Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA.
Department of Urology, Istanbul Medipol University, Istanbul, Turkey.
World J Urol. 2021 Mar;39(3):651-659. doi: 10.1007/s00345-020-03310-z. Epub 2020 Jun 24.
Prostate cancer has traditionally been diagnosed by an elevation in PSA or abnormal exam leading to a systematic transrectal ultrasound (TRUS)-guided biopsy. This diagnostic pathway underdiagnoses clinically significant disease while over diagnosing clinically insignificant disease. In this review, we aim to provide an overview of the recent literature regarding the role of multiparametric MRI (mpMRI) in the management of prostate cancer.
A thorough literature review was performed using PubMed to identify articles discussing use of mpMRI of the prostate in management of prostate cancer.
The incorporation of mpMRI of the prostate addresses the shortcomings of the prostate biopsy while providing several other advantages. mpMRI allows some men to avoid an immediate biopsy and permits visualization of areas likely to harbor clinically significant cancer prior to biopsy to facilitate use of MR-targeted prostate biopsies. This allows for reduction in diagnosis of clinically insignificant disease as well as improved detection and better characterization of higher risk cancers, as well as the improved selection of patients for active surveillance. In addition, mpMRI can be used for selection and monitoring of patients for active surveillance and treatment planning during surgery and focal therapy.
前列腺癌传统上通过 PSA 升高或异常检查导致系统的经直肠超声(TRUS)引导活检来诊断。这种诊断途径会漏诊具有临床意义的疾病,而过度诊断具有临床意义的疾病。在这篇综述中,我们旨在提供关于多参数 MRI(mpMRI)在前列腺癌管理中作用的最新文献综述。
使用 PubMed 进行了全面的文献复习,以确定讨论前列腺 mpMRI 在前列腺癌管理中应用的文章。
前列腺 mpMRI 的应用解决了前列腺活检的缺点,并提供了其他几个优势。mpMRI 允许一些男性避免立即进行活检,并允许在活检前观察可能存在具有临床意义的癌症的区域,以促进使用 MR 靶向前列腺活检。这可以减少对临床意义不大的疾病的诊断,以及提高对高危癌症的检测和更好的特征化,并改善对主动监测的患者选择。此外,mpMRI 可用于主动监测患者的选择和监测以及手术和局部治疗中的治疗计划。