Prostascint/MRI Fusion Imaging in Prostate Brachytherapy
Prostascint imaging combined with MRI scanning is a new technological advance in the diagnosis and treatment of prostate cancer. New state of the art software combines the anatomic clarity of an MRI picture with the ability of the Prostascint test to immunologically detect deposits of PSMA bearing cells.
The Prostascint/MRI fusion images are useful in the preoperative evaluation of newly diagnosed cases of prostate cancer as well as for guiding the intraoperative planning of a radioisotope seed implant.
Recent studies have shown the surprising finding of intra-abdominal lymph node metastasis in 20% of newly diagnosed prostate cancer patients. This does not appear related to PSA or Gleason score and emphasizes the heterogeneous nature of prostate cancer. This finding of intra-abdominal lymph node metastasis can indicate the need for systemic treatment such as hormone therapy.
Finally, the fusion images allow customization of the intraoperative treatment planning for brachytherapy. This permits increasing radiation doses to areas of higher cancer cell burden. Prostascint/MRI evidence of extra capsular extension or seminal vesicle involvement allows increase of radiation doses at these sites.