Lymph node imaging in initial staging of prostate cancer:An overview and update

• 作者: Jessica G Zarzour John V Thomas Jonathan McConathy Sam Galgano Soroush Rais-Bahrami
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: 前列腺癌症 阶段 磁性的回声成像 极端小的超级顺磁的氧化铁 分子的成像 正电子排放断层摄影术 淋巴节点
• 年，卷（期）: 2017,（10）
• 页码范围: 389-399
• 页数: 11页
• 分类号: R445.2

摘要

Accurate nodal staging at the time of diagnosis of prostate cancer is crucial in determining a treatment plan for the patient.Pelvic lymph node dissection is the most reliable method,but is less than perfect and has increased morbidity.Cross sectional imaging with computed tomography（CT） and magnetic resonance imaging（MRI） are non-invasive tools that rely on morphologic characteristics such as shape and size of the lymph nodes.However,lymph nodes harboring metastatic disease may be normal sized and non-metastatic lymph nodes may be enlarged due to reactive hyperplasia.The optimal strategy for preoperative staging remains a topic of ongoing research.Advanced imaging techniques to assess lymph nodes in the setting of prostate cancer utilizing novel MRI contrast agents as well as positron emission tomography（PET） tracers have been developed and continue to be studied.Magnetic resonance lymphography utilizing ultra-small super paramagnetic iron oxide has shown promising results in detection of metastatic lymph nodes.Combining MRL with diffusion-weighted imaging may also improve accuracy.Considerable efforts are being made to develop effective PET radiotracers that are performed using hybrid-imaging systems that combine PET with CT or MRI.PET tracers that will be reviewed in this article include [18F]fluoro-D-glucose,sodium [18F]fluoride,[18F]choline,[11C]choline,prostate specific membrane antigen binding ligands,[11C]acetate,[18F]fluciclovine,gastrin releasing peptide receptor ligands,and androgen binding receptors.This article will review these advanced imaging modalities and ability to detect prostate cancer metastasis to lymph nodes.While more research isneeded,these novel techniques to image lymph nodes in the setting of prostate cancer show a promising future in improving initial lymph node staging.