Magnetic resonance imaging for prostate cancer before radical and salvage radiotherapy: What radiation oncologists need to know
نویسندگان
چکیده
External beam radiotherapy (EBRT) is one of the principal curative treatments for patients with prostate cancer (PCa). Risk group classification is based on prostate-specific antigen (PSA) level, Gleason score, and T-stage. After risk group determination, the treatment volume and dose are defined and androgen deprivation therapy is prescribed, if appropriate. Traditionally, imaging has played only a minor role in T-staging due to the low diagnostic accuracy of conventional imaging strategies such as transrectal ultrasound, computed tomography, and morphologic magnetic resonance imaging (MRI). As a result, a notable percentage of tumours are understaged, leading to inappropriate and imprecise EBRT. The development of multiparametric MRI (mpMRI), an imaging technique that combines morphologic studies with functional diffusion-weighted sequences and dynamic contrast-enhanced imaging, has revolutionized the diagnosis and management of PCa. As a result, mpMRI is now used in staging PCa prior to EBRT, with possible implications for both risk group classification and treatment decision-making for EBRT. mpMRI is also being used in salvage radiotherapy (SRT), the treatment of choice for patients who develop biochemical recurrence after radical prostatectomy. In the clinical context of biochemical relapse, it is essential to accurately determine the site of recurrence - pelvic (local, nodal, or bone) or distant - in order to select the optimal therapeutic management approach. Studies have demonstrated the value of mpMRI in detecting local recurrences - even in patients with low PSA levels (0.3-0.5 ng/mL) - and in diagnosing bone and nodal metastasis. The main objective of this review is to update the role of mpMRI prior to radical EBRT or SRT. We also consider future directions for the use and development of MRI in the field of radiation oncology.
منابع مشابه
Optimization of clinical target volume delineation using magnetic resonance spectroscopic imaging (MRSI) in 3D conformal radiotherapy of prostate cancer
Background: For the purpose of individual clinical target volume assessment in radiotherapy of prostate cancer, MRSI was used as a molecular imaging modality with MRI and CT images. Materials and Methods: The images of 20 prostate cancer patients were used in this study. The MR and MRSI images were registered with CT ones using non-rigid registration technique. The CT based planning (BP), CT/MR...
متن کاملSingle Orbital Metastasis in Castration-Resistant Prostate Cancer
Introduction: Orbital metastasis of prostate cancer (PC) is very rare and even more unique in castration-resistant PC (CRPC). In this scenario, choline positron emission tomography/computed tomography (choline PET/CT) is the gold-standard restaging method of choice available in our setting, and new anti-androgens treatments show improvement in overall survival. Case presentation: We report the...
متن کاملSingle Orbital Metastasis in Castration-Resistant Prostate Cancer
Introduction: Orbital metastasis of prostate cancer (PC) is very rare and even more unique in castration-resistant PC (CRPC). In this scenario, choline positron emission tomography/computed tomography (choline PET/CT) is the gold-standard restaging method of choice available in our setting, and new anti-androgens treatments show improvement in overall survival. Case presentation: We report the...
متن کاملThe Role of MRSI in Target Volume Definition for Radiation Therapy of Prostate Cancer
Introduction: Recently, magnetic resonance spectroscopic imaging (MRSI), as a functional imaging method, has been used for clinical target volume definition. In this study, we used this method to define the target volume in prostate radiotherapy. Material and Method: In this study, we used images of 20 prostate cancer cases. MRSI and MRI images were fused with CT images. Then, treatment plannin...
متن کاملThe possibility of hormone-mediated PSA derangement in prostate cancer treatment
Background: This study was designed to suggest the possibility of hormone-related derangement in salvage radiotherapy (SRT) after radical prostatectomy in terms of prostate-specific antigen (PSA) control. Materials and Methods: Among 160 consecutive prostate cancer patients who received radical prostatectomy, 34 with SRT between 2004 and 2012 were retrospectively reviewed. The numbers of patien...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 8 شماره
صفحات -
تاریخ انتشار 2017