title: Current Use of Imaging after Primary Treatment of Prostate Cancer.
abstract: OBJECTIVE
  Data are limited on imaging after primary treatment of localized prostate cancer.
  
  
  METHODS
  We identified 8,435 men newly diagnosed with nonmetastatic prostate cancer in 1995 to 2012 who were enrolled in CaPSURE™. Patients were followed after primary treatment with radical prostatectomy, cryosurgery, brachytherapy, external beam radiation therapy or androgen deprivation therapy. We assessed the use of bone scan, computerized tomography and magnetic resonance imaging after primary treatment. Factors associated with posttreatment outcomes (number of imaging tests, and time to first imaging and salvage treatment) were evaluated with multivariate Poisson regression and Cox proportional hazards regression.
  
  
  RESULTS
  The incidence of posttreatment bone scan, computerized tomography and magnetic resonance imaging was 20% or less. Last posttreatment log(prostate specific antigen) was associated with multiple posttreatment imaging. Management by radical prostatectomy, cryosurgery, external beam radiation therapy or brachytherapy vs androgen deprivation therapy was associated with a lower likelihood of posttreatment imaging. Of patients who were imaged after treatment 25% with radical prostatectomy and 9% with radiation underwent imaging before prostate specific antigen failure. The 5-year salvage treatment-free survival rate was 81%. Positive findings on posttreatment imaging were associated with a higher risk of salvage treatment.
  
  
  CONCLUSIONS
  Patients treated with androgen deprivation therapy for localized disease were most likely to be imaged, primarily by bone scan. Men treated with other therapies were less likely to be imaged and tended to undergo computerized tomography. Imaging may add value to posttreatment prostate specific antigen monitoring to identify disease recurrence and progression. Further studies are needed to establish guidelines for the optimal frequency and imaging type to monitor the treatment response.
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California; Department of Urology, Cairo University, Cairo, Egypt.
authors: Ahmed A
authors: AA
authors: Hussein
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
authors: Sanoj
authors: S
authors: Punnen
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
authors: Shoujun
authors: S
authors: Zhao
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
authors: Janet E
authors: JE
authors: Cowan
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
authors: Michael
authors: M
authors: Leapman
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
authors: Thanh C
authors: TC
authors: Tran
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
authors: Samuel L
authors: SL
authors: Washington
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
authors: Matthew D
authors: MD
authors: Truesdale
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California.
authors: Peter R
authors: PR
authors: Carroll
authors: Department of Urology and Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California. Electronic address: mcooperberg@urology.ucsf.edu.
authors: Matthew R
authors: MR
authors: Cooperberg
mesh_terms: D000368:Aged; D003952:Diagnostic Imaging; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D012189:Retrospective Studies
keywords: diagnostic imaging; disease progression; prostate-specific antigen; prostatic neoplasms; salvage therapy