Role of imaging and biopsy to assess local recurrence after definitive treatment for prostate carcinoma (surgery, radiotherapy, cryotherapy, HIFU)
Role of imaging and biopsy to assess local recurrence after definitive treatment for prostate carcinoma (surgery, radiotherapy, cryotherapy, HIFU)
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DOI：
10.1007/s00345-011-0687-y
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发表时间：
2011-10-01
影响因子：
3.4
通讯作者：
Barozzi, Libero
中科院分区：
文献类型：
--
作者：
Martino, Pasquale;Scattoni, Vincenzo;Barozzi, Libero
局限性前列腺癌根治性治疗后早期确定复发部位是一个关键问题，因为它可能极大地影响后续的治疗策略或患者管理。通过检索Medline对1995年1月至2011年1月的文献进行系统回顾。电子检索仅限于英文，关键词为前列腺癌、放射治疗[RT]、高强度聚焦超声[HIFU]、冷冻治疗[CRIO]、经直肠超声[TRUS]、磁共振[MRI]、使用了 PET/TC 和前列腺活检。尽管局部复发的诊断是基于 PSA 值和动力学，但通过不同技术进行成像可能是有效疾病管理的先决条件。不幸的是，前列腺癌局部复发很难通过 TRUS 和传统成像来检测，至少在早期阶段，其准确性有限。相反，功能和分子成像，如动态对比增强磁共振成像（DCE-MRI）和扩散加权成像（DWI），提供了对单个肿瘤的分子或细胞过程进行成像的可能性。最近，使用 11C-胆碱、18F-氟胆碱或 11C-乙酸盐的 PET/CT 已被成功提出用于检测局部复发和远处转移。然而，在有争议的病例中，有必要在MRI或TRUS检查结果的指导下进行前列腺窝活检或前列腺活检来评估是否存在局部复发。未来影像学很可能会广泛用于在挽救治疗前检测和定位前列腺癌局部复发。
Defining the site of recurrent disease early after definitive treatment for a localized prostate cancer is a critical issue as it may greatly influence the subsequent therapeutic strategy or patient management.A systematic review of the literature was performed by searching Medline from January 1995 up to January 2011. Electronic searches were limited to the English language, and the keywords prostate cancer, radiotherapy [RT], high intensity focused ultrasound [HIFU], cryotherapy [CRIO], transrectal ultrasound [TRUS], magnetic resonance [MRI], PET/TC, and prostate biopsy were used.Despite the fact that diagnosis of a local recurrence is based on PSA values and kinetics, imaging by means of different techniques may be a prerequisite for effective disease management. Unfortunately, prostate cancer local recurrences are very difficult to detect by TRUS and conventional imaging that have shown limited accuracy at least at early stages. On the contrary, functional and molecular imaging such as dynamic contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI), offers the possibility of imaging molecular or cellular processes of individual tumors.Recently, PET/CT, using 11C-choline, 18F-fluorocholine or 11C-acetate has been successfully proposed in detecting local recurrences as well as distant metastases. Nevertheless, in controversial cases, it is necessary to perform a biopsy of the prostatic fossa or a biopsy of the prostate to assess the presence of a local recurrence under guidance of MRI or TRUS findings.It is likely that imaging will be extensively used in the future to detect and localize prostate cancer local recurrences before salvage treatment.