Wijkstra Hessel, Wink Margot H, de la Rosette Jean J M C H
Department of Urology (G4-162), Academic Medical Center, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands.
World J Urol. 2004 Nov;22(5):346-50. doi: 10.1007/s00345-004-0419-7. Epub 2004 Oct 5.
Prostate cancer (PCa) is the most common cancer in elderly men and is one of the most important causes of death from cancer in men. The diagnosis of PCa is based on a combination of digital rectal examination, PSA and transrectal ultrasound (TRUS). However, this combination does not reach the accuracy of detection and localization necessary for proper decisions on treatment methods. Therefore, biopsies are performed in all cases for which the suspicion of PCa is raised. Even with biopsies, staging and grading of PCa is far from optimal. More accurate imaging is necessary to improve the biopsy sampling, the goals being to replace systematic biopsies by a targeted approach and to improve staging and grading of PCa. Ultrasound imaging of the prostate remains the first choice of imaging to visualize the prostate, however, gray-scale ultrasound imaging has an accuracy of about 50-60% for the detection of PCa and TRUS used for local staging has an even lower accuracy. The development of PCa is associated with changes in the metabolism of tumor cells, and therefore with changes in the blood perfusion of the involved tissue. This paper focuses on contrast specific imaging techniques to visualize these changes in blood perfusion. Techniques such as color and power Doppler imaging, and contrast enhanced imaging techniques using color and power Doppler, harmonic imaging and intermittent imaging are discussed.
前列腺癌（PCa）是老年男性中最常见的癌症，也是男性癌症死亡的最重要原因之一。PCa的诊断基于直肠指检、前列腺特异性抗原（PSA）和经直肠超声（TRUS）的联合应用。然而，这种联合检查无法达到确定治疗方法所需的检测和定位准确性。因此，对于所有怀疑患有PCa的病例都要进行活检。即便进行了活检，PCa的分期和分级仍远未达到理想状态。需要更精确的成像来改善活检采样，目标是以靶向方法取代系统性活检，并改善PCa的分期和分级。前列腺超声成像仍然是可视化前列腺的首选成像方法，然而，灰阶超声成像检测PCa的准确率约为50%-60%，用于局部分期的TRUS准确率甚至更低。PCa的发展与肿瘤细胞代谢变化相关，因此与受累组织的血流灌注变化相关。本文重点关注用于可视化这些血流灌注变化的对比特异性成像技术。讨论了诸如彩色和能量多普勒成像，以及使用彩色和能量多普勒、谐波成像和间歇成像的对比增强成像技术等。
