Riassunto
Nell’era dell’imaging molecolare ciò che si chiede alla diagnostica per immagini è avere buona accuratezza nella diagnosi precoce di un’alterazione patologica, sia benigna sia, soprattutto, maligna. La criticità di questo aspetto risulta indiscutibile dal punto di vista oncologico e terapeutico, in cui è di primaria importanza superare i limiti dell’evidenza morfologica; in altre parole, la possibilità di identificare un focus patologico prima ancora che sia morfologicamente apprezzabile cambia necessariamente l’outcome del trattamento [1]. È chiaro che i requisiti richiesti esaltano l’aspetto funzionale delle tecniche utilizzate, come per la diffusione, di cui si è trattato nel capitolo 13. Le altre tecniche che sicuramente esaltano l’aspetto funzionale dell’esame di RM sono la spettroscopia a immagini (1H-MRSI) e lo studio dinamico-perfusionale (DCE-MR). Entrambe offrono la visione di due aspetti fondamentali, riguardanti rispettivamente il metabolismo e la vascolarizzazione, che indirizzano indubbiamente verso una più corretta interpretazione diagnostica, quando ancora la lesione si trova in uno stato di pre-evidenza clinico-morfologica. In tale contesto la RM assume significato di completezza e, secondo l’acquisizione anglosassone, diventa un one-stop-shop examination.
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Panebianco, V., Lisi, D., Bernardo, S. (2010). Carcinoma della prostata: pattern RM metabolici e di vascolarizzazione. In: Passariello, R., Panebianco, V., Di Silverio, F., Sciarra, A. (eds) Imaging RM della prostata. Springer, Milano. https://doi.org/10.1007/978-88-470-1516-6_14
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