Editing AUA: Advanced Prostate Cancer (2023) (section)

===== Imaging =====
* '''Assess extent of metastatic disease (bone, lymph node, visceral)'''
** Increasing burden of metastatic disease in the form of the number of metastatic sites is associated with increasing risk of overall mortality.
** Visceral metastases are known to portend the highest risk of mortality, followed by bone, compared to lymph nodes
* '''Assess the extent of metastatic disease using conventional imaging at least annually or at intervals determined by lack of response to therapy.'''
** In patients with mCRPC treated with enzalutamide prior to chemotherapy in the PREVAIL trial, radiographic progression occurred in 24.5% of patients without PSA progression, suggesting that routine imaging can identify a significant portion of patients with radiographic progression who would otherwise not be identified.