Der Urologe

, Volume 45, Issue 6, pp 702–706

MR-Techniken zur nicht-invasiven Diagnostik des Prostatakarzinoms

  • N. Morakkabati-Spitz
  • P. J. Bastian
  • A. Meisner
  • F. Träber
  • J. Gieseke
  • H. H. Schild
  • S. C. Müller
Leitthema

Zusammenfassung

Die Diagnosestellung des Prostatakarzinoms basiert auf einem erhöhten PSA-Wert, einem suspekten Tastbefund und einer auffälligen transrektalen Sonographie (TRUS). Die Diagnose wird durch US-gestützte Stanzbiopsie gesichert, allerdings werden bis zu 30% der Karzinome mit dieser Methode nicht erkannt. Zwischenzeitlich haben sich die MRT und die MR-Spektroskopie als sensitivste Zusatzmethoden für die nicht-invasive Abklärung des Prostatakarzinoms etabliert.

Dieser Artikel gibt einen Überblick über klinische Indikationen zur MRT der Prostata und berichtet über neue Techniken (Hochfeld-MRT und die dynamische kontrastverstärkte MRT der Prostata).

Schlüsselwörter

Prostata Bildgebung MRT 3T Kontrastmitteldynamik 

MR techniques for noninvasive diagnosis of prostate cancer

Abstract

The diagnosis of prostate cancer is suggested on the basis of an elevated PSA level, abnormal digital exam, and abnormal transrectal ultrasound. US-guided biopsy is used to confirm the diagnosis, but up to 30% of prostate cancer may be missed with this approach. Meanwhile MR imaging and proton MR spectroscopy have emerged as the most sensitive additional tools for the noninvasive evaluation of prostate cancer.

This article reviews the clinical indications for MRI of the prostate and summarizes new techniques such as high field strength (3 tesla) and dynamic contrast-enhanced MRI.

Keywords

Prostate Imaging MRI 3T Dynamic contrast-enhanced 

Literatur

  1. 1.
    Bellin MF, Roy C, Kinkel K et al. (1998) Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall iron oxide particles-initial clinical experience. Radiology 207: 799–808PubMedGoogle Scholar
  2. 2.
    Beyersdorff D, Taupitz M, Winkelmann B et al. (2002) Patients with a history of elevated prostate-specific antigen levels and negative transrectal US-guided quadrant or sextant biopsy results: value of MR imaging. Radiology 224(3): 701–706PubMedGoogle Scholar
  3. 3.
    Bloch BN, Rofsky NM, Baroni RH et al. (2004) 3 Tesla magnetic resonance imaging of the prostate with combined pelvic phased-array and endorectal coils; Initial experience. Acad Radiol 11(8): 863–867PubMedGoogle Scholar
  4. 4.
    Brown TR, Kincaid BM, Ugurbil K (1982) NMR chemical shift imaging in three dimensions. Proc Natl Acad Sci USA 79: 3523–3536PubMedGoogle Scholar
  5. 5.
    Buckley DL, Roberts C, Parker GJ et al. (2004) Prostate cancer: evaluation of vascular characteristics with dynamic contrast-enhanced T1-weighted MR imaging – initial experience. Radiology 233(3): 709–15PubMedGoogle Scholar
  6. 6.
    Casciani E, Polettini E, Bertini L et al. (2004) Prostate cancer: evaluation with endorectal MR imaging and three-dimensional proton MR spectroscopic imaging. Radiol Med (Torino) 108(5–6): 530–541Google Scholar
  7. 7.
    Claus FG, Hricak H, Hattery R (2004) Pretreatment evaluation of prostate cancer: role of MR imaging and 1H MR spectroscopy. Radiographics 24: 167–180Google Scholar
  8. 8.
    Coakley FV, Eberhardt S, Wei DC et al. (2002) Blood loss during radical retropubic prostatectomy: relationship to morphologic features on preoperative endorectal magnetic resonance imaging. Urology 59: 884–888CrossRefPubMedGoogle Scholar
  9. 9.
    Coakley FV, Eberhardt S, Kattan MW et al. (2002) Urinary incontinence after radical retropubic prostatectomy: relationship with membranous urethral length on preoperative endorectal magnetic resonance imaging. J Urol 168: 1032–1035CrossRefPubMedGoogle Scholar
  10. 10.
    Coakley FV, Teh HS, Qayyum A et al. (2004) Endorectal MR imaging and MR Spectroscopic imaging for locally recurrent prostate cancer after external beam radiation Therapy: preliminary experience. Radiology 233: 441–448PubMedGoogle Scholar
  11. 11.
    Ellis WJ, Brawer MK (1995) Repeat prostate needle biopsy: who needs it? J Urol 153: 1496–1498CrossRefPubMedGoogle Scholar
  12. 12.
    Engelbrecht MR, Jager GJ, Laheij RJ et al. (2002) Local staging of prostate cancer using magnetic resonance imaging: a meta-analysis. Eur Radiol 12: 2294–2302PubMedGoogle Scholar
  13. 13.
    Futterer JJ, Scheenen TW, Huisman HJ et al. (2004) Initial experience of 3 tesla endorectal coil magnetic resonance imaging and 1H-spectroscopic imaging of the prostate. Invest Radiol. 39(11): 671–680Google Scholar
  14. 14.
    Futterer JJ, Heijmink SW, Scheenen TW et al. (2006) Prostate cancer:local staging at 3T endorectal MR imaging, early experience. Radiology 238(1): 184–191PubMedGoogle Scholar
  15. 15.
    Harisinghani MG, Barentsz J, Hahn PF et al. (2003) Noninvasive detection of clinically occult lymph-node metastases in prostate cancer. N Engl J Med 348: 2491–2494CrossRefPubMedGoogle Scholar
  16. 16.
    Hasumi M, Suzuki K, Taketomi A et al. (2003) The combination of multi-voxel MR spectroscopy with MR imaging improve the diagnostic accuracy for localization of prostate cancer. Anticancer Res. 23 (5b): 4223–4227Google Scholar
  17. 17.
    Hricak H (2005) MR imaging and MR spectroscopic imaging in the pre-treatment evaluation of prostate cancer. Br J Radiol 78: 103–111CrossRefPubMedGoogle Scholar
  18. 18.
    Hricak H, Wang L, Wei DC et al. (2004) The role of preoperative endorectal magnetic resonance imaging in the decision regarding whether to preserve or resect neurovascular bundles during radical retropubic prostatectomy. Cancer 100: 2655–2663CrossRefPubMedGoogle Scholar
  19. 19.
    Jager GJ, Severens JL, Thornbury JR et al. (2000) Prostate cancer staging: should MR imaging be used? A decision analytic approach. Radiology 215(2): 445–451PubMedGoogle Scholar
  20. 20.
    Kim JK, Hong SS, Choi YJ et al. (2005) Wash-in rate on the basis of dynamic contrast-enhanced MRI: usefulness for prostate cancer detection and localization. J Magn Reson Imag 22(5): 639–646CrossRefGoogle Scholar
  21. 21.
    Kubik-Huch RA, Hailemariam S, Hamm B (1999) CT and MRI of the male genital tract: radiologic-pathologic correlation. Eur Radiol 9(1): 16–28CrossRefPubMedGoogle Scholar
  22. 22.
    Kurhanewicz J, Vigneron DB, Hricak H et al. (1996) Three-dimensional H-1 MR spectroscopic imaging of the in situ human prostate with high (0.24–0.7-cm3) spatial resolution. Radiology 198(3): 795–805PubMedGoogle Scholar
  23. 23.
    Lutz JM, Francisci S, Mugno E et al. (2003) Cancer prevalence in Central Europe: the EUROPREVAL Study. Ann Oncol 14(2): 313–322CrossRefPubMedGoogle Scholar
  24. 24.
    Mullerad M, Hricak H, Wang L et al. (2004) Prostate cancer: Detection of extracapsular extension by genitourinary and general body radiologists at MR Imaging. Radiology 232: 140–146PubMedGoogle Scholar
  25. 25.
    Ogura K, Maekawa S, Okubo K et al. (2001) Dynamic endorectal magnetic resonance imaging for local staging and detection of neurovascular bundle involvement of prostate cancer: correlation with histopathologic results. Urology 57: 721–726CrossRefPubMedGoogle Scholar
  26. 26.
    Rabbani F, Stroumbakis N, Kava BR et al. (1998) Incidence and clinical significance of false-negative sextant biopsies of the prostate. J Urol 159: 1247–1250CrossRefPubMedGoogle Scholar
  27. 27.
    Scheidler J, Hricak H, Vigneron DB et al. (1999) Prostate cancer: localization with three-dimensional proton MR spectroscopic imaging-clinicopathologic study. Radiology 213: 473–480PubMedGoogle Scholar
  28. 28.
    Sosna J, Pedrosa I, Dewolf WC et al. (2004) MR imaging of the prostate at 3 Tesla: comparison of an external phased-array coil to imaging with an endorectal coil at 1.5 Tesla. Acad Radiol 11(8): 857–862CrossRefPubMedGoogle Scholar
  29. 29.
    Star-Lack J, Nelson SJ, Kurhanewicz J et al. (1997) Improved water and lipid suppression for 3D PRESS CSI using RF band-selective inversion with gradient dephasing (BASING). Magn Reson Med 38: 311–321PubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  • N. Morakkabati-Spitz
    • 3
  • P. J. Bastian
    • 1
  • A. Meisner
    • 1
  • F. Träber
    • 3
  • J. Gieseke
    • 2
  • H. H. Schild
    • 3
  • S. C. Müller
    • 1
  1. 1.Klinik und Poliklinik für Urologie, Klinikum Rheinische Friedrich-Wilhelms UniversitätBonn
  2. 2.Philips Medizin SystemeHamburg
  3. 3.Radiologische Klinik, KlinikumRheinische Friedrich-Wilhelms UniversitätBonn

Personalised recommendations