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25

NCCN Guidelines for Patients

®

Prostate Cancer, Version 1.2016

3

Treatment planning

Imaging for metastases

Guide 1. Deciding factors for imaging tests

Imaging test

Signs of metastases

Get a bone scan if your test results match

any the following:

• T1 tumor and your PSA levels >20 ng/mL,

• T2 tumor and your PSA levels >10 ng/mL,

• Gleason score of 8 or higher,

• T3 or T4 tumor, or

• You have symptoms that suggest cancer is in bone

Get a pelvic CT or MRI if your test results

match any the following:

• T3 or T4 tumor, or

• T1 or T2 tumor and nomogram results show >10% risk of

cancer spread to the lymph nodes

Imaging for metastases

Imaging tests 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

Guide 1.

If you have these signs, you may get a 1) bone scan

or 2) CT (

c

omputed

t

omography) or MRI scan of your

pelvis. Your doctor may change his or her rating of the

cancer stage based on these test results.

Most men have minor, if any, problems with imaging

tests. There are usually no side effects. Depending

on the test, you may need to stop taking some

medicines, stop eating and drinking for a few hours,

and take off any 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.