Highlights of the American Society of Clinical Oncology (ASCO) Multidisciplinary Prostate Cancer Symposium: Current Status and Future Directio for Prevention and Management

2005年2月17－19日

美国佛罗里达州奥兰多

February 17 - 19, 2005, Orlando, Florida

Imaging Evaluation of Prostate Cancer

Ho ein Jadvar, MD, PhD, FACNM

Imaging evaluation of prostate cancer remai a challenging endeavor.[1] As oncology departs from no ecific diagnosis and treatment toward patient- ecific a roach to therapy, accurate knowledge of the presence and extent of metastatic disease becomes even more crucial in order to tailor the treatment plan a ropriately.[2] This information in combination with the physiologic, histologic, antigenic, molecular, and genetic markers of the disease will provide u recedented o ortunities for the new era of imaging-based cancer diagnosis and therapy.[3] Imaging tests include ultrasound, CT, MRI, bone scintigraphy, In-111 capromab pendetide (ProstaScint; Cytoge Princeton, New Jersey), and PET. This article provides a brief discu ion of the research that was presented at the 2005 American Society of Clinical Oncology (ASCO) Multidisciplinary Prostate Cancer Symposium; February 17-19, 2005; Orlando, Florida.

Ultrasound and Contrast Visualizes Malignancies

Ultrasound is an important imaging modality in the evaluation of the prostate gland. Targeted bio y with tra rectal sonography during infusion of a microbu le contrast agent has been shown to be advantageous in comparison to a modified sextant a roach, although the contrast enhancement at the apex may be le efficacious.[4] However, the co icuity of hypervascular prostate cancer for Do ler sonography may be improved with short-term oral therapy with a 5a-reductase inhibitor.[5] The same group of investigators reported the use of sonography with manual compre ion of the prostate gland with the tra rectal probe in order to generate elastograms.[6] The basis for improved detection of cancer is that the elasticity of the neoplastic ti ue is le in comparison with normal prostate.

MRI and CT Expanding Diagnostic Capabilities

The use of dynamic CT for the a e ment of the prostate perfusion was reported.[7] Since the alteratio in microve el de ity within the prostate is a ociated with the presence of cancer, dynamic contrast-enhanced CT may prove useful in the detection of cancer. Ives and a ociates[7] showed that quantitative CT estimates of perfusion are positively correlated with high-grade tumors (Gleason >/= 8).

Menard and colleagues[8] reported on the integration of diagnostic and interventional MRI for bio y of prostate gland. The technique provided precise MRI-guided needle bio y of the prostate during a diagnostic MRI procedure. The use of the newer imaging methods using highly lymphotropic superparamagnetic nanoparticles in conjunction with high-resolution MRI for detection of small and otherwise undetectable lymph-node me

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