Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Br J Radiol. 2022 Mar 1;95(1131):20210698. doi: 10.1259/bjr.20210698. Epub 2021 Nov 1.
Whole gland prostate cancer treatment, . radical prostatectomy or radiation therapy, is highly effective but also comes with a significant impact on quality of life and possible overtreatment in males with low to intermediate risk disease. Minimal-invasive treatment strategies are emerging techniques. Different sources of energy are used to aim for targeted treatment in order to reduce treatment-related complications and morbidity. Imaging plays an important role in targeting and monitoring of treatment approaches preserving parts of the prostatic tissue. Multiparametric magnetic resonance imaging (mpMRI) is widely used during image-guided interventions due to the multiplanar and real-time anatomical imaging while providing an improved treatment accuracy. This review evaluates the available image-guided prostate cancer treatment options using MRI or magnetic resonance imaging/transrectal ultrasound (MRI/TRUS)-fusion guided imaging. The discussed minimal invasive image-guided prostate interventions may be considered as safe and feasible partial gland ablation in patients with (recurrent) prostate cancer. However, most studies focusing on minimally invasive prostate cancer treatments only report early stages of research and subsequent high-level evidence is still needed. Ensuring a safe and appropriate utilization in patients that will benefit the most, and applied by physicians with relevant training, has become the main challenge in minimally invasive prostate cancer treatments.
全腺体前列腺癌治疗，包括根治性前列腺切除术或放射治疗，具有高度有效性，但也对生活质量产生重大影响，并可能对低危到中危疾病的男性造成过度治疗。微创治疗策略是新兴技术。不同的能源被用于靶向治疗，以减少治疗相关的并发症和发病率。成像在靶向和监测治疗方法中发挥着重要作用，以保留前列腺组织的部分。多参数磁共振成像（mpMRI）由于具有多平面和实时解剖成像功能，在图像引导介入中得到广泛应用，同时提供了更高的治疗准确性。本综述评估了使用 MRI 或 MRI/经直肠超声（MRI/TRUS）融合引导成像的现有图像引导前列腺癌治疗选择。讨论的微创图像引导前列腺介入治疗可被视为（复发性）前列腺癌患者安全可行的部分腺体消融。然而，大多数关注微创前列腺癌治疗的研究仅报告了研究的早期阶段，仍然需要后续的高级别证据。确保最受益的患者安全和适当的应用，并由具有相关培训的医生进行应用，已成为微创前列腺癌治疗的主要挑战。
