Pi rads 5 prostate cancer treatment. Evaluarea imagistică prin Rezonanţă Magneticămultiparametrică. de prostată
Cancer de prostată
Magnetic Resonance Imaging MRI is the best imaging modality for evaluating the prostate and accurately diagnose the prostatic carcinoma, especially in cases with aggressive and larger volume tumors. The main impuls din prostatită of this article are: to review the multiparametric MRI assessment technique used in prostate pathology, to list and illustrate the most common MRI features in prostate cancer, and to present the role of the multidisciplinary team in the diagnosis and management of patients with prostate tumoral pathology.
Keywords prostate cancer, multiparametric MRI, multidisciplinarity Rezumat Cancerul de prostată reprezintă o importantă problemă de sănătate publică.
Introducere Ipoteza de lucru Material şi metodă Rezultate Discuţii Concluzii Studiul 3 Variabilitatea interobservaţională în detecţia şi stadializarea locală a cancerului de prostată utilizând Imagistica 77 prin Rezonanţă Magnetică 5. Neoplasmul de prostată este actualmente al doilea cancer ca frecvenţă la sexul masculin, reprezentând la nivel global, a cincea cauză de mortalitate prin neoplazii. Măsurarea nivelului seric al antigenului specific prostatic PSAtuşeul rectal şi biopsia prostatică ghidată prin ecografie transrectală sunt utilizate pe scară largă ca metode diagnostice în cancerul de prostată. Bilanţul iniţial al acestei neoplazii include detecţia, localizarea şi stadializarea, acurateţea acestor date influenţând în mod direct adoptarea atitudinii clinice optime şi instituirea terapiei adecvate.
Imagistica prin rezonanţă magnetică IRM este cea mai bună modalitate de evaluare a prostatei şi de a diagnostica cancerul de prostată, mai ales în cazurile în care tumora este voluminoasă şi agresivă. Principalele obiective ale acestui articol sunt: revizuirea tehnicii utilizate în evaluarea IRM multiparametrică în patologia prostatită proserină, prezentarea şi ilustrarea principalelor aspecte IRM întâlnite în cancerul de prostată şi prezentarea rolului abordului multidisciplinar în diagnosticul şi managementul pacienţilor cu patologie tumorală prostatică.
To become familiar with the MRI features of prostate cancer.
To delineate the importance of the multidisciplinary team in the diagnosis and management of patients with prostate cancer. Introduction Epidemiology.
Cancer with benign prostatic hyperplasia
Prostate cancer is the most common solid neoplasm in Europe and the second leading cause of male cancer deaths in USA and UK. Age is the most important risk factor Allmost all prostate cancers are adenocarcinomas.
Gleason score grade corresponds to a well differentiated prostatic tumor; grade is a moderately differentiated tumor, and signifies a poorly differentiated prostatic cancer 3. Prognostic indicators.
Cuvinte cheie hiperplazie benignă de prostată IRM multiparametrică cancer de prostată PI-RADS imagistică medicală Introduction Benign prostatic hyperplasia BPH is a histologic diagnosis characterized by proliferation of the prostatic cellular elements. Benign hyperplastic nodules are most commonly seen in the transition zone, but they can also protrude into the peripheral zone or even beyond the prostatic capsule, appearing as an exophitic pelvic mass or as a mass within the bladder 2. Usually, there is a direct relationship between prostate enlargement and symptoms severity, although many patients with small prostates also present urinary obstruction, because of the strategically position of the adenoma, sitting right on the bladder outlet 2. The initial evaluation should asses the frequency and severity of symptoms by using the International Prostate Symptom Score IPSS 4 and it should also include a digital rectal examination and urinalysis.
TNM stage is the most important prognostic variable. Prostate specific antigen PSA is primarily used in the diagnosis and detection of disease recurrence.
Cancer de prostata pirads 4. RMN Prostată Multiparametric (IRM) 3T
High levels is correlated with advanced TNM stage at diagnosis 3. Indications of MRI evaluation in prostate cancer: 1. Detection localization — detection and characterization protocol. Staging protocol: tumor extension, presence of node and bone metastasis.
Follow-up of a known prostatic tumor. Recurrences after treatment. A scale from 1 to 5, stratifying a focal prostatic abnormality according to the MRI findings, obtained with different MRI sequences, pi rads 5 prostate cancer treatment the reproducibility of radiologists reports and the communication with referring physicians Other sequences and technical requirements.
The prostate and seminal vesicles must be covered entirely slice thickness: 3 mm. Imaging, parallel to the prostate, perpendicular to the rectal face of the prostate, or oblique into the seminal vesicles plane are essential to evaluate extraprostatic extension Figure 1. Figure 1.
MRI of the Prostate: A Practical Approach
MRI acquisition planes in prostate cancer evaluation T1-wi SE are useful for detecting enlarged pelvic lymph nodes slices from the pubic symphysis till the aortic bifurcationbone metastases and post biopsy hemorrhage. The interpretation is based on an attentive qualitative and quantitative analysis of each sequence Figure 2. Post-biopsy intraprostatic hemorrhagic spot hyperintense on T1FS wi, and hypointense T2 wiwhich can mimic a tumoral nodule arrow It is pi rads 5 prostate cancer treatment important that the slices obtained on T2 wi, diffusion, dynamic T1 after gadolinium Gd injection have the same plane centeringslices number, slice thickness and identical interslice space for a correct and easy analysis.
Different publications and studies regarding the correlation between ADC value on diffusion-weighted MR imaging and the Gleason score in prostate cancer have demonstrated that ADC values are lower in aggressive PC and correlated with the Gleason score Prostate cancer located in the PZ corresponds to an area of low signal intensity Figure 3 and Table 1.
Cancer with benign prostatic hyperplasia, ROLUL GANGLIOZIDELOR ÎN PATOLOGIA PROSTATICĂ.
But T2 hyposignal in the peripheral zone may be present also in noncancerous conditions 12 : inflammation, biopsy-related hemorrhage blood products may persist weeks or longer after prostate biopsypost-radiation therapy fibrosis, and changes after hormone deprivation therapy Figure 2. Table 1.
Large tumoral prostatic nodule located into the left PZ white arrow T2-wi has significant limitations for depicting cancer involving the TZ and CZ Table 2 : cancer and normal tissues have both low signal intensity