USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California 90089-2211, USA.
Curr Opin Urol. 2011 Mar;21(2):115-20. doi: 10.1097/MOU.0b013e3283435118.
Active surveillance and focal therapy for prostate cancer have been proposed as treatment alternatives for prostate cancer. In this review, we track the emerging technologies that will support the viability of such management strategies.
Widespread prostate-specific antigen (PSA) testing and extended prostate biopsy practice patterns have resulted in a significant increase in the diagnosis of low-risk prostate cancer. As most low-risk prostate cancers may not require radical treatment, alternatives for appropriately selected patients have been proposed and implemented - namely, active surveillance and focal therapy. Both alternatives to radical therapy require accurate mapping and precise targeting of lesions within the prostate, for which current technological shortfalls limit their clinical utility. The emerging tools that will help overcome these challenges include refined imaging modalities, three-dimensional modeling for planning and tracking intervention, elastic fusion image technology, and automated mechanical delivery of the intervention needle.
Current prostate biopsy technologies have largely advanced as separate entities. Further refinement of these innovations continue, but the ultimate challenge will be integrating them into one comprehensive platform.
主动监测和前列腺癌局部治疗已被提议作为前列腺癌的治疗选择。在这篇综述中，我们追踪了新兴技术，这些技术将支持这种管理策略的可行性。
广泛的前列腺特异性抗原（PSA）检测和扩展的前列腺活检实践模式导致了低危前列腺癌的诊断显著增加。由于大多数低危前列腺癌可能不需要根治性治疗，因此为适当选择的患者提出并实施了替代方案-即主动监测和局部治疗。根治性治疗的这两种替代方法都需要对前列腺内的病变进行精确的定位和精确的靶向治疗，而目前的技术缺陷限制了其临床应用。有助于克服这些挑战的新兴工具包括改进的成像方式、用于规划和跟踪干预的三维建模、弹性融合图像技术以及干预针的自动机械输送。
目前的前列腺活检技术在很大程度上已经作为独立的实体得到了发展。这些创新的进一步改进仍在继续，但最终的挑战将是将它们整合到一个综合平台中。
