Sandler Kiri, Patel Mausam, Lynne Charles, Parekh Dipen J, Punnen Sanoj, Jorda Merce, Casillas Javier, Pollack Alan, Stoyanova Radka
Department of Radiation Oncology, University of Miami , Miami, FL , USA.
Department of Urology, University of Miami , Miami, FL , USA.
Front Oncol. 2015 Jan 26;5:4. doi: 10.3389/fonc.2015.00004. eCollection 2015.
An important key to clinical management of prostate cancer patients is to determine early those who will benefit from primary treatment and are not good candidates for active surveillance (AS). We describe a 67-year-old gentleman with a long history of stable prostate-specific antigen (PSA) levels and a negative biopsy. After slight PSA rise and low volume Gleason score 6 biopsy, the patient was considered for primary treatment or AS. A multiparametric (MP)-MRI exam revealed a suspicious lesion in the anterior apex of the prostate. Biopsies were carried out on a 3D-ultrasound prostate biopsy system with MRI-fusion. The location of the target area was challenging and could have been missed using standard 12-core biopsy template. The pathology determined Gleason 3 + 4 disease in 30% of the core from this region. Consequently, the patient underwent radiotherapy (RT). MP-MRI was also used to follow the changes from pre- to post-RT.
前列腺癌患者临床管理的一个重要关键是尽早确定那些将从初始治疗中获益且不适合进行主动监测（AS）的患者。我们描述了一位67岁的男性，其前列腺特异性抗原（PSA）水平长期稳定且活检结果为阴性。在PSA略有升高且穿刺活检Gleason评分6分、肿瘤体积较小后，该患者被考虑进行初始治疗或主动监测。多参数（MP）-MRI检查显示前列腺尖前部有一个可疑病变。在具有MRI融合功能的三维超声前列腺活检系统上进行了活检。靶区的定位具有挑战性，使用标准的12针活检模板可能会遗漏该病变。病理检查确定该区域30%的针芯为Gleason 3+4病变。因此，该患者接受了放射治疗（RT）。MP-MRI还用于跟踪放疗前后的变化。
