Woodrum D A, Kawashima A, Gorny K R, Mynderse L A
Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Clin Radiol. 2017 Aug;72(8):665-679. doi: 10.1016/j.crad.2017.02.010. Epub 2017 Apr 3.
In 2016, it is estimated 180,890 men are newly diagnosed with prostate cancer and 3,306,760 men live with prostate cancer in the United States. The introduction of multiparametric (mp) magnetic resonance imaging (MRI) of the prostate, standardised interpretation guidelines such as Prostate Imaging Reporting and Data System (PI-RADS version 2), and MRI-based targeted biopsy has improved detection of clinically significant prostate cancer. Accurate risk stratification (Gleason grade/score and tumour stage) using imaging and image-guided targeted biopsy has become critical for the management of patients with prostate cancer. Recent advances in MRI-guided minimally invasive ablative treatment (MIAT) utilising cryoablation, laser ablation, high-intensity focused ultrasound ablation, have allowed accurate focal or regional delivery of optimal thermal energy to the biopsy proven, MRI-detected tumour, under real-time or near simultaneous MRI monitoring of the ablation zone. A contemporary review on prostate mpMRI, MRI-based targeted biopsy, and MRI-guided ablation techniques is presented.
2016年，据估计美国有180,890名男性被新诊断出患有前列腺癌，3,306,760名男性患有前列腺癌。前列腺多参数（mp）磁共振成像（MRI）的引入、诸如前列腺影像报告和数据系统（PI-RADS第2版）等标准化解读指南以及基于MRI的靶向活检，提高了临床显著性前列腺癌的检测率。使用影像学和影像引导靶向活检进行准确的风险分层（Gleason分级/评分和肿瘤分期）对于前列腺癌患者的管理至关重要。利用冷冻消融、激光消融、高强度聚焦超声消融的MRI引导微创消融治疗（MIAT）的最新进展，能够在对消融区域进行实时或近乎同步MRI监测的情况下，将最佳热能准确地聚焦或局部传递至经活检证实且MRI检测到的肿瘤。本文对前列腺mpMRI、基于MRI的靶向活检以及MRI引导的消融技术进行了当代综述。
