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A prospective multi-institutional study of preoperative TRUS in men with clinically localized prostate cancer eligible for radical prostatectomy showed that TRUS was no better than digital rectal examination in predicting extracapsular tumor extension or seminal vesicle involvement.[22] Computed tomography (CT) scans CT scans can detect grossly enlarged lymph nodes but poorly define intraprostatic features;[23] therefore, it is not reliable for the staging of pelvic node disease when compared with surgical staging.[24] Technetium Tc 99m (99mTc)-methylene diphosphonate (MDP) bone scan A 99mTc-MDP bone scan is the most widely used test for metastasis to the bone, which is the most common site of distant tumor spread

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Practice points are consensus statements about a specific aspect of care and represent the expert judgment of the guideline work group, but may also be based on limited evidence (not graded for strength or quality of evidence)