Martin Spahn, MD, from the University Hospital Bern, Bern, Switzerland, discusses new imaging modalities at the European Association of Urology (EAU) conference 2017 in London, UK. Different imaging modalities, for example, PSMA PET/CT, for detecting metastases at an earlier stage have been developed recently. This has raised the question of how to treat patients with metastasis in the bone or lymph nodes, especially high-risk patients, or those with a high PSA. Local treatment is currently thought to be the best course of action. The introduction of new imaging modalities will lead to an improved staging system, which will in turn lead to more effective treatment modalities. A big challenge for the future is determining which patients may benefit from systemic treatment instead of metastasis targeted therapy. He states that as treatments currently in use have little evidence behind them, more clinical trials will be required.