The Role of Imaging in Prostate Cancer Care Pathway: Novel Approaches to Urologic Management Challenges Along 10 Imaging Touch Points - 27/09/18

Doi : 10.1016/j.urology.2018.04.026

Qian Li ^a, Feixiang Xiang ^b, Xueying Lin ^c, Joseph R. Grajo ^d, Long Yang ^e, Yufeng Xu ^f, Yu Duan ^g, Urvi Vyas ^h, Mukesh Harisinghani ^a, Umar Mahmood ^a, Anthony E. Samir ^a,^⁎
^a Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
^b Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
^c Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
^d Department of Radiology, Division of Abdominal Imaging, University of Florida College of Medicine, Gainesville, FL
^e Department of Ultrasound, Henan Province People's Hospital, Zhengzhou, China
^f Department of Radiology, Peking University First Hospital, Beijing, China
^g Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
^h Product Management, BK Ultrasound, Peabody, MA

^⁎Address correspondence to: Anthony E. Samir, M.D., M.P.H., Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA 02114.Department of RadiologyMassachusetts General HospitalHarvard Medical School55 Fruit Street, White 270BostonMA02114

Abstract

We map out a typical prostate cancer care pathway through discussion of updates on modern imaging. Multiparametric magnetic resonance imaging is the most sensitive and specific imaging tool for diagnosis and local staging, but transrectal ultrasound remains the most widely used technique for prostate biopsy guidance. Computed tomography and bone scan are useful in initial staging and recurrence detection. Novel imaging techniques in ultrasound elastography and multiparametric magnetic resonance imaging allow for increased lesion detection sensitivity and have the potential to enhance biopsy, while the development of new positron emission tomography radiotracers has great promise for improved detection of local and metastatic disease in patients with biochemical recurrence.

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Plan

Imaging Touch Points

Touch Point 1: Diagnosis—Prostate Cancer Lesion Localization

Touch Point 2: Diagnosis—Prostate Biopsy Imaging Guidance

Ultrasound-guided Targeted Biopsy

MRI Guided Targeted Biopsy

Touch Point 3: Staging—Evaluation of Intraprostatic Lesion and Capsule Involvement

Touch Point 4: Staging—Evaluation of Regional Lymph Nodes

Touch Point 5: Staging—Evaluation of Distant Metastases

Touch Point 6: Treatment—Risk Stratification

Touch Point 7: Treatment—Disease Monitoring

Touch Point 8: Treatment—Therapy Selection

Touch Point 9: Surveillance—Postintervention Local Recurrence

Touch Point 10: Surveillance—Postintervention Distant Metastases

Summary

	Financial Disclosure: The authors declare that they have no relevant financial interests.
	Funding Support: This study was sponsored by the Analogic Corporation of Peabody, MA.

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Vol 119

P. 23-31 - septembre 2018 Retour au numéro

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The Role of Imaging in Prostate Cancer Care Pathway: Novel Approaches to Urologic Management Challenges Along 10 Imaging Touch Points - 27/09/18

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