One of the obstacles for the adequate treatment of prostate cancer is the lack of reliable modalities to detect lymph node involvement in newly diagnosed patients. Until now, the only accurate solution is to perform an extended lymph node dissection. In this dissertation, investigated the role of choline positron emission tomography-computed tomography, diffusion-weighted magnetic resonance imaging and a sentinel node procedure for nodal staging were investigated showing that these novel approaches are not reliable enough to substitute for a lymphadenectomy. Furthermore, we reported which regions are of most importance if a staging lymphadenectomy is performed.
A second part, focused on the accurate localisation of the macroscopic tumour nodule within the prostate since delivering a higher radiation dose to this specific region might reduce the chances of local recurrence after radiotherapy. Therefore, the performance of the aforementioned imaging modalities were tested in the detection of intraprostatic tumour nodule(s). In conclusion, combining different functional magnetic resonance imaging modalities improved visualisation of the tumour but that the additional value of a positron emission tomography scan in this specific setting was limited.
(BELG J MED ONCOL 2013;7(5):156–58)