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How prostate cancer is diagnosed and staged is an ever-evolving field. It plays a fundamental role in ensuring the appropriate therapeutic options are offered to the patient whilst preventing overdiagnosis and overtreatment. Despite the numerous advances in the field, a suspicion of prostate cancer continues to arise from digital rectal examination and measurement of serum prostate specific antigen (PSA). Additional derivatives of serum PSA along with urinary biomarkers and multiparametric magnetic resonance imaging can then help to risk stratify patients in order to appropriately counsel them on the risks and benefits of a prostate biopsy. After a diagnosis of prostate cancer is reached, further staging may be required and can be achieved by a variety of imaging techniques such as computed tomography (CT), bone scintigraphy, and prostate specific membrane antigen-based positron-emission tomography/CT. In this chapter, we review the current role of these and other diagnostic tools in prostate cancer.
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