Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Charing Cross Campus, Fulham Palace Road, London, W6 8RF, UK.
Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
World J Urol. 2021 Jan;39(1):57-63. doi: 10.1007/s00345-020-03182-3. Epub 2020 Apr 6.
Transrectal ultrasound (TRUS)-guided biopsy has been the traditional biopsy route in the detection of prostate cancer. However, due to concern regarding overdetection of low-risk cancer and missed clinically significant cancers as well as risk of sepsis, alternative approaches have been explored. Transperineal template biopsy-sampling the gland every 5 m to 10 mm-reduces error by sampling the whole prostate but increases risk of detecting clinically insignificant cancers as well as conferring risks of side effects such as urinary retention and bleeding.
There are various targeted biopsy techniques, each with different cancer detection rates, costs and learning curves. Current research focuses on refining biopsy methodology to maximize detection of significant cancers, whilst minimising invasiveness and complications. In this article, the up-to-date research data about MRI-targeted prostate biopsy were reviewed to show its utilization in prostate cancer management and diagnosis.
Prostate multiparametric MRI has become an effective tool in the detection of significant cancers and an essential component of the prostate cancer diagnostic pathway incorporating MRI-guided biopsy decisions.
经直肠超声(TRUS)引导活检一直是前列腺癌检测的传统活检途径。然而,由于担心过度检测低风险癌症和漏诊临床显著癌症以及脓毒症的风险,已经探索了替代方法。经会阴模板活检——每隔 5-10mm 对腺体进行采样——通过对整个前列腺进行采样来减少误差,但会增加检测到临床意义不大的癌症的风险,并带来诸如尿潴留和出血等副作用的风险。
有各种靶向活检技术,每种技术的癌症检测率、成本和学习曲线都不同。目前的研究重点是改进活检方法,最大限度地发现有意义的癌症,同时最大限度地减少侵袭性和并发症。本文综述了最新的关于 MRI 靶向前列腺活检的研究数据,以展示其在前列腺癌管理和诊断中的应用。
前列腺多参数 MRI 已成为检测显著癌症的有效工具,也是将 MRI 引导活检决策纳入前列腺癌诊断途径的重要组成部分。