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Urol Int 2010;85:1–10

Imaging Studies in Metastatic Urogenital Cancer Patients Undergoing Systemic Therapy: Recommendations of a Multidisciplinary Consensus Meeting of the Association of Urological Oncology of the German Cancer Society

Heidenreich A.a · Albers P.b · Classen J.f · Graefen M.h · Gschwend J.c · Kotzerke J.i · Krege S.d · Lehmann J.j · Rohde D.e · Schmidberger H.g · Uder M.k · Zeeb H.l
Departments of Urology,aRWTH University, Aachen, bHeinrich Heine University, Düsseldorf, c Technical University, Munich, dKrankenhaus Maria Hilf, Krefeld, and eKatholisches Krankenhaus Duisburg Zentrum, Duisburg; Departments of Radiation Oncology, fSt. Vincentius Hospital, Karlsruhe, and gJohannes Gutenberg University, Mainz; hMartini-Klinik, University Hospital, Hamburg; iDepartment of Nuclear Medicine, Carl Gustav Carus University, Dresden; jUrologist, Kiel; kDepartment of Radiology, University Hospital, Erlangen; lDepartment of Biostatistics, Johannes Gutenberg University, Mainz, Germany
email Corresponding Author

 goto top of outline Key Words

  • Bladder cancer
  • Computed tomography
  • Germ cell tumors
  • Magnetic resonance imaging
  • PET-CT
  • Prostate cancer
  • Renal cell cancer
  • Skeletal scintigraphy
  • Testis cancer
  • Therapy response assessment

 goto top of outline Abstract

Introduction: Imaging studies are an integral and important diagnostic modality to stage, to monitor and follow-up patients with metastatic urogenital cancer. The currently available guidelines on diagnosis and treatment of urogenital cancer do not provide the clinician with evidence-based recommendations for daily practice. Objectives: To develop scientifically valid recommendations with regard to the most appropriate imaging technique and the most useful time interval in metastatic urogenital cancer patients undergoing systemic therapy. Methods: A systematic literature review was performed searching MedLine, Embase and Web of Science databases using the terms prostate, renal cell, bladder and testis cancer in combination with the variables lymph node, lung, liver, bone metastases, chemotherapy and molecular therapy, and the search terms computed tomography, magnetic resonance imaging and positron emission tomography were applied. A total of 11,834 records were retrieved from all databases. The panel reviewed the records to identify articles with the highest level of evidence using the recommendation of the US Agency for Health Care Policy and Research. Conclusions: Contrast-enhanced computed tomography remains the standard imaging technique for monitoring of pulmonary, hepatic and lymph node metastases. Bone scintigraphy is still the most widely used imaging technique for the detection and follow-up of osseous lesions. For clinical trials it might be replaced by either PET-CT or MRI of the skeletal axis. Response assessment for patients treated with cytotoxic regime is best performed by the RECIST/WHO criteria; treatment response to molecular triggered therapy is best assessed by CT evaluating decrease in tumor size and density. Cross-sectional imaging studies for response assessment might be obtained after each 2 cycles of systemic therapy to early stratify responders from non-responders.

Copyright © 2010 S. Karger AG, Basel

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 goto top of outline Author Contacts

Prof. Dr. med. Axel Heidenreich
Department of Urology, RWTH University Aachen
Pauwelsstrasse 30
DE–52074 Aachen (Germany)
Tel. +49 241 808 9377, Fax +49 241 802 441, E-Mail

 goto top of outline Article Information

Published online: July 26, 2010
Number of Print Pages : 10
Number of Figures : 0, Number of Tables : 4, Number of References : 65

 goto top of outline Publication Details

Urologia Internationalis

Vol. 85, No. 1, Year 2010 (Cover Date: July 2010)

Journal Editor: Wirth M.P. (Dresden), Porena M. (Perugia), Hakenberg O.W. (Rostock), Castro-Diaz D. (Santa Cruz de Tenerife)
ISSN: 0042-1138 (Print), eISSN: 1423-0399 (Online)

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