Northwestern University, Chicago, Illinois, USA.
J Am Coll Radiol. 2011 Dec;8(12):863-71. doi: 10.1016/j.jacr.2011.09.003.
Although prostate cancer can be effectively treated, recurrent or residual disease after therapy is not uncommon and is usually detected by a rise in prostate-specific antigen. Patients with biochemical prostate-specific antigen relapse should undergo a prompt search for the presence of local recurrence or distant metastatic disease, each requiring different forms of therapy. Various imaging modalities and image-guided procedures may be used in the evaluation of these patients. Literature on the indications and usefulness of these radiologic studies and procedures in specific clinical settings is reviewed. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
虽然前列腺癌可以有效治疗,但治疗后复发或残留疾病并不少见,通常通过前列腺特异性抗原(PSA)升高来检测。出现生化复发的前列腺癌患者应及时查找局部复发或远处转移疾病,这两种情况分别需要不同的治疗形式。在这些患者的评估中可能会使用各种影像学方式和影像引导下的操作。本文回顾了特定临床环境下这些影像学研究和操作的适应证和有效性的文献。ACR 适宜性标准(®)是针对具体临床情况的循证指南,由多学科专家小组每 2 年进行一次审查。指南的制定和审查包括对同行评议期刊中现有医学文献的广泛分析,并应用成熟的共识方法(改良 Delphi 法)对专家组评估影像学和治疗操作的适宜性进行评分。在缺乏证据或证据不明确的情况下,可以使用专家意见来推荐影像学或治疗。