前列腺靶向穿刺活檢新進(jìn)展
The latest progress of prostate targeted biopsy
ZHENG Zhongyi,CAO Xiaoming
(Department of Urology,The First Hospital of Shanxi Medical University,Taiyuan 030001,China)
ABSTRACT:
Image,guided targeted biopsy is currently the mainstream method of prostate cancer puncture biopsy,while risk stratification based on imaging and biochemical markers may become the new standard. This paper comprehensively reviews the latest advancements in various imaging techniques and strategies of targeted prostate biopsy. Ultrasound,assisted prostate biopsy mainly includes transrectal ultrasound (TRUS),transrectal,contrast enhanced ultrasound (TR,CEUS),and transrectal real,time elastography (TRTE),which can significantly increase the diagnosis rate of prostate cancer when combined with biopsy. Three,dimensional transrectal ultrasound (3D,TRUS) technology may be used in patients with a negative previous biopsy. At present,micro,ultrasound (Micro,US),the latest ultrasound method,is not inferior to mp,MRI in targeted biopsy of the prostate. Targeted biopsy by mp,MRI has improved the detection rate of clinically significant prostate cancer
(csPCa),and the common NMR targeted technologies are magnetic resonance imaging,visual,targeted biopsy (MRI,visual,TB),magnetic resonance imaging,fusion,targeted biopsy (MRI,fusion,TB),and in,bore magnetic resonance imaging,target biopsy (MRI,TB). The fusion of MRI and Micro,US imaging for targeted biopsy has also become a new targeted biopsy method,and MR robot,assisted biopsy is gradually being applied. PET/CT improves localization of tumors and may be valuable for initial staging,re,staging after biochemical recurrence,even in patients with MRI,negative prostate cancer. PET/CT targeted biopsy using tracer has been shown to yield good diagnostic efficacy. PET/MRI technology has the potential to be the imaging test for needle,free biopsies in the future. The development of technology has led to the adaptation and optimization of biopsy strategies in clinical practice.
KEY WORDS:prostate cancer;biopsy;targeted biopsy;biopsy strategy;imaging technology;ultrasound assisted;MRI assisted;PET/CT guidance
摘要:影像學(xué)引導(dǎo)下靶向活檢是當(dāng)下前列腺癌穿刺活檢的主流方式,基于影像學(xué)和生化標(biāo)志物的風(fēng)險(xiǎn)分組可能成為前列腺癌穿刺活檢的新標(biāo)準(zhǔn),本文就前列腺靶向穿刺活檢中不同影像學(xué)方法的新進(jìn)展以及活檢策略進(jìn)行綜述:超聲輔助引導(dǎo)下前列腺活檢的方法主要包括直腸超聲前列腺活檢(TRUS)、經(jīng)直腸超聲造影(TR,CEUS)、經(jīng)直腸實(shí)時(shí)彈性成像(TRTE),與活檢聯(lián)合應(yīng)用能顯著增加前列腺癌的診斷率。(剩余18131字)
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