Megahed Haidy, Tremblay Samuel, Koehler Jason, Han Simon, Hamimi Ahmed, Oto Aytekin, Sidana Abhinav
Section of Urology, Department of Surgery, University of Chicago, Chicago, IL 60637, USA.
College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA.
Diagnostics (Basel). 2025 May 26;15(11):1328. doi: 10.3390/diagnostics15111328.
As the adoption of focal therapy (FT) for prostate cancer (PCa) grows, the demand for accurate post-treatment imaging to monitor outcomes and detect residual or recurrent cancer increases. Traditional diagnostic systems like the Prostate Imaging Reporting and Data System (PI-RADS) are ill-suited for post-FT evaluations due to treatment-induced tissue changes. MRI-based scoring systems specific for evaluation after FT have been developed to address these challenges and improve post-FT imaging accuracy by distinguishing benign alterations from recurrence. The currently developed scoring systems are Transatlantic Recommendations for Prostate Gland Evaluation with MRI after Focal Therapy (TARGET) and Prostate Imaging after Focal Ablation (PI-FAB). In this review, we describe and compare these two systems. These scoring systems standardize imaging assessments, enhance follow-up care, and support clinical decision-making. While promising, TARGET and PI-FAB require further large-scale validation to confirm their utility. Nevertheless, they represent critical advances in optimizing PCa management, particularly for patients undergoing FT, by improving diagnostic accuracy and guiding treatment decisions.
随着前列腺癌（PCa）聚焦治疗（FT）的应用日益广泛，对用于监测治疗效果以及检测残留或复发性癌症的精确治疗后成像的需求也在增加。像前列腺影像报告和数据系统（PI-RADS）这样的传统诊断系统，由于治疗引起的组织变化，并不适合FT后的评估。专门用于FT后评估的基于MRI的评分系统已经开发出来，以应对这些挑战，并通过区分良性改变和复发来提高FT后成像的准确性。目前已开发的评分系统是《聚焦治疗后前列腺MRI评估的跨大西洋建议》（TARGET）和《聚焦消融后前列腺成像》（PI-FAB）。在本综述中，我们描述并比较这两个系统。这些评分系统使成像评估标准化，加强后续护理，并支持临床决策。尽管很有前景，但TARGET和PI-FAB需要进一步的大规模验证以确认其效用。然而，它们代表了在优化PCa管理方面的关键进展，特别是对于接受FT的患者，通过提高诊断准确性和指导治疗决策来实现。
