The expanding role of next-generation imaging in prostate cancer management: a cross-sectional survey exploring the clinical practice of uro-oncologists in North-Eastern Italy; on behalf of GUONE (Gruppo Uro-Oncologico del Nord-Est)

Fabio Matrone¹, Luca Urso², Rossano Girometti^{3

4}, Jerry Polesel⁵, Matteo Sepulcri⁶, Francesco Pierantoni⁷, Paolo Artioli⁸, Anna Caliò⁹, Irene Campo¹⁰, Alessia Cimadamore¹¹, Enrico Munari¹², Luca Ongaro¹³, Valentina Orlando¹⁴, Camilla Sachs¹⁵, Alessandro Veccia¹⁶, Alessandro Antonelli¹⁶, Roberto Bortolus¹⁷, Matteo Brunelli⁹, Orazio Caffo¹⁸, Laura Evangelista¹⁹, Matteo Salgarello²⁰, Umberto Basso²¹, Rocco De Vivo²², Mario Gardi²³, Andrea Guttilla²⁴, Marco Andrea Signor²⁵, Fabio Zattoni²⁶, Filippo Alongi^{27

28}, Giampaolo Montesi²⁹, Gianluca Giannarini³⁰

Affiliations

¹ Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, Aviano 33081, Italy.
² Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
³ Istituto di Radiologia, Dipartimento di Medicina (DMED), Università di Udine, Udine, Italy.
⁴ Presidio Ospedaliero S. Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
⁵ Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
⁶ Radiation Therapy Unit, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy.
⁷ Oncology Unit 3, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
⁸ UOC Medicina Nucleare, Istituto Oncologico Veneto IOV-IRCCS, Castelfranco Veneto, Italy.
⁹ Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
¹⁰ Radiology Unit, SC Radiologia Gorizia-Monfalcone, Monfalcone, Italy.
¹¹ Institute of Pathological Anatomy, Department of Medicine, University of Udine, Udine, Italy.
¹² Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
¹³ Urological Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
¹⁴ Oncology Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italy.
¹⁵ Department of Radiology, Ospedale Ca' Foncello, Treviso, Italy.
¹⁶ Urology Unit, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
¹⁷ Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
¹⁸ Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy.
¹⁹ Department of Biomedical Sciences, Humanitas University, Milan, Italy.
²⁰ Nuclear Medicine Unit, Ospedale Sacro Cuore Don Calabria IRCCS, Negrar di Valpolicella, Italy.
²¹ Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
²² Department of Oncology, Ospedale San Bartolo, Vicenza, Italy.
²³ Urology Clinic, Azienda Ospedale Universitaria di Padova, Padova, Italy.
²⁴ Urology Clinic, Camposampiero Hospital, Camposampiero, Italy.
²⁵ Radiation Therapy Unit, S. Maria della Misericordia University Hospital, Udine, Italy.
²⁶ Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
²⁷ Advanced Radiation Oncology Department, Ospedale Sacro Cuore Don Calabria IRCCS, Negrar di Valpolicella, Italy.
²⁸ University of Brescia, Brescia, Italy.
²⁹ Radiation Oncology Unit, Santa Maria della Misericordia Hospital, Rovigo, Italy.
³⁰ Urology Unit, S. Maria della Misericordia University Hospital, Udine, Italy.

PMID: 40083770
PMCID: PMC11905040
DOI: 10.1177/17562872251321971

The expanding role of next-generation imaging in prostate cancer management: a cross-sectional survey exploring the clinical practice of uro-oncologists in North-Eastern Italy; on behalf of GUONE (Gruppo Uro-Oncologico del Nord-Est)

Fabio Matrone et al. Ther Adv Urol. 2025.

. 2025 Mar 12:17:17562872251321971.

doi: 10.1177/17562872251321971. eCollection 2025 Jan-Dec.

Authors

Affiliations

¹ Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, via F. Gallini 2, Aviano 33081, Italy.
² Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
³ Istituto di Radiologia, Dipartimento di Medicina (DMED), Università di Udine, Udine, Italy.
⁴ Presidio Ospedaliero S. Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
⁵ Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
⁶ Radiation Therapy Unit, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy.
⁷ Oncology Unit 3, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
⁸ UOC Medicina Nucleare, Istituto Oncologico Veneto IOV-IRCCS, Castelfranco Veneto, Italy.
⁹ Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
¹⁰ Radiology Unit, SC Radiologia Gorizia-Monfalcone, Monfalcone, Italy.
¹¹ Institute of Pathological Anatomy, Department of Medicine, University of Udine, Udine, Italy.
¹² Department of Pathology and Diagnostic, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
¹³ Urological Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
¹⁴ Oncology Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italy.
¹⁵ Department of Radiology, Ospedale Ca' Foncello, Treviso, Italy.
¹⁶ Urology Unit, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
¹⁷ Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
¹⁸ Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy.
¹⁹ Department of Biomedical Sciences, Humanitas University, Milan, Italy.
²⁰ Nuclear Medicine Unit, Ospedale Sacro Cuore Don Calabria IRCCS, Negrar di Valpolicella, Italy.
²¹ Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
²² Department of Oncology, Ospedale San Bartolo, Vicenza, Italy.
²³ Urology Clinic, Azienda Ospedale Universitaria di Padova, Padova, Italy.
²⁴ Urology Clinic, Camposampiero Hospital, Camposampiero, Italy.
²⁵ Radiation Therapy Unit, S. Maria della Misericordia University Hospital, Udine, Italy.
²⁶ Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
²⁷ Advanced Radiation Oncology Department, Ospedale Sacro Cuore Don Calabria IRCCS, Negrar di Valpolicella, Italy.
²⁸ University of Brescia, Brescia, Italy.
²⁹ Radiation Oncology Unit, Santa Maria della Misericordia Hospital, Rovigo, Italy.
³⁰ Urology Unit, S. Maria della Misericordia University Hospital, Udine, Italy.

PMID: 40083770
PMCID: PMC11905040
DOI: 10.1177/17562872251321971

Abstract

Background: Next-generation imaging (NGI) technologies such as multiparametric magnetic resonance imaging (mpMRI) and total-body NGI (tbNGI) methodologies including choline, fluciclovine or PSMA positron emission tomography/computed tomography (PET/CT), whole-body MRI (wbMRI), and PET/MRI are becoming increasingly available, but their use in different prostate cancer (PCa) settings is under debate. The Gruppo Uro-Oncologico del Nord-Est (GUONE) designed a survey to explore the current clinical practice of NGI utilization in a specific macro-region in North-Eastern Italy.

Methods: A cross-sectional survey was conducted by administering an anonymous online multiple-choice questionnaire to uro-oncologists practicing in North-Eastern Italy, using the Google Forms^® platform. The use of NGI was investigated in the following settings: primary staging of PCa; management of biochemical (BCR) and local recurrence (LR); re-staging in metastatic hormone-sensitive PCa (mHSPC), metastatic castration-resistant PCa (mCRPC), non-metastatic CRPC (nmCRPC), and oligometastatic PCa (OMPC).

Results: In all, 100 uro-oncologists accessed and completed the survey. In primary N/M staging, the use of tbNGI increases in accordance with NCCN risk groups. Re-staging with choline and PSMA PET/CT is the prevalent choice in the case of BCR after radical prostatectomy. Moreover, when the PSA value rises, there is a parallel increased use of tbNGI. When an LR is suspected, PSMA PET/CT plus mpMRI is the most selected option. Re-staging with tbNGI (PSMA PET/CT) is preferred in mHSPC, mCRPC, and nmCRPC patients in case of progression of disease. Overall, there is a limited use of wbMRI and PET/MRI in all the settings investigated.

Conclusion: Our survey describes the expanding role of NGI modalities in the management of PCa patients, from primary staging and re-staging to management of advanced PCa and assessment of treatment response. Several controversial issues have emerged, which need to be addressed in prospective studies to develop a standardized and cost-effective NGI utilization.

Keywords: PET/MRI; PSMA PET/CT; mpMRI; prostate cancer; whole-body MRI.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

**Figure 1.**
Distribution of NGI technologies by Local Health Unit in North-Eastern Italy. NGI, next-generation imaging.

See this image and copyright information in PMC

References

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The expanding role of next-generation imaging in prostate cancer management: a cross-sectional survey exploring the clinical practice of uro-oncologists in North-Eastern Italy; on behalf of GUONE (Gruppo Uro-Oncologico del Nord-Est)

Affiliations

The expanding role of next-generation imaging in prostate cancer management: a cross-sectional survey exploring the clinical practice of uro-oncologists in North-Eastern Italy; on behalf of GUONE (Gruppo Uro-Oncologico del Nord-Est)

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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Research Materials

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