The current role of CT and bone scintigraphy in prostate cancer staging

According to the current guidelines, com­ puted tomography (CT) and bone scin­ tigraphy (BS) are optional in intermediate­ risk and recommended in high-risk prostate cancer (PCa) for the preoperative staging.1, z I-Iowever, their use has been questioned by several studies reporting a limited staging ability for both the procedures. In particu­ lar, BS is deeply influenced by PSA level and Gleason score,3 while the accuracy of CT scan has been shown to be really poor, even in those patients with a ve1y high risk of nodal metastases.4 On the other hand, preoperative clinical models such as Partin 5 or Briganti nomograms 6 have shown more accuracy than CT to decide for the need of pelvic lymph node dissection (PLND). All these things considered, we wondered whether it is time for these examinations to be dismissed, evaluating their staging ac­ curacy in a large cohort of radical prostate­ ctomy patients.