Shimizu Yuki, Nakajima Nobuyuki, Nagao Kentaro, Nitta Masahiro, Hasegawa Masanori, Kawamura Yoshiaki, Kazama Toshiki, Shoji Sunao, Takahara Taro, Miyajima Akira
Department of Urology Tokai University School of Medicine Isehara Japan.
Department of Diagnostic Radiology Tokai University School of Medicine Isehara Japan.
IJU Case Rep. 2020 Feb 17;3(2):65-68. doi: 10.1002/iju5.12146. eCollection 2020 Mar.
Treatment for oligometastasis in prostate cancer has changed from systemic therapy to metastatic lesion-targeted therapy. Early detection of metastatic lesions and assessment of the treatment response have become very important. Therefore, we started to perfume assessments with whole-body magnetic resonance imaging, especially diffusion-weighted imaging with background body signal suppression, as a modality to detect metastasis in patients with prostate cancer.
We encountered two cases of castration-resistant prostate cancer in which oligometastasis was detected by diffusion-weighted imaging with background body signal suppression. Metastasis-directed therapy was initiated for to treat the lesions in each case. The treatment was effective for disease control and symptom relief. Diffusion-weighted imaging with background body signal suppression could detect new lesions at an early phase and delineate changes in lesions immediately after therapy.
Diffusion-weighted imaging with background body signal suppression enables early decision-making for metastasis-directed therapy compared with conventional imaging modalities. Further, metastasis-directed therapy targeting oligometastatic lesions detected by diffusion-weighted imaging with background body signal suppression may improve patients' overall survival and quality of life.
前列腺癌寡转移的治疗已从全身治疗转变为转移病灶靶向治疗。转移病灶的早期检测和治疗反应评估变得非常重要。因此，我们开始采用全身磁共振成像进行评估，尤其是采用背景体部信号抑制的扩散加权成像，作为检测前列腺癌患者转移灶的一种方法。
我们遇到两例去势抵抗性前列腺癌病例，通过背景体部信号抑制的扩散加权成像检测到寡转移。针对每例患者的病灶启动了转移灶导向治疗。该治疗对疾病控制和症状缓解有效。背景体部信号抑制的扩散加权成像能够在早期检测到新病灶，并在治疗后立即描绘病灶的变化。
与传统成像方式相比，背景体部信号抑制的扩散加权成像能够为转移灶导向治疗做出早期决策。此外，针对通过背景体部信号抑制的扩散加权成像检测到的寡转移病灶进行转移灶导向治疗，可能会提高患者的总生存率和生活质量。
