Sigle August, Michaelis Jakob, Schöb Dominik, Benndorf Matthias, Schimmöller Lars, Becker Benedikt, Pallauf Maximilian, Gross Andreas J, Herrmann Thomas R W, Klein Jan-Thorsten, Lusuardi Lukas, Netsch Christopher, Häcker Axel, Westphal Jens, Jilg Cordula, Gratzke Christian, Miernik Arkadiusz
Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland.
Berta-Ottenstein-Programm, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland.
Urologie. 2022 Oct;61(10):1137-1148. doi: 10.1007/s00120-022-01929-x. Epub 2022 Aug 30.
The recommendations on carrying out a multiparametric magnetic resonance imaging (mpMRI) for the primary diagnostics and during active surveillance of prostate cancer, include as a consequence an image-guided sampling from conspicuous areas. In doing so, the information on the localization provided by mpMRI is used for a targeted biopsy of the area suspected of being a tumor. The targeted sampling is mainly performed under sonographic control and after fusion of MRI and ultrasound but can also be (mostly in special cases) carried out directly in the MRI scanner. In an ultrasound-guided biopsy, it is vital to coregister the MR images with the ultrasound images (segmentation of the contour of the prostate and registration of suspect findings). This coregistration can either be carried out cognitively (transfer by the person performing the biopsy alone) or software based. Each method shows specific advantages and disadvantages in the prioritization between diagnostic accuracy and resource expenditure.
关于在前列腺癌的初步诊断和主动监测期间进行多参数磁共振成像(mpMRI)的建议,相应地包括从明显区域进行图像引导采样。在此过程中,mpMRI提供的定位信息用于对疑似肿瘤区域进行靶向活检。靶向采样主要在超声引导下并在MRI与超声融合后进行,但也可以(大多在特殊情况下)直接在MRI扫描仪中进行。在超声引导活检中,将MR图像与超声图像进行配准(前列腺轮廓分割和可疑发现的配准)至关重要。这种配准既可以通过认知方式(仅由进行活检的人员进行转移)进行,也可以基于软件进行。在诊断准确性和资源消耗之间的优先级方面,每种方法都有其特定的优缺点。