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磁力共振成像和主动监视:来自池的想法
Rebecca A Campbell1, Andrew Wood1, Zeyad Schwen1
1Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
European radiology
|September 12, 2024
概括
多参数MRI (mpMRI) 通过改善检测和风险分层,有助于前列腺癌的积极监测 (AS). 然而,它应该补充,而不是取代AS患者的定期活检和PSA监测.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 建议对低风险前列腺癌 (PCa) 进行主动监测 (AS),并选择在美国对有利的中等风险PCa进行选择.
- 多参数磁共振成像 (mpMRI) 越来越多地用于PCa查,监测和分期.
- 目前的美国指导方针建议对AS进行mpMRI,但缺乏关于随访时间的具体指导,并强调它不应该取代活检.
研究的目的:
- 审查当前关于使用mpMRI对PCa患者进行主动监测的文献,重点关注美国的方法.
- 讨论mpMRI在增加AS协议中的风险分层和监测中的作用.
- 突出一种多式联络方法的重要性,该方法将mpMRI与PSA动力学和活检相结合.
主要方法:
- 关于mpMRI在前列腺癌活跃监测中的使用现有文献的综述.
- 分析美国泌尿病学指南,包括美国泌尿病学协会 (AUA) 和国家综合癌症网络 (NCCN) 的建议.
- 专注于将mpMRI发现与诊断,确认和后续活检相结合.
主要成果:
- 将mpMRI添加到AS患者的诊断和监测协议中显示出在检测临床显著PCa方面具有好处.
- 没有强有力的证据支持mpMRI替代大多数AS患者的定期监测活检.
- 对于AS患者的随访mpMRI的最佳时间尚不清楚,目前的指导方针并没有具体说明.
结论:
- mpMRI是积极监测男性前列腺癌监测的宝贵工具,改善了检测和风险分层.
- mpMRI应纳入多模式方法,补充PSA动力学和监测活检.
- 需要进一步的研究来澄清AS协议中随访mpMRI的最佳时间.
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