BACKGROUND: Prostate cancer is the most common type of solid tumor in men and the second most common cause of cancer-related death in males in Germany. The conventional strategy for its primary detection, i.e., systematic ultrasound-guided prostate biopsy in men who have elevated PSA levels and/or positive findings on digital rectal examination, fails to reveal all cases. The same is true of the use of conventional computed tomography (CT), magnetic resonance imaging (MRI), and skeletal scintigraphy for the early detection of recurrences and distant metastases. METHODS: This review is based on pertinent publications retrieved by a selective search, including the German clinical practice guideline on prostate cancer and systematic review articles. RESULTS: Prospective multicenter trials have shown that the detection of clinically significant prostate cancer is markedly improved with multiparametric MRI (mpMRI) and MR/TRUS fusion biopsy (TRUS = transrectal ultrasonography), compared to conventional systematic biopsy. A recent Cochrane review showed that the rate of overdiagnosis of low-risk prostate cancer was reduced with mpMRI and MR/TRUS fusion biopsy compared with conventional systematic biopsy (95/1000 vs. 139/1000), and that clinically significant prostate cancer was more reliably detected (sensitivity 72% vs. 63%), albeit with slightly lower specificity (96% vs. 100%). Prostate- specific membrane antigen (PSMA) hybrid imaging improves the detection of lymphogenic and bony metastases in patients with high-risk prostate cancer. PSMA hybrid imaging is most commonly used to detect biochemical recurrences. A metaanalysis showed that the detection rate depends on the PSA concentration: 74.1% overall, 33.7% with PSA <0.2 ng/mL, and 91.7% with PSA ≥= 2.0 ng/mL. CONCLUSION: The appropriate use of mpMRI and MR/TRUS fusion biopsy improves the initial detection of prostate cancer as well as the assessment of the prognosis. PSMA hybrid imaging is useful for the staging of high-risk patients and for the detection of recurrences. These methods are now recommended in the German clinical practice guideline on prostate cancer as well as in guidelines from other countries.
BACKGROUND: Prostate cancer is the most common type of solid tumor in men and the second most common cause of cancer-related death in males in Germany. The conventional strategy for its primary detection, i.e., systematic ultrasound-guided prostate biopsy in men who have elevated PSA levels and/or positive findings on digital rectal examination, fails to reveal all cases. The same is true of the use of conventional computed tomography (CT), magnetic resonance imaging (MRI), and skeletal scintigraphy for the early detection of recurrences and distant metastases. METHODS: This review is based on pertinent publications retrieved by a selective search, including the German clinical practice guideline on prostate cancer and systematic review articles. RESULTS: Prospective multicenter trials have shown that the detection of clinically significant prostate cancer is markedly improved with multiparametric MRI (mpMRI) and MR/TRUS fusion biopsy (TRUS = transrectal ultrasonography), compared to conventional systematic biopsy. A recent Cochrane review showed that the rate of overdiagnosis of low-risk prostate cancer was reduced with mpMRI and MR/TRUS fusion biopsy compared with conventional systematic biopsy (95/1000 vs. 139/1000), and that clinically significant prostate cancer was more reliably detected (sensitivity 72% vs. 63%), albeit with slightly lower specificity (96% vs. 100%). Prostate- specific membrane antigen (PSMA) hybrid imaging improves the detection of lymphogenic and bony metastases in patients with high-risk prostate cancer. PSMA hybrid imaging is most commonly used to detect biochemical recurrences. A metaanalysis showed that the detection rate depends on the PSA concentration: 74.1% overall, 33.7% with PSA <0.2 ng/mL, and 91.7% with PSA ≥= 2.0 ng/mL. CONCLUSION: The appropriate use of mpMRI and MR/TRUS fusion biopsy improves the initial detection of prostate cancer as well as the assessment of the prognosis. PSMA hybrid imaging is useful for the staging of high-risk patients and for the detection of recurrences. These methods are now recommended in the German clinical practice guideline on prostate cancer as well as in guidelines from other countries.
Authors: Jan Philipp Radtke; Manuel Wiesenfarth; Claudia Kesch; Martin T Freitag; Celine D Alt; Kamil Celik; Florian Distler; Wilfried Roth; Kathrin Wieczorek; Christian Stock; Stefan Duensing; Matthias C Roethke; Dogu Teber; Heinz-Peter Schlemmer; Markus Hohenfellner; David Bonekamp; Boris A Hadaschik Journal: Eur Urol Date: 2017-04-08 Impact factor: 20.096
Authors: Niall M Corcoran; Matthew K H Hong; Rowan G Casey; Antonio Hurtado-Coll; Justin Peters; Laurence Harewood; S Larry Goldenberg; Chris M Hovens; Anthony J Costello; Martin E Gleave Journal: BJU Int Date: 2011-03-28 Impact factor: 5.588
Authors: Frank-Jan H Drost; Daniel Osses; Daan Nieboer; Chris H Bangma; Ewout W Steyerberg; Monique J Roobol; Ivo G Schoots Journal: Eur Urol Date: 2019-07-18 Impact factor: 20.096
Authors: Nicolas Mottet; Joaquim Bellmunt; Michel Bolla; Erik Briers; Marcus G Cumberbatch; Maria De Santis; Nicola Fossati; Tobias Gross; Ann M Henry; Steven Joniau; Thomas B Lam; Malcolm D Mason; Vsevolod B Matveev; Paul C Moldovan; Roderick C N van den Bergh; Thomas Van den Broeck; Henk G van der Poel; Theo H van der Kwast; Olivier Rouvière; Ivo G Schoots; Thomas Wiegel; Philip Cornford Journal: Eur Urol Date: 2016-08-25 Impact factor: 20.096
Authors: Ali Afshar-Oromieh; Tim Holland-Letz; Frederik L Giesel; Clemens Kratochwil; Walter Mier; Sabine Haufe; Nils Debus; Matthias Eder; Michael Eisenhut; Martin Schäfer; Oliver Neels; Markus Hohenfellner; Klaus Kopka; Hans-Ulrich Kauczor; Jürgen Debus; Uwe Haberkorn Journal: Eur J Nucl Med Mol Imaging Date: 2017-05-12 Impact factor: 9.236
Authors: Frederik L Giesel; B Hadaschik; J Cardinale; J Radtke; M Vinsensia; W Lehnert; C Kesch; Y Tolstov; S Singer; N Grabe; S Duensing; M Schäfer; O C Neels; W Mier; U Haberkorn; K Kopka; C Kratochwil Journal: Eur J Nucl Med Mol Imaging Date: 2016-11-26 Impact factor: 9.236
Authors: Magdalena Görtz; Jan Philipp Radtke; Gencay Hatiboglu; Viktoria Schütz; Georgi Tosev; Maximilian Güttlein; Jonas Leichsenring; Albrecht Stenzinger; David Bonekamp; Heinz-Peter Schlemmer; Markus Hohenfellner; Joanne Nyaboe Nyarangi-Dix Journal: Eur Urol Focus Date: 2019-12-12
Authors: Nils Netzer; Cedric Weißer; Patrick Schelb; Xianfeng Wang; Xiaoyan Qin; Magdalena Görtz; Viktoria Schütz; Jan Philipp Radtke; Thomas Hielscher; Constantin Schwab; Albrecht Stenzinger; Tristan Anselm Kuder; Regula Gnirs; Markus Hohenfellner; Heinz-Peter Schlemmer; Klaus H Maier-Hein; David Bonekamp Journal: Invest Radiol Date: 2021-12-01 Impact factor: 6.016
Authors: Michael S Hofman; Nathan Lawrentschuk; Roslyn J Francis; Colin Tang; Ian Vela; Paul Thomas; Natalie Rutherford; Jarad M Martin; Mark Frydenberg; Ramdave Shakher; Lih-Ming Wong; Kim Taubman; Sze Ting Lee; Edward Hsiao; Paul Roach; Michelle Nottage; Ian Kirkwood; Dickon Hayne; Emma Link; Petra Marusic; Anetta Matera; Alan Herschtal; Amir Iravani; Rodney J Hicks; Scott Williams; Declan G Murphy Journal: Lancet Date: 2020-03-22 Impact factor: 79.321