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磁共振成像在前列腺癌筛查、诊断和治疗中的作用。

CURRENT ROLE OF MAGNETIC RESONANCE IMAGING IN THE SCREENING, DIAGNOSIS, AND TREATMENT OF PROSTATE CANCER.

机构信息

Department of Urology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

Department of Radiology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2022 Oct;61(Suppl 3):92-94. doi: 10.20471/acc.2022.61.s3.14.

Abstract

Prostate cancer is the most common cancer in men. Diagnosis of prostate cancer poses a significant challenge, due to several different key parameters that need to be evaluated, such as age, history of prostate specific antigen (PSA), clinical examination and more recently magnetic resonance imaging (MRI). The current diagnostic pathway for prostate cancer has resulted in overdiagnosis and overtreatment as well as underdiagnosis and missed diagnoses in many men. Multiparametric MRI (mp-MRI) of the prostate has been identified as a test that could alleviate these diagnostic errors. Before prostate cancer treatment pathological confirmation is mandatory. Prostate biopsy is an invasive procedure with rare but not negligible potential complications. There are several methods of prostate biopsy of which most common are systemic or planar prostate biopsy and cognitive or targeted MRI-guided prostate biopsy. Multiparametric MRI has demonstrated better accuracy and reproducibility in detecting, locating and evaluating prostate cancer and also sparing some men unnecessary biopsies. Recent studies have shown a mpMRI benefit for better procedure planning regarding prostate cancer location, extent of disease and length of the urethra. There are still some challenges ahead, such as ensuring high-quality execution and reporting of mpMRI and ensuring that this diagnostic pathway is cost-effective. According to the latest urological clinical guidelines mpMRI became fundamental tool in management of prostate cancer. The aim of this study is to give a brief insight in use of mpMRI in prostate cancer diagnosis and treatment.

摘要

前列腺癌是男性最常见的癌症。由于需要评估多个不同的关键参数,如年龄、前列腺特异性抗原(PSA)病史、临床检查以及最近的磁共振成像(MRI),前列腺癌的诊断具有很大的挑战性。目前的前列腺癌诊断途径导致许多男性出现过度诊断和过度治疗、诊断不足和漏诊。前列腺多参数 MRI(mp-MRI)已被确定为一种可以减少这些诊断错误的检查方法。在进行前列腺癌治疗之前,必须进行病理确认。前列腺活检是一种有创性检查,有罕见但不可忽视的潜在并发症。有几种前列腺活检方法,其中最常见的是系统或平面前列腺活检和认知或靶向 MRI 引导的前列腺活检。mp-MRI 在检测、定位和评估前列腺癌方面具有更高的准确性和可重复性,也可以为一些男性避免不必要的活检。最近的研究表明,mpMRI 可以更好地规划前列腺癌的位置、疾病范围和尿道长度等方面的治疗方案。但仍存在一些挑战,例如确保 mpMRI 的高质量执行和报告,以及确保该诊断途径具有成本效益。根据最新的泌尿外科临床指南,mpMRI 已成为前列腺癌管理的基本工具。本研究旨在简要介绍 mpMRI 在前列腺癌诊断和治疗中的应用。

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