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[前列腺癌——多参数磁共振成像以及干预和治疗规划中的替代方法]

[Prostate cancer-multiparametric MRI and alternative approaches in intervention and therapy planning].

作者信息

Handke Analena Elisa, Ritter Manuel, Albers Peter, Noldus Joachim, Radtke Jan Philipp, Krausewitz Philipp

机构信息

Marienhospital Herne, Universitätsklinikum, Ruhr-Universität Bochum, Herne, Deutschland.

Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

出版信息

Urologie. 2023 Nov;62(11):1160-1168. doi: 10.1007/s00120-023-02190-6. Epub 2023 Sep 4.

Abstract

BACKGROUND

In recent years, multiparametric magnetic resonance imaging (mpMRI) of the prostate has gained importance and plays a crucial role in both personalized diagnostics and increasingly in the treatment planning for patients with prostate cancer.

OBJECTIVE

The aim of this study is to present established and innovative applications of MRI in the diagnosis and treatment of localized prostate cancer, evaluating their strengths and weaknesses. Furthermore, it will explore alternative approaches and compare them in a comprehensive manner.

MATERIALS AND METHODS

A systematic literature review on the application of mpMRI for biopsy and therapy planning was conducted.

RESULTS

The integration of modern imaging techniques, especially mpMRI, into the diagnostic algorithm has revolutionized prostate cancer diagnosis. MRI and MRI-guided biopsy detect more significant prostate cancer, with the potential to reduce unnecessary biopsies and the diagnosis of clinically insignificant carcinomas. In addition, MRI provides crucial information for risk stratification and treatment planning in prostate cancer patients, both before radical prostatectomy and during active surveillance.

CONCLUSION

Multiparametric MRI offers significant added value for the diagnosis and treatment of localized prostate cancer. The advancement of MRI analysis, such as the implementation of artificial intelligence algorithms, holds the potential for further enhancing imaging diagnostics.

摘要

背景

近年来,前列腺多参数磁共振成像(mpMRI)变得越发重要,在前列腺癌患者的个性化诊断以及越来越多的治疗规划中发挥着关键作用。

目的

本研究旨在介绍MRI在局限性前列腺癌诊断和治疗中的既定应用与创新应用,评估其优缺点。此外,还将全面探索替代方法并进行比较。

材料与方法

对mpMRI在活检和治疗规划中的应用进行了系统的文献综述。

结果

将现代成像技术,尤其是mpMRI,整合到诊断算法中,彻底改变了前列腺癌的诊断方式。MRI及MRI引导下的活检能检测出更多显著的前列腺癌,有可能减少不必要的活检以及对临床意义不显著的癌肿的诊断。此外,无论是在根治性前列腺切除术之前还是在主动监测期间,MRI都能为前列腺癌患者的风险分层和治疗规划提供关键信息。

结论

多参数MRI为局限性前列腺癌的诊断和治疗提供了显著的附加价值。MRI分析的进展,如人工智能算法的应用,有可能进一步提高影像诊断水平。

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