Optimising prostate biopsies and imaging for the future—a review

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations Pub Date : 2024-09-19 DOI:10.1016/j.urolonc.2024.08.019

Kimberley Chan M.A. , Drkhairul Asri Mohammad Ghani M.S. , Jeremy Teoh M.B.B.S. , Andrew Brodie M.B., Ch.B. , Christine Gan M.A. , Charlotte Foley M.D. , Prokar Dasgupta M.D., D.L.S. , Nikhil Vasdev Ch.M. F.R.C.S. (Urol)

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引用次数: 0

Abstract

Conventionally, transrectal ultrasound guided prostate biopsy (TRUS-Bx) was the main technique used for the diagnosis of prostate cancer since it was first described in 1989 [1]. However, the PROMIS trial showed that this random, nontargeted approach could miss up to 18% of clinically significant cancer (csPCa) [2]. Furthermore, risk of sepsis post TRUS-Bx can be as high as 2.4% [3]. Understanding the demerits of TR-biopsy have led to the introduction of transperineal prostate biopsy (TP-Bx). The incorporation of mpMRI revolutionized prostate cancer diagnostics, allowing visualization of areas likely to harbor csPCa whilst permitting some men to avoid an immediate biopsy. Furthermore, the advent of prostate specific membrane antigen-positron emission tomography (PSMA-PET) is highly promising, because of its role in primary diagnosis of prostate cancer and its higher diagnostic accuracy over conventional imaging in detecting nodal and metastatic lesions. Our narrative review provides an overview on prostate biopsy techniques and an update on prostate imaging, with particular focus on PSMA-PET.

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优化前列腺活检和成像的未来--综述。

自 1989 年首次描述经直肠超声引导前列腺活检术（TRUS-Bx）以来，它一直是诊断前列腺癌的主要技术[1]。然而，PROMIS 试验表明，这种随机、非靶向的方法可能会漏诊高达 18% 的有临床意义的癌症（csPCa）[2]。此外，TRUS-Bx 术后发生败血症的风险高达 2.4% [3]。了解到 TR-活检的缺点后，经会阴前列腺活检（TP-Bx）应运而生。mpMRI 的加入彻底改变了前列腺癌的诊断方法，它可以观察到可能藏有 csPCa 的区域，同时允许一些男性避免立即进行活检。此外，前列腺特异性膜抗原-正电子发射断层扫描（PSMA-PET）的出现也非常令人期待，因为它在前列腺癌的初诊中发挥了重要作用，而且在检测结节和转移病灶方面比传统成像技术具有更高的诊断准确性。我们的综述概述了前列腺活检技术，并介绍了前列腺成像技术的最新进展，尤其侧重于 PSMA-PET。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologic Oncology-seminars and Original Investigations 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.70%

发文量

297

审稿时长

7.6 weeks

期刊介绍： Urologic Oncology: Seminars and Original Investigations is the official journal of the Society of Urologic Oncology. The journal publishes practical, timely, and relevant clinical and basic science research articles which address any aspect of urologic oncology. Each issue comprises original research, news and topics, survey articles providing short commentaries on other important articles in the urologic oncology literature, and reviews including an in-depth Seminar examining a specific clinical dilemma. The journal periodically publishes supplement issues devoted to areas of current interest to the urologic oncology community. Articles published are of interest to researchers and the clinicians involved in the practice of urologic oncology including urologists, oncologists, and radiologists.