The Brady Urological Institute, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
World J Urol. 2022 Jan;40(1):51-59. doi: 10.1007/s00345-021-03762-x. Epub 2021 Jun 19.
To discuss the potential utility of newer imaging modalities including micro-ultrasound and PSMA-PET for the detection of clinically significant prostate cancer, technologies that may gain roles as adjuncts to multiparametric magnetic resonance imaging (mpMRI) in the active surveillance (AS) setting.
Narrative review of two new imaging modalities used for primary prostate cancer through April 2021. A targeted search was performed to identify current relevant literature on the role of new imaging modalities for primary prostate cancer using search terms "micro-ultrasound," "molecular imaging," "prostate cancer," "active surveillance," "multiparametric MRI," "PI-RADS," "PRI-MUS," and "detection rate." In addition, references of included articles were screened for further relevant publications.
Micro-ultrasound (micro-US) and prostate-specific membrane antigen-positron emission tomography (PSMA-PET) are increasing in their use and applicability to prostate cancer imaging. Micro-US is used for cancer detection and may identify higher grade cancers more accurately than conventional ultrasound, despite technical hurdles in its initial launch. PSMA-PET is highly sensitive and specific for high-grade and metastatic prostate cancer, though costly and not easily available. Though data are sparse, it may have an emerging role in cancer diagnosis in select localized cases, and in some men considering (or currently on) AS who have indications of more aggressive disease.
There are very limited data on micro-US and PSMA-PET in AS patients. However, given the ability of these modalities to identify high-grade cancer, their judicious use in AS patients may be of utility in the future.
讨论包括微超声和 PSMA-PET 在内的新型成像方式在检测临床显著前列腺癌方面的潜在应用，这些技术可能在主动监测 (AS) 环境中作为多参数磁共振成像 (mpMRI) 的辅助手段发挥作用。
对截至 2021 年 4 月用于原发性前列腺癌的两种新型成像方式进行叙述性综述。使用“微超声”、“分子成像”、“前列腺癌”、“主动监测”、“多参数 MRI”、“PI-RADS”、“PRI-MUS”和“检测率”等搜索词，针对新成像方式在原发性前列腺癌中的作用进行了有针对性的搜索，以确定当前相关文献。此外，还对纳入文章的参考文献进行了筛选，以获取更多相关出版物。
微超声 (micro-US) 和前列腺特异性膜抗原正电子发射断层扫描 (PSMA-PET) 在前列腺癌成像中的应用越来越广泛。微超声用于癌症检测，与传统超声相比，可能更准确地识别高级别癌症，尽管其最初推出存在技术障碍。PSMA-PET 对高级别和转移性前列腺癌具有高度的敏感性和特异性，但成本高且不易获得。尽管数据有限，但它在某些局部病例的癌症诊断中可能具有新兴作用，并且在一些考虑（或正在进行）具有侵袭性疾病迹象的 AS 患者中可能具有应用价值。
在 AS 患者中，关于 micro-US 和 PSMA-PET 的数据非常有限。然而，鉴于这些方式能够识别高级别癌症，因此在 AS 患者中谨慎使用这些方式可能在未来具有一定的应用价值。
