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World Journal of Urology

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01-08-2014 | Invited Review

Innovations in diagnostic imaging of localized prostate cancer

Authors: Karl Pummer, Malte Rieken, Herbert Augustin, Thomas Gutschi, Shahrokh F. Shariat

Published in: World Journal of Urology | Issue 4/2014

Abstract

Purpose

In recent years, various imaging modalities have been developed to improve diagnosis, staging, and localization of early-stage prostate cancer (PCa).

Methods

A MEDLINE literature search of the time frame between 01/2007 and 06/2013 was performed on imaging of localized PCa.

Results

Conventional transrectal ultrasound (TRUS) is mainly used to guide prostate biopsy. Contrast-enhanced ultrasound is based on the assumption that PCa tissue is hypervascularized and might be better identified after intravenous injection of a microbubble contrast agent. However, results on its additional value for cancer detection are controversial. Computer-based analysis of the transrectal ultrasound signal (C-TRUS) appears to detect cancer in a high rate of patients with previous biopsies. Real-time elastography seems to have higher sensitivity, specificity, and positive predictive value than conventional TRUS. However, the method still awaits prospective validation. The same is true for prostate histoscanning, an ultrasound-based method for tissue characterization. Currently, multiparametric MRI provides improved tissue visualization of the prostate, which may be helpful in the diagnosis and targeting of prostate lesions. However, most published series are small and suffer from variations in indication, methodology, quality, interpretation, and reporting.

Conclusions

Among ultrasound-based techniques, real-time elastography and C-TRUS seem the most promising techniques. Multiparametric MRI appears to have advantages over conventional T2-weighted MRI in the detection of PCa. Despite these promising results, currently, no recommendation for the routine use of these novel imaging techniques can be made. Prospective studies defining the value of various imaging modalities are urgently needed.

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Title: Innovations in diagnostic imaging of localized prostate cancer
Authors: Karl Pummer
Malte Rieken
Herbert Augustin
Thomas Gutschi
Shahrokh F. Shariat
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 4/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-013-1172-6

At a glance: The STEP trials

Springer Medicine

Innovations in diagnostic imaging of localized prostate cancer

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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