Multiparametric MRI - local staging of prostate cancer and beyond

被引:63
作者
Caglic, Iztok [1 ,2 ]
Kovac, Viljem [2 ,3 ]
Barrett, Tristan [4 ,5 ,6 ]
机构
[1] Norfolk & Norwich Univ Hosp, Dept Radiol, Norwich, Norfolk, England
[2] Univ Ljubljana, Fac Med, Ljubljana, Slovenia
[3] Inst Oncol Ljubljana, Zaloska 2, Ljubljana 1000, Slovenia
[4] Addenbrookes Hosp, Dept Radiol, Cambridge, England
[5] Univ Cambridge, Cambridge, England
[6] Addenbrookes Hosp, CamPARI Clin, Cambridge, England
基金
英国工程与自然科学研究理事会;
关键词
multiparametric MRI; prostate cancer; staging; PELVIC LYMPH-NODES; APPARENT DIFFUSION-COEFFICIENT; SEMINAL-VESICLE INVASION; ULTRASMALL SUPERPARAMAGNETIC PARTICLES; INFLUENCES BIOCHEMICAL RECURRENCE; EXTRACAPSULAR EXTENSION; WEIGHTED MRI; DATA SYSTEM; EXTRAPROSTATIC EXTENSION; PROGNOSTIC-SIGNIFICANCE;
D O I
10.2478/raon-2019-0021
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. Accurate local staging is critical for treatment planning and prognosis in patients with prostate cancer (PCa). The primary aim is to differentiate between organ-confined and locally advanced disease with the latter carrying a worse clinical prognosis. Multiparametric MRI (mpMRI) is the imaging modality of choice for the local staging of PCa and has an incremental value in assessing pelvic nodal disease and bone involvement. It has shown superior performance compared to traditional staging based on clinical nomograms, and provides additional information on the site and extent of disease. MRI has a high specificity for diagnosing extracapsular extension (ECE), seminal vesicle invasion (SVI) and lymph node (LN) metastases, however, sensitivity remains poor. As a result, extended pelvic LN dissection remains the gold standard for assessing pelvic nodal involvement, and there has been recent progress in developing advanced imaging techniques for more distal staging. Conclusions. T2W-weighted imaging is the cornerstone for local staging of PCa. Imaging at 3T and incorporating both diffusion weighted and dynamic contrast enhanced imaging can further increase accuracy. "Next generation" imaging including whole body MRI and PE-MRI imaging using prostate specific membrane antigen (Ga-68-PSMA), has shown promising for assessment of LN and bone involvement as compared to the traditional work-up using bone scintigraphy and body CT.
引用
收藏
页码:159 / 170
页数:12
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