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多参数磁共振成像与前列腺癌:有哪些新进展?

Multiparametric magnetic resonance imaging and prostate cancer: what's new?

作者信息

Catalá V, Vilanova J C, Gaya J M, Algaba F, Martí T

机构信息

Servicio de Radiología, Fundació Puigvert, Barcelona, España.

Departamento de Radiología, Clínica Girona, Institut Català de la Salut, IDI; Departamento de Ciencias Médicas, Facultad de Medicina, Universitat de Girona, Girona, España.

出版信息

Radiologia. 2017 May-Jun;59(3):196-208. doi: 10.1016/j.rx.2016.12.003. Epub 2017 Feb 21.

Abstract

Prostatic multi-parametric magnetic resonance imaging (MP-MRI) has recently had a wide development becoming a key tool in the diagnostic and therapeutic decisions in prostate cancer (Pca). The fast development both in technology and in reading (PIRADS V2) requires a continuous updating of knowledge within this area. The aim of this article is to present an updated revision of technical aspects, reading patterns and prostatic MP-MRI in Pca, with a multidisciplinary approach. Currently guidelines establish the use of the MP-MRI when there is a high PSA and a negative prostatic biopsy; tumor staging; evaluation in candidates to active surveillance; focal treatments plans and tumoral recurrence evaluation. Although it is used in other indications in some centers, like its use in patients suspicious of Pca but with no previous biopsy, there is still the need of a cost/benefit assessment for its use to be wider.

摘要

前列腺多参数磁共振成像(MP-MRI)近年来得到了广泛发展,成为前列腺癌(Pca)诊断和治疗决策中的关键工具。技术和解读(前列腺影像报告和数据系统第2版,PIRADS V2)方面的快速发展要求该领域的知识不断更新。本文旨在采用多学科方法,对Pca中前列腺MP-MRI的技术方面、解读模式进行最新修订。目前的指南规定,在前列腺特异性抗原(PSA)水平高且前列腺活检阴性时使用MP-MRI;进行肿瘤分期;对主动监测的候选者进行评估;制定局部治疗方案以及评估肿瘤复发情况。尽管在一些中心它还用于其他适应症,比如用于怀疑患有Pca但之前未进行活检的患者,但要更广泛地使用它仍需要进行成本效益评估。

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