进展期前列腺癌下一代影像学检查概览

来源：医学影像学英语

Next Generation Imaging in Advanced Prostate Cancer: An Overview

Dr Neeral R Patel, Professor Anwar R Padhani,

Dr Wai-Lup Wong, Dr Kathryn Wallitt, Dr Andrew Gogbashian,

Dr Heminder K Sokhi, Dr Amish Lakhani

Radiological Society of North America Annual Meeting

McCormick Place Convention Centre, Chicago

November 2018

Learning Objectives

• To appreciate role and limitations of current modalities used in advanced prostate cancer (APC) assessment and follow-up

• To understand the emerging role of next generation imaging techniques such as whole body MRI (WB-MRI) and PET in assessing response to therapy in APC

• To understand the role of morphologic and diffusion weighted WB-MRI sequences in the assessment of osseous and extra-osseous metastatic disease

• To appreciate the different PET tracers which are currently being used in the assessment of APC

• Pearls and pitfalls of assessing patients with these next generation imaging solutions

Introduction What is Advanced Prostate Cancer?

• Advanced prostate cancer (APC) = patient who presents with metastatic disease at the time of diagnosis or after failed attempts at curative therapy

• Sites of metastases:

• Bone 

• Lymph nodes (usually pelvic)

• Visceral metastases (liver, lungs) → infrequent

• APC with bone disease → skeletal morbidity → reduced quality of life → bone pain/pathological fractures/hypercalcemia/spinal cord compression

• Usually respond to androgen deprivation therapy (ADT) → ADT leads to castration resistant prostate cancer (CRPC) state within 1-3 years

• Determining presence/volume/distribution of metastatic disease in APC using imaging → allows treatment options to be decided: systemic, radiotherapy and surgery → palliative intent

Padhani et al. 2017

译者：何惠琴