Uro Oncology: Imaging

Imaging plays a crucial role in diagnosing and monitoring prostate, kidney, bladder, and testicular cancers. Various imaging modalities help detect tumors, assess their extent, and guide treatment decisions. The choice of imaging depends on the type and stage of cancer, as well as the specific clinical needs of the patient.

For prostate cancer, imaging techniques such as multiparametric MRI (mpMRI) provide detailed images of the prostate, helping to distinguish between aggressive and non-aggressive tumors. Prostate-specific membrane antigen (PSMA) PET scans have emerged as an advanced imaging tool, allowing for the detection of prostate cancer metastases with high accuracy. Transrectal ultrasound (TRUS) is commonly used for guiding prostate biopsies to confirm the presence of cancer.

In kidney cancer, CT scans with contrast are the primary imaging method to evaluate kidney masses and distinguish benign from malignant tumors. MRI is also useful, particularly in patients with impaired kidney function who cannot tolerate contrast dye. Additionally, ultrasound is often used for initial screening or to assess cystic kidney lesions, though it is less detailed than CT or MRI.

For bladder cancer, cystoscopy remains the gold standard for diagnosing tumors inside the bladder, but imaging plays a vital role in staging the disease. CT urography is commonly used to assess the urinary tract and detect tumors. MRI can provide additional detail, especially for evaluating the depth of bladder wall invasion. PET scans may be used in advanced cases to assess the spread of the disease.

In testicular cancer, scrotal ultrasound is the first-line imaging modality to detect testicular masses and determine if they are solid (more likely cancerous) or cystic (likely benign). If cancer is confirmed, CT scans of the abdomen and pelvis are performed to evaluate lymph node involvement and metastasis. MRI may be used in cases where more detailed imaging is needed, particularly for retroperitoneal lymph nodes.