2 tumor and your PSA
level is >10 ng/mL,
• Gleason score of 8 or
• T3 or T4 tumor, or
• You have symptoms that
suggest cancer is in bone
Pelvic CT or MRI scan if
you have a:
• T3 or T4 tumor, or
• T1 or T2 tumor and
nomogram results show
>10% risk of cancer
spread to the lymph
Getting an imaging test is often easy. There are usually
no side effects. If radiation is used, the amount is small.
Depending on the test, you may need to stop taking
some medicines, stop eating and drinking for a few
hours, and remove metal objects from your body.
After an imaging test, you will be able to resume your
activities right away unless you took a sedative. You may
not learn of the results for a few days since a radiologist
or nuclear medicine specialist needs to see the pictures.
A radiologist is a doctor who’s an expert in reading
images. A nuclear medicine specialist is a doctor who’s
an expert in tests that use radioactive substances.
A bone scan is suggested if you have signs or symptoms
of bone metastases. For this test, a radiotracer will be
injected into your vein. The most common radiotracer
used for bone scans is technetium. A special camera
will then take pictures of the dye in the bones. The
radiotracer can be seen in your bones 2 to 3 hours after
it is injected. You may be asked to drink water and empty
your bladder to wash out any of the radiotracer that is not
in your bones.
Figure 7 shows the machine used to take the pictures.
You will need to lie still on the padded table for 45 to 60
minutes to complete the pictures. Prostate cancer in bone
can damage the bone causing the bone to repair itself.