Prostat kanserinin aktif izleminde multiparametrik manyetik rezonans görüntüleme: literatür gözden geçirilmesi

Year 2022, Volume: 17 Issue: 2, 116 - 122, 30.06.2022

Fatih Yanaral , Ufuk Çağlar , Furkan Şendoğan , Murat Binbay

https://doi.org/10.33719/yud.2022;17-2-1068641

Abstract

Günümüzde aktif izlem, düşük riskli prostat kanserine sahip erkeklerde küratif tedaviye alternatif ve kabul edilebilir bir yönetim olarak popülerlik kazanmıştır. Aktif izlem, hastaya gerekli olmayan müdahalelerden kaçınmayı veya önlemeyi, böylece aşırı tedaviyle ilişkili morbiditeyi azaltmayı amaçlar. Güncel kılavuzlarda aktif izlem yaygın olarak kabul görmesine rağmen hem doktor hem de hasta için ileri evre hastalık ve tekrarlayan biyopsi gereksinimi endişesini ortadan kaldıramamaktadır. Bu durum, aktif izlem protokolünde hastalığın durumu hakkında fikir verebilecek, non-invaziv bir yöntem ihtiyacını ortaya çıkarmaktadır. Görüntüleme yöntemlerindeki son teknolojik gelişmeler, modern anatomik ve fonksiyonel sekansların tanımlanması, prostat kanserinin saptanması, risk değerlendirmesi ve takibinde multiparametrik manyetik rezonans görüntülemenin (mpMRG) artan bir role sahip olmasını sağlamıştır. MpMRG'nin başlıca avantajları, üstün anatomik ve kontrast çözünürlüğüne sahip olması, iyonize radyasyonun olmaması ve multi-planar görüntüleme özelliğinin olmasıdır. Ayrıca mpMRG'de PIRADS sınıflaması, prostat kanserinin raporlanmasındaki standardizasyonu sağlamakta ve radyologlar arasındaki yorumlara olan güvenilirliği artırarak avantaj sağlamaktadır. Bu derleme, prostat kanserinin aktif izleminde güncel bilgiler ışığında mpMRG’nin rolünü değerlendirmeyi ve özetlemeyi amaçlamaktadır.

Keywords

aktif izlem , prostat kanseri , multiparametrik manyetik rezonans görüntüleme

Active surveillance of prostate cancer with multiparametric magnetic resonance imaging: Review of the literature

Abstract

Nowadays, active surveillance has gained popularity as an acceptable management alternative to definitive treatment for men with low-risk prostate cancer. Active surveillance aims to delay or prevent unnecessary interventions – thereby reducing the morbidity associated with overtreatment. Despite widespread acceptance from current guidelines, active surveillance does not eliminate the concern that the advanced disease and repeat biopsy anxiety for both the clinician and the patient. This situation leads to the search for a method that is non-invasive and can give an idea to the clinician about the status of the disease in the active surveillance protocol. Recent technological advancements and the introduction of modern anatomical and functional sequences have led to a growing role for multiparametric magnetic resonance imaging (mpMRI) in the detection, risk assessment, and monitoring of prostate cancer. The main advantages of MRI are its superior anatomic and contrast resolution, lack of ionizing radiation, and multi-planar capabilities. In addition, standardization of reporting findings such as PI-RADS in mpMRI in prostate cancer provides an advantage by increasing inter-reader reliability among radiologists. This review aims to evaluate and summarize the role of magnetic resonance imaging in the active surveillance of prostate cancer.

Keywords

active surveilliance , prostate cancer , multiparametric magnetic resonance imaging

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