Screening and detection advances in magnetic resonance image-guided prostate biopsy.

Screening and detection advances in magnetic resonance image-guided prostate biopsy.
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磁共振图像引导前列腺活检的筛查和检测进展。

DOI:
10.1016/j.ucl.2014.01.007
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发表时间:
2014
期刊:
The Urologic clinics of North America
影响因子:
--
通讯作者:
Marks,LeonardS
Marks,LeonardS
中科院分区:
--
文献类型:
--
作者:
Stephenson,SamuelK;Chang,EdwardK;Marks,LeonardS

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近世纪来,直肠指检(DRE)是唯一可用于帮助组织取样以诊断前列腺癌(CaP)的工具1。随着20世纪80年代超声波的出现,医生有了一种实时引导活检针的新模式。最初由Stamey开发,超声引导下,经直肠六分仪方法被广泛采用2。从那时起,额外的样本(通常总共12个)和局部麻醉已经增加,但在其他方面,20世纪80年代的随机,系统的程序基本上保持不变。饱和活检一直被提倡,但可能会增加不重要的癌症的检出率,并且通常需要全身麻醉。因此,CaP是唯一重要的实体恶性肿瘤,通过器官盲法活检诊断,即没有肿瘤可视化。通过这种方法检测到的癌症中约有50%可能没有临床意义3。此外,系统活检在前列腺前部、中线和顶端的病变取样方面较差。这可能导致重要的诊断不足。
For nearly a century, digital rectal exam (DRE) was the only tool available to aid in tissue sampling for diagnosis of prostate cancer (CaP) 1. With the advent of ultrasound in the 1980’s, physicians had a new modality for directing biopsy needles in real-time. Originally developed by Stamey, the ultrasound-guided, trans-rectal sextant method became widely adopted2. Since that time, additional samples are taken (usually totaling 12) and local anesthesia has been added, but otherwise the random, systematic procedure of the 1980s has remained largely unchanged.‘Saturation’biopsy has been advocated, but may increase detection of insignificant cancers, and it typically requires general anesthesia.Thus, CaPis the only important solid malignancy diagnosed by blind biopsy of the organ, ie, without tumor visualization. Some 50% of cancers detected by this methodmay not be of clinical significance 3. In addition, systematic biopsies are poor at sampling lesions in the anterior, midline, and apex of the prostate. This can lead to under-diagnosis of important
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