Laboratory of Radiobiology, Division of Radiation Oncology, Department of Experimental Medicine, University of L'Aquila, Medical School, Via Vetoio, Coppito 2, L'Aquila, 67100, Italy.
Eur Radiol. 2012 Dec;22(12):2848-58. doi: 10.1007/s00330-012-2546-7. Epub 2012 Jul 14.
In this article the state of art the of prostate cancer (Pca) imaging and non-surgical salvage treatments (STs) is surveyed in order to explore the impact of imaging findings on the identification of radiorecurrent Pca after external beam radiotherapy (EBRT).
A computerised search was performed to identify all relevant studies in Medline up to 2012. Additional articles were extracted based on recommendations from an expert panel of authors.
Definitive EBRT for Pca is increasingly used as treatment. After radiorecurrent Pca, non-surgical STs are emerging and shifting from investigational status to more established therapeutic options. Therefore, several scientific societies have published guidelines including clinical and imaging recommendations, even if the timing, efficacy and long-term toxicity of these STs have to be established. In some measure, accurately delineating the location and the extent of cancer is critical in selecting target lesions and in identifying patients who are candidates for STs. However, there is increasing awareness that anatomical approaches based on measurements of tumour size have substantial limitations, especially for tumours of unknown activity that persist or recur following irradiation
To date, the main focus for innovations in imaging is the combination of excellence in anatomical resolution with specific biological correlates that depict metabolic processes and hallmarks at the tumour level. The emergence of new molecular markers could favour the development of methods that directly determine their presence, thereby improving tumour detection.
Imaging may influence therapeutic decisions during non-surgical STs. MRI findings correlate with parametric maps derived from multiple functional techniques. Non-surgical salvage treatments allow local tumour control in patients with radiorecurrent PCa.
本文旨在调查前列腺癌（Pca）成像和非手术挽救治疗（STs）的最新技术，以探讨影像学发现对体外放射治疗（EBRT）后放射性复发性 Pca 的识别的影响。
通过计算机检索 Medline 中截至 2012 年的所有相关研究。根据作者专家组的建议，进一步提取其他文章。
确定性 EBRT 越来越多地用于治疗 Pca。放射性复发性 Pca 后，非手术 STs 正在出现，并从研究状态转变为更成熟的治疗选择。因此，一些科学协会已经发布了指南，包括临床和影像学建议，即使这些 STs 的时机、疗效和长期毒性仍需确定。在某种程度上，准确描绘癌症的位置和范围对于选择靶病灶和识别适合 STs 的患者至关重要。然而，人们越来越意识到，基于肿瘤大小测量的解剖方法存在很大的局限性，尤其是对于放疗后持续存在或复发的未知活性肿瘤。
迄今为止，成像领域创新的主要重点是将卓越的解剖分辨率与特定的生物学相关性相结合，这些相关性描绘了肿瘤水平的代谢过程和标志。新的分子标志物的出现可能有利于开发直接确定其存在的方法，从而提高肿瘤检测的准确性。
影像学可能影响非手术 STs 期间的治疗决策。MRI 结果与源自多种功能技术的参数图相关。非手术挽救治疗可实现放射性复发性 PCa 患者的局部肿瘤控制。
