Advances in medical imaging for the diagnosis and management of common genitourinary cancers

Abstract

Medical imaging of the three most common genitourinary (GU) cancers—prostate adenocarcinoma, clear cell renal cell carcinoma (RCC), and urothelial carcinoma of the bladder—has evolved significantly during the past decades. The most commonly used imaging modalities for the diagnosis, staging, and follow-up of GU cancers are computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). Multiplanar multidetector CT and multiparametric MRI (mpMRI) with diffusion-weighted imaging are the main imaging modalities for RCC and urothelial carcinoma, and while mpMRI is rapidly becoming the main imaging tool in the evaluation of prostate adenocarcinoma, biopsy is still required for diagnosis. Functional and molecular imaging using 18-fluorodeoxyglucose (FDG)-PET, and sodium fluoride (NaF)-PET are essential for the diagnosis, and especially follow-up, of metastatic GU tumors. This review will provide an overview of the latest advances in the imaging of these three major GU cancers.

EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer—An International Collaborative Multistakeholder Effort†

“…However, in a staging study of 42 patients prior to cystectomy, FDG-PET-CT detected metastases in seven patients who showed no evidence of disease on CT and bone scans [57]. A published review of six series also found a high diagnostic accuracy for metastatic lesions using FDG-PET-CT [58], and a recent review from the National Institutes of Health (Bethesda, MD, USA) concluded that FDG-PET-CT was the optimal technology in this setting [59]. Statement 2: PET-CT scanning should be included in OMD staging when considering radical treatment.…”

Usefulness of multi‑parametric MRI for diagnosis of invasive urothelial cancer: Case reports of bladder and ureteral cancer

“…For high-grade non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC), MRI may detect and stage tumors with high sensitivity and specificity (7). mpMRI has demonstrated high diagnostic accuracy in differentiating NMIBC from MIBC and organ-confined disease from non-organ confined disease (8); exceeding that of T2 weighted imaging (T2W) or diffusion weighted imaging (DWI)-MRI used alone (8).…”

EAU–ESMO consensus statements on the management of advanced and variant bladder cancer—an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees

“…However, in a staging study of 42 patients before cystectomy, FDG-PET-CT detected metastases in seven patients who showed no evidence of disease on CT and bone scans [57]. A published review of six series also found a high diagnostic accuracy for metastatic lesions using FDG-PET-CT [58], and a recent review from The National Institutes of Health, Bethesda, USA, concluded that FDG-PET-CT was the optimal technology in this setting [59].…”