title: Diagnostic imaging to detect and evaluate response to therapy in bone metastases from prostate cancer: current modalities and new horizons.
abstract: Different therapeutic options for the management of prostate cancer (PC) have been developed, and some are successful in providing crucial improvement in both survival and quality of life, especially in patients with metastatic castration-resistant PC. In this scenario, diverse combinations of radiopharmaceuticals (for targeting bone, cancer cells and receptors) and nuclear medicine modalities (e.g. bone scan, SPECT, SPECT/CT, PET and PET/CT) are now available for imaging bone metastases. Some radiopharmaceuticals are approved, currently available and used in the routine clinical setting, while others are not registered and are still under evaluation, and should therefore be considered experimental. On the other hand, radiologists have other tools, in addition to CT, that can better visualize bone localization and medullary involvement, such as multimodal MRI. In this review, the authors provide an overview of current management of advanced PC and discuss the choice of diagnostic modality for the detection of metastatic skeletal lesions in different phases of the disease. In addition to detection of bone metastases, the evaluation of response to therapy is another critical issue, since it remains one of the most important open questions that a multidisciplinary team faces when optimizing the management of PC. The authors emphasize the role of nuclear modalities that can presently be used in clinical practice, and also look at future perspectives based on relevant clinical data with novel radiopharmaceuticals.
authors.affiliation: Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padova, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Evangelista
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Verona, Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bertoldo
authors.affiliation: Academic Unit of Medical Oncology, IRCCS AOU San Martino-IST (San Martino University Hospital and National Cancer Research Institute), Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Boccardo
authors.affiliation: Department of Urology, Sant' Anna Hospital, Como, Italy.
authors.forename: Giario
authors.initials: G
authors.lastname: Conti
authors.affiliation: Department of Diagnostic Imaging, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Ilario
authors.initials: I
authors.lastname: Menchi
authors.affiliation: Department of Diagnostic Imaging, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mungai
authors.affiliation: Department of Oncology, Radiation Oncology, University of Torino, Torino, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
authors.affiliation: Nuclear Medicine Department, Humanitas Gavazzeni, Via Gavazzeni 31, 24125, Bergamo, Italy. emilio.bombardieri@gavazzeni.it.
authors.forename: Emilio
authors.initials: E
authors.lastname: Bombardieri
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy*; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D008297:Male; D009683:Nuclear Medicine; D011471:Prostatic Neoplasms / Q000473:pathology*; D016896:Treatment Outcome
keywords: Bone metastases; Bone scan; Functional imaging; MRI; Metastatic resistant prostate cancer; PET scan