Recent advances in imaging-guided interventions for prostate cancers

Abstract

The numbers of patients diagnosed with prostate cancers is increasing due to the widespread application of prostate-specific antigen screening and subsequent prostate biopsies. The methods of systemic administration of therapeutics are not target-specific and thus cannot efficiently destroy prostate tumour cells while simultaneously sparing the surrounding normal tissues and organs. Recent advances in imaging-guided minimally invasive therapeutic techniques offer considerable potential for the effective management of prostate cancers. An objective understanding of the feasibility, effectiveness, morbidity, and deficiencies of these interventional techniques is essential for both clinical practice and scientific progress. This review presents the recent advances in imaging-guided interventional techniques for the diagnosis and treatment of prostate cancers.

Clinical utility of transperineal template-guided mapping biopsy of the prostate after negative magnetic resonance imaging−guided transrectal biopsy

“…The overall accuracy of mp-MRI for detection of PCa varies between 74% and 96% and a pre-biopsy MRI appears to assist in identifying clinically significant cancers with fewer target cores than the random systematic cores [1,8]. MRI-guided biopsy has been attempted in 3 different approachescognitive/visually directed, image fusion/registration software, and in-bore targeting [9][10][11]. With the cognitive registration technique, the surgeon develops a spatial orientation of the target lesion in the mind and performs the TRUS biopsy with more cores targeted toward the lesion in addition to the regular systematic cores.…”

“…Software fusion/registration techniques use specialized software for fusion of MRI and TRUS images and provide real-time guidance for the biopsy. There is no convincing evidence that MRI-guided software fusion is superior to visually directed biopsies and the specialized hardware is not widely available [9]. In-bore techniques are not widely available, require significant capital outlay, and require between 1 and 2 hours of scan time [12].…”

Radiofrequency heat‑enhanced direct intratumoral chemotherapy for prostate cancer

“…Docetaxel is one of the most potent chemotherapy drugs used for the treatment of prostate cancer ( 6 ). However, its clinical applications via systemic delivery are limited by its low chemotherapeutic distribution at the tumor site and its high toxicity to other vital organs ( 7 ). Furthermore, previous studies also suggested that an insufficient deposition of chemotherapeutic drugs at the target tumor via systemic administration contributes significantly to the development of cancer chemoresistance ( 8 ).…”

Trends in targeted prostate brachytherapy: from multiparametric MRI to nanomolecular radiosensitizers

“…The addition of multiple functional imaging sequences to the anatomical information provided by T2-weighted (T2W) static MR images—including diffusion-weighted imaging (DWI), dynamic contrast-enhanced imaging (DCEI), and magnetic resonance spectroscopic imaging (MRSI)—produce a wealth of additional information to aid in the delineation of active disease (Panebianco et al 2015 ; Maneti et al 2014 ; Verma et al 2012 ; DiBiase et al 2002 ). More recently, mpMRI has garnered attention in prostate brachytherapy treatment planning, for improving both prostate gland and intraprostatic lesion localization (Gomez-Iturriaga et al 2016 ; Marks et al 2013 ; Kaplan et al 2010 ; Wu et al 2014 ; Menard et al 2004 ). The advantages provided by co-registering mpMRI with intra-operative transrectal ultrasound (TRUS) within the prostate BT workflow could significantly reduce the current limitations imposed on dose escalation; this review will examine mpMRI with relation to both its diagnostic and target localization potential for BT (Gomez-Iturriaga et al 2016 ).…”