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Elevated PSA levels and/or abnormal digital rectal exam findings prompt multiparametric MRI to localize prostate lesions. For men with intermediate- or high-risk disease and an unfavorable prognosis, prostate-specific membrane antigen PSMA PET/CT is used to evaluate local nodal spread and extensive metastases, aiming to detect limited metastatic deposits that may offer a therapeutic window.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-current-and-future-role-of-mri-and-psma-petct-in-diagnosing-oligometastatic-prostate-cancer/353633/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-current-and-future-role-of-mri-and-psma-petct-in-diagnosing-oligometastatic-prostate-cancer/353633.png","ImageObject",300,407,{"name":92,"@type":93},"Aria","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What imaging approach is used for initial prostate cancer assessment?","Question",{"text":113,"@type":114},"Men with elevated PSA and/or abnormal digital rectal exam findings undergo multiparametric MRI to identify possible lesions in the prostate.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"When is PSMA PET/CT offered, and what does it assess?",{"text":118,"@type":114},"For intermediate- or high-risk patients with an unfavorable prognosis, PSMA PET/CT is offered to assess local nodal disease and the presence of extensive metastatic involvement.",{"name":120,"@type":111,"acceptedAnswer":121},"Why is accurate lymph node staging important in prostate cancer treatment planning?",{"text":122,"@type":114},"N-staging helps determine whether treatment aims for cure or palliation; traditionally it relied on invasive extended pelvic lymph node dissection, which can miss outside-field nodes and produce false negatives.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},353633,1790171424,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46},2336464648322,"https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488","The Current and Future Role of MRI and PSMA-PET/CT in Diagnosing Oligometastatic Prostate Cancer  \nTom W.J. Scheenen, PhD, Ansje S. Fortuin, PhD, Daniela E. Oprea-Lager, PhD, and  \nMaarten de Rooij, PhD  \nAbstract: This review describes the role of different imaging techniques in the initial diagnosis and staging of prostate cancer (PCa), with a focus onoligometastatic disease. Men with an elevated prostate-specific antigen level and/or with an abnormal digital rectal exam are subject to a multiparametric MRI examination to identify a possible lesion in the prostate. Inpatients with high-risk or intermediate-risk disease with an unfavorable prognosis, additional imaging with prostate-specific membrane antigen (PSMA) PET/CT is offered to assess the presence of local nodal or extensive metastatic disease. Oligometastatic disease, which is PCa with a limited number of 1 to 5 metastatic deposits, possibly provides a time window to delay the course of the disease, or perhaps even still cure the patient. To detect these first metastases in small or normal-sized lymph nodes, the most sensitive, noninvasive imaging method should be selected. In this review, we summarize the current use of MRI and PSMA-PET/CT and discuss the latest developments in these techniques that could further improve initial diagnosis and staging of oligometastatic PCa.  \nKey Words: prostate cancer, USPIO, PSMA, whole-body MRI, lymph nodes, metastases, prostate-specific membrane antigenultrasmall superparamagnetic iron oxide  \n(Invest Radiol 2026;61:185–192)  \nP rostate cancer (PCa) is the most commonly diagnosed cancer  \namong men in 118 of the 185 countries, including many European nations. Its incidence varies markedly across different regions, with higher incidence rates (35.5 per 100,000 men) in transitioned countries compared with transitioning countries (12.6 per 100,000 men) .1 Access to early detection and effective treatment in high-income countries explains the disparity between incidence and mortality rates, of which the latter are highest in the Caribbean and sub-Saharan Africa. 1,2 As with many solid malignancies, cancer localized within the prostate is not lethal; it is its extensive metastases from lymph nodes (LNs) to bones, liver, and lungs that are the final cause of death. The European Association of Urology (EAU) classifies PCa into risk groups—low,  \nReceived for publication June 16, 2025; and accepted for publication, after revision, November 10, 2025 .  \nFrom the Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands (T.W.J. S., A. S.F., D.E.O.L., M.D. R.); Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany (T.W.J.S.); and Department of Radiology, Ziekenhuis Gelderse Vallei, Ede, The Netherlands (A. S.F.) .  \nConflicts of interest and sources of funding: none declared.  \nCorrespondence to: Tom W.J. Scheenen, PhD, Department of Medical Imaging, Radboud University Medical Centre, Geert Grooteplein 10, Nijmegen 6525GA, The Netherlands. E-mail: tom. [scheenen@radboudumc.nl](scheenen@radboudumc.nl).  \nCopyright © 2026 The Author(s) . Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4 .0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nISSN: 1536-0210/26/6102–0185  \nDOI: 10.1097/RLI.0000000000001264  \nInvestigative Radiology 􀀁 Volume 61, Number 3, March 2026  \nintermediate (favorable and unfavorable), and high—based on prostate-specific antigen (PSA) levels, Gleason score, and clinical T-stage.3 This classification helps guide treatment decisions by assessing the likelihood of cancer progression and spread. Identifying the correct risk group is crucial for selecting the most appropriate additional imaging techniques and treatment strategy. The early stage of metastatic involvement, with a limited number of 1 to 5 metastatic deposits,","cbCaigzQc7yuMdiq","https://ap.wps.com/l/cbCaigzQc7yuMdiq","pdf",583481,"English","# Abstract\n# Traditional Staging of Lymph Node Metastases\n# Multiparametric MRI of the Prostate","[{\"question\":\"What imaging approach is used for initial prostate cancer assessment?\",\"answer\":\"Men with elevated PSA and/or abnormal digital rectal exam findings undergo multiparametric MRI to identify possible lesions in the prostate.\"},{\"question\":\"When is PSMA PET/CT offered, and what does it assess?\",\"answer\":\"For intermediate- or high-risk patients with an unfavorable prognosis, PSMA PET/CT is offered to assess local nodal disease and the presence of extensive metastatic involvement.\"},{\"question\":\"Why is accurate lymph node staging important in prostate cancer treatment planning?\",\"answer\":\"N-staging helps determine whether treatment aims for cure or palliation; traditionally it relied on invasive extended pelvic lymph node dissection, which can miss outside-field nodes and produce false negatives.\"}]","The Current and Future Role of MRI and PSMA-PET/CT in Diagnosing Oligometastatic Prostate Cancer | PDF",1790106468]