• The lancet oncology · Oct 2018

    Review Practice Guideline

    Use of modern imaging methods to facilitate trials of metastasis-directed therapy for oligometastatic disease in prostate cancer: a consensus recommendation from the EORTC Imaging Group.

    • Frédéric E Lecouvet, Daniela E Oprea-Lager, Yan Liu, Piet Ost, Luc Bidaut, Laurence Collette, Christophe M Deroose, Karolien Goffin, Ken Herrmann, Otto S Hoekstra, Gem Kramer, Yolande Lievens, Egesta Lopci, David Pasquier, Lars J Petersen, Jean-Noël Talbot, Helle Zacho, Bertrand Tombal, and Nandita M deSouza.
    • Department of Radiology, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium. Electronic address: frederic.lecouvet@uclouvain.be.
    • Lancet Oncol. 2018 Oct 1; 19 (10): e534-e545.

    AbstractOligometastatic disease represents a clinical and anatomical manifestation between localised and polymetastatic disease. In prostate cancer, as with other cancers, recognition of oligometastatic disease enables focal, metastasis-directed therapies. These therapies potentially shorten or postpone the use of systemic treatment and can delay further metastatic progression, thus increasing overall survival. Metastasis-directed therapies require imaging methods that definitively recognise oligometastatic disease to validate their efficacy and reliably monitor response, particularly so that morbidity associated with inappropriately treating disease subsequently recognised as polymetastatic can be avoided. In this Review, we assess imaging methods used to identify metastatic prostate cancer at first diagnosis, at biochemical recurrence, or at the castration-resistant stage. Standard imaging methods recommended by guidelines have insufficient diagnostic accuracy for reliably diagnosing oligometastatic disease. Modern imaging methods that use PET-CT with tumour-specific radiotracers (choline or prostate-specific membrane antigen ligand), and increasingly whole-body MRI with diffusion-weighted imaging, allow earlier and more precise identification of metastases. The European Organisation for Research and Treatment of Cancer (EORTC) Imaging Group suggests clinical algorithms to integrate modern imaging methods into the care pathway at the various stages of prostate cancer to identify oligometastatic disease. The EORTC proposes clinical trials that use modern imaging methods to evaluate the benefits of metastasis-directed therapies.Copyright © 2018 Elsevier Ltd. All rights reserved.

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