[Diagnosis and staging of metastatic hormone-sensitive prostate cancer].

Background: Risk stratification of patients with metastatic hormone-sensitive prostate cancer (mHSPC) has undergone significant changes in recent years in light of new therapies and innovative imaging.
Objectives: Established and innovative methods for detection of metastasis, risk group stratification, and treatment of mHSPC are outlined and compared.
Materials and Methods: Background knowledge and treatment-relevant guideline recommendations on mHSPC are presented and complemented by recent study results.
Results: Integration of modern imaging techniques, especially prostate-specific membrane antigen (PSMA) PET/CT, into the diagnostic algorithm has the potential to significantly improve risk stratification and treatment of mHSPC. By using PSMA PET/CT, metastases are detected early and sensitively. This leads to the definition of new subgroups amenable to modern therapeutic strategies. The prognostic value of using PSMA PET/CT with regard to established risk categories in mHSPC is currently being evaluated.
Conclusions: Modern imaging, especially PSMA PET/CT, has significant added value for the diagnosis and treatment of mHSPC in almost all subgroups. In particular, it helps to select patients who will benefit from intensification or de-escalation of systemic therapy.
(© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)