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Prostate cancer staging

Radiology Department, St George's Hospital, Blackshaw Road, London SW17 0QT, UK

• Prostate cancer is the most commonly diagnosed cancer in men in the UK.
  
• The majority of patients have no symptoms and are detected with routine prostate-specific antigen testing.
  
• Transrectal ultrasound can diagnose the primary tumour but its main role is in guiding biopsy to obtain a histological diagnosis.
  
• MRI is used to stage the primary tumour and to detect local nodal disease.
  
• CT should be used in patients with metastatic disease to assess complications and to plan radiotherapy.
  

The diagnosis of prostate cancer is suggested by elevated prostate-specific antigen but is confirmed by histopathological examination of ultrasound-guided transrectal biopsies. Recent NICE guidelines have made specific recommendations regarding imaging, and this review focuses on the value of existing imaging modalities in the staging of prostate cancer.