Impact of Modern Imaging on the Management of Prostate Cancer
(2026)
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- Abstract
- Imaging plays a central role in prostate cancer, with two major objectives: the detection of metastases and the assessment of treatment response. The emergence of whole-body MRI and, more recently, PSMA-targeted PET/CT has profoundly modified initial staging and follow-up strategies. The first part of this thesis questions the relevance of conventional staging, combining bone scintigraphy and thoraco-abdomino-pelvic CT, due to its limited sensitivity for accurate staging and for assessing therapeutic response, particularly in patients with predominant bone involvement. The second part compares the diagnostic performance of whole-body MRI and PSMA PET/CT in detecting metastases. Our results demonstrate the overall superiority of PSMA PET/CT, particularly for lymph node detection, while highlighting the value of whole-body MRI as a non-irradiating alternative. Finally, the third part analyses imaging criteria for assessing response to hormonal therapy using whole-body MRI in both hormone-naïve metastatic and castration-resistant disease. Our findings demonstrate the prognostic value of imaging beyond PSA levels to guide therapeutic strategies, particularly in terms of treatment escalation or de-escalation.
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Van Damme, J. (2026). Impact of Modern Imaging on the Management of Prostate Cancer. https://hdl.handle.net/2078.5/274345