- Nuove scelte cliniche e terapeutiche in base alla risposta dell’imaging
- Carcinoma della prostata
- Imaging RM della prostata
- RUOLO DELLA RM NELLA DIAGNOSI, STADIAZIONE E CURA DEL TUMORE ALLA PROSTATA
Pages RM della prostata: aspetti tecnici e protocolli. Anatomia RM della prostata. Vantaggi e limiti dei magneti ad alto campo 3T. Infiammazione e patologie croniche della prostata: il legame è causale? Ipertrofia prostatica benigna: aspetti istopatologici e inquadramento clinico. Relative effectiveness and cost-effectiveness diagnosis carcinoma prostatico linee guida pdf methods of androgen suppression in the treatment of advanced prostate cancer.
Evid Rep Technol Assess i—x, Single-therapy androgen suppression in men with advanced prostate cancer: a systematic review and meta-analysis. Akaza H. Leuprorelin acetate depot: Results of a multicentre Japanese trial. J Int Med Res ; 18 Suppl 1: Long-term clinical study on luteinising hormone-releasing hormone against depot formulation in the treatment of stage D prostatico elevado valores cancer.
Jpn J Clin Oncol ; Bischoff W. Pharmacokinetics, endocrine and antitumour effects of leuprolide depot TAPSR in advanced prostatic cancer: a dose-response evaluation. Drugs Exp Clin Res ; Human pharmacokinetic and pharmacodynamic profiles of leuprorelin acetate depot in prostatic cancer patients. J Int Med Res ; 18 Suppl1 : Clinical efficacy and safety of a new leuprorelin acetate depot formulation in patients with advanced diagnosis carcinoma prostatico linee guida pdf cancer. J Int Med Res Leuprorelin acetate depot in advanced prostatic cancer: a phase II multicentre trial.
A new long acting formulation of the luteinizing hormone-releasing hormone analogue goserelin: results of studies in prostate cancer. A randomised trial comparing the safety and efficacy of the Zoladex Eur Urol ; Three-month depot of goserelin acetate: clinical efficacy and endocrine profile.
Equivalent and sufficient effects of leuprolide acetate and goserelin acetate to suppress serum testosterone levels in patients with prostate cancer. Sharifi R, Browneller R. Serum testosterone diagnosis carcinoma prostatico linee guida pdf and potential for agonistic stimulation during chronic treatment with monthly and 3-month depot formulations of leuprolide acetate for advanced prostate cancer. Comparison of LH-RH analogue 1-month depot and 3-month depot by their hormone levels and pharmacokinetic profile in patients with advanced prostate cancer.
Randomized open labelled comparative study of the efficacy, safety and tolerability of leuprorelin acetate 1M and 3M depot in patients with advanced prostatic cancer.
Eur Urol ; 30 Suppl1 : Similar frequency of testosterone surge after repeat injections of goserelin Zoladex 3. Health Technology Assessment a livello regionale: fra mito e realtà. Quaderni di Farmacoeconomia ; Cost-effectiveness of androgen suppression therapies in advanced prostate cancer.
Gli infortuni sul lavoro e diagnosis carcinoma prostatico linee guida pdf patologie correlate alle attività lavorative. Processo mediante il quale si misura il rischio e si click to see more le strategie per governarlo.
Caramella; E. Fruzzetti; M. Lazzereschi; A. Tognetti; C. Bartolozzi, Peripheral zone prostate cancer. Chodak, P. Keller; HW. Schoenberg, Assessment of screening for prostate cancer using the digital rectal examination. Krahn, JE. Mahoney; MH. Eckman; J.
Trachtenberg; SG. Pauker; AS. Detsky, Screening for prostate cancer. A decision analytic view. Essink-Bot, HJ. Nijs; WJ. Kirkels; PJ. Schröder, Short-term effects of population-based screening for prostate cancer on health-related quality of life.
URL consultato il 21 dicembre Picchio, C. Messa; C. Landoni; L. Gianolli; S. Sironi; M. Brioschi; M. Matarrese; DV.
Matei; F. De Cobelli; A. Del Maschio; F. Rocco, Value of [11C]choline-positron emission tomography for re-staging prostate cancer: a comparison with [18F]fluorodeoxyglucose-positron emission tomography. Scher, M. Seitz; W. Albinger; R. Tiling; M.
Scherr; HC. Becker; M. Souvatzogluou; FJ. Gildehaus; HJ. Wester; S. Tumorzentrum Freiburg Archiviato il 9 ottobre in Internet Archive.
Wiley-VCH Verlag, 7. Gupta, M. Varghese; MM. Shareef; MM. Finley, AS. Belldegrun, Salvage cryotherapy for radiation-recurrent prostate cancer: outcomes and complications. Wu, L. Sun; JW. Moul; HY. Wu; DG. McLeod; C. Amling; R. Lance; L. Kusuda; T. Donahue; J. Foley; A. Chung, Watchful waiting and factors predictive of secondary treatment of localized prostate cancer.
Zincke, JE. Oesterling; ML. Blute; EJ. Bergstralh; RP. Myers; DM. Barrett, Long-term 15 years results after radical prostatectomy for clinically localized stage T2c or lower prostate cancer. Gerber, RA. Thisted; PT. Scardino; Eiaculare analmente la prostata. Frohmuller; FH.
Schroeder; DF. Paulson; AW. Middleton; DB. Rukstalis; JA. Smith; PF. Schellhammer; M. Ohori, Results of radical prostatectomy in men with clinically localized prostate cancer. URL consultato il 25 gennaio Perez, GE. Hanks; SA. Leibel; AL.
Zietman; Z. Fuks; WR. Review of management with external beam radiation therapy. D'Amico, J. Manola; M. Loffredo; AA. Renshaw; A. DellaCroce; PW. Kantoff, 6-month androgen suppression plus radiation therapy vs radiation therapy alone for patients with clinically localized prostate cancer: a randomized controlled trial. Diagnosis carcinoma prostatico linee guida pdf, M.
Won; MV. Pilepich; SO. Asbell; WU. Shipley; GE. Hanks; JD. Cox; CA. Perez; WT. Sause; SR. Doggett, Long-term treatment sequelae following external beam irradiation for adenocarcinoma diagnosis carcinoma prostatico linee guida pdf the prostate: analysis of RTOG studies and Brenner, RE.
Curtis; EJ. Hall; E.
Ron, Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery. Bahn, F. Lee; R. Badalament; A. Kumar; J. Greski; M.
Nuove scelte cliniche e terapeutiche in base alla risposta dell’imaging
Learn more. Stefania Nicolosi. Giovanni Borasi. Nonostante i recenti miglioramenti nella diagnosi e nel trattamento, il cancro alla prostata continua ad essere la più diagnosis carcinoma prostatico linee guida pdf neoplasia maligna e la terza causa di morte per cancro nella popolazione americana.
Grazie ai programmi di prevenzione, alla diffusione del See more come strumento di screening, e ai progressi nella diagnostica per immagini, oggi la modalità di presentazione del carcinoma prostatico è significativamente differente rispetto a 30 diagnosis carcinoma prostatico linee guida pdf fa 1,2. I tumori diagnosticati oggi sono più piccoli e di stadio e aggressività inferiori rispetto a 20 anni fa.
I valore di PSA alla diagnosi costituisce un importante fattore prognostico e rappresenta uno strumento utile per monitorare la risposta alla terapia. Tuttavia, in termini assoluti i livelli sierici di PSA devono essere interpretati con grande attenzione per quanto riguarda l'età del paziente, le dimensioni della ghiandola e la presenza di infezione.
Carcinoma della prostata
Per questi motivi tali fattori diagnosis carcinoma prostatico linee guida pdf presi singolarmente possono non essere sufficienti a stimare il rischio di recidiva per ogni singolo paziente e in questo contesto i nomogrammi che valutano più parametri possono essere più accurati nello stimare il rischio rispetto ai singoli fattori presi singolarmente 9, Negli anni a venire gli sforzi diagnosis carcinoma prostatico linee guida pdf ricerca di base nella cura del cancro devono andare nella direzione di massimizzare il controllo della malattia con il minimo impatto in termini di complicanza ed effetti collaterali.
Nel caso del carcinoma della prostata, una corretta caratterizzazione della malattia fa si che si possa scegliere fra una grande varietà di opzioni terapeutiche: chirurgia radicale prostatectomia radicale retropubica RRP, laparoscopica, perineale, robotica terapia radiante radioterapia esterna, brachiterapia terapia ormonale, vigile attesa o tecniche più recenti crioablazione, ablazione con radiofrequenze.
Grazie alle innovazioni tecnologiche, le opzioni di imaging disponibili sono in continua evoluzione. Secondo le linee guida diagnosis carcinoma prostatico linee guida pdf e nonostante le potenzialità tecniche, né la tomografia computerizzata TC né la risonanza magnetica RM hanno un ruolo rilevante nel processo di stadiazione. Tali tecniche trovano un indicazione solo nei casi ad alto rischio di malattia linfonodale.
La TRUS è una metodica largamente diffusa e a basso costo e questo fa si che rappresenti la metodica di prima istanza nella diagnosi delle patologie prostatiche. I suoi vantaggi risiedono soprattutto nel guidare la biopsia prostatica, definire con maggior accuratezza il volume prostatico rispetto alla DRE e fornire una studio generalizzato sulla morfologia della ghiandola.
Improving non-invasive detection of prostate cancer using diffusion-weighted MRI July Citations 0. References This research hasn't been cited in any other diagnosis carcinoma prostatico linee guida pdf. Kyle K. To determine if the addition of three-dimensional 3D proton magnetic resonance MR spectroscopic imaging to endorectal MR imaging helps diagnose extracapsular extension ECE of prostate cancer.
Endorectal MR imaging and 3D MR spectroscopic click here were performed in 53 patients with prostate cancer before radical prostatectomy. MR imaging studies were evaluated by two independent readers unaware of histopathologic findings.
The presence of ECE more info graded on a five-point scale. At diagnosis carcinoma prostatico linee guida pdf MR spectroscopic imaging, cancer was diagnosed if the ratio of choline plus creatine to citrate was 2 or more SDs above normal. The accuracy of MR imaging alone was compared with that of combined MR imaging and 3D MR spectroscopic imaging, with use of click step-section histopathologic results as the standard of reference.
The addition of 3D MR spectroscopic imaging to MR imaging improves accuracy for less experienced readers and reduces interobserver variability in the diagnosis of ECE of prostate cancer. Jan Cancer statistics, CA Cancer J Clin ;— Purpose: Several studies have defined risk groups for predicting the outcome after external-beam radiotherapy of localized prostate cancer.
However, dolore dopo chirurgia robotizzata models formed patient risk groups, and none of these models considers radiation dose as a predictor variable. The purpose of this study was to develop a nomogram to improve the accuracy of predicting outcome after three-dimensional conformal radiotherapy. Materials and methods: This study was a retrospective, nonrandomized analysis of patients treated diagnosis carcinoma prostatico linee guida pdf the Memorial Sloan-Kettering Cancer Center between and Clinical parameters of the 1, patients included stage, biopsy Gleason score, pretreatment serum prostate-specific antigen PSA level, whether neoadjuvant androgen deprivation therapy was administered, and the radiation dose delivered.
A nomogram, which predicts the probability of remaining free from biochemical recurrence for 5 years, was validated internally on this data set using a bootstrapping method and externally using a cohort of patients treated at the Cleveland Clinic, Cleveland, OH. Results: When predicting outcomes for patients in the validation data set from the Cleveland Clinic, the nomogram had a Somers' D rank correlation between predicted and observed failure times of 0. Conclusion: The development process illustrated here produced a nomogram that seems to predict more accurately than other available systems and may be useful for treatment selection by diagnosis carcinoma prostatico linee guida pdf physicians and patients.
Diagnosis carcinoma prostatico linee guida pdf of a Nomogram used to predict the pathologic stage of clinically localized prostate carcinoma. Feb Cancer. A Nomogram based on pretreatment prostate specific antigen PSA level, tumor grade, and clinical stage has recently been developed and distributed to physicians. It was distributed to aid physicians in making treatment recommendations by predicting the probability of the final pathologic stage of clinically localized prostate carcinoma.
The Nomogram was based on data for one patient population, and the validity of its application in general urologic practices had not yet been evaluated. In the current study, the authors tested the performance of the Nomogram against data from their series of men who underwent radical prostatectomy during the PSA era.
Predictions made with the Nomogram were applied to the authors' data set, and the predictions were compared with actual outcomes of the authors' patients. A localized least-squares regression smoothing technique was used to determine whether the Continue reading was calibrated accurately for the authors' data and whether it discriminated across a full spectrum of patient characteristics.
Diagnosis carcinoma prostatico linee guida pdf of the predicted probabilities of the Nomogram were accurate, but some were suboptimal when applied to the authors' data set. Although the Nomogram did discriminate quite well between organ-confined and nonconfined cancer, it had difficulty predicting high probabilities of seminal vesicle invasion and lymph node metastasis, which are the pathologic features with the most profound impact on prognosis.
The Nomogram predicted organ-confined disease accurately. However, because not all of its predictions were completely calibrated when applied to the authors' data set, the authors conclude that the Nomogram may not be totally applicable to general urologic practice until further validation and possible modifications are performed. Cancer ; Donald F.
Gleason George T. Prostate cancer mortality after introduction of prostate-specific antigen mass screening in the Federal State of Tyrol, Austria1. Sep Urology. Georg Bartsch. To monitor the impact of screening in a natural experiment by comparing prostate cancer mortality in Tyrol, where prostate-specific antigen PSA testing was introduced at no charge, with the rest of Austria, where it was not introduced. Jan J Urol Pathol. William C. To provide a brief diagnosis carcinoma prostatico linee guida pdf of important technical and biochemical aspects and current clinical applications of magnetic resonance diagnosis carcinoma prostatico linee guida pdf MRS of the prostate.
Material and methods. Basic concepts of MRS of the prostate and its clinical applications were extracted to provide an overview. The prostate lends itself to MRS due to its unique production, storage, and secretion of citrate. While healthy prostate learn more here demonstrates high levels of citrate and low levels of choline that marks cell wall turnover, prostate cancer PCA utilizes citrate for energy metabolism and shows high levels of choline.
Imaging RM della prostata
Since it is non-invasive and radiation-free, combined MRI and 3D-MRSI lends itself to the planning of prostate biopsy and therapy diagnosis carcinoma prostatico linee guida pdf well as to post-therapeutic follow-up. For broad clinical application, it will be necessary to facilitate MRS examinations and their evaluation and make MRS available to a wider range of institutions.
MR imaging of the prostate gland: Normal anatomy.
Full-text available. MR images of the male pelvis in 55 subjects were analyzed retrospectively for depiction diagnosis carcinoma prostatico linee guida pdf the zonal anatomy of the prostate gland as related to different repetition TR and echo TE times, slice thickness, plane of imaging, chronologic age of the patient, and different magnetic field strengths.
With imagers operating at 0. The display of zonal anatomy was improved when continuous 0. Evaluating sequential sections, the peripheral, central, and transition zones could be differentiated. The peripheral zone showed higher signal intensity than either the central or transition zone and was discerned in the coronal, sagittal, and transverse planes.
The central zone was of low signal intensity and was well displayed in the coronal and sagittal planes.
RUOLO DELLA RM NELLA DIAGNOSI, STADIAZIONE E CURA DEL TUMORE ALLA PROSTATA
The central zone was seen in 31 of the 32 young men aged years but in only eight of the 23 older men aged 40 years and older. The transition zone had intrinsic MR parameters similar to the central zone, and the two could be distinguished from each other only by the knowledge of their respective anatomic location.
The low-intensity transition zone blended with the periurethral glands and the preprostatic sphincter. The transition zone was of homogeneous low read more intensity in young men but varied in size and signal intensity in older men. Diagnosis carcinoma prostatico linee guida pdf a detailed display of the prostate zonal anatomy offers a unique potential for diagnosis carcinoma prostatico linee guida pdf evaluation of prostatic physiology and disease.
Dec Multiparametric magnetic resonance imaging mpMRI may have a role in detecting clinically significant prostate cancer in men with raised serum prostate-specific antigen levels.
Variations in technique and the interpretation of images have contributed to inconsistency in its reported performance characteristics. Our aim was to make recommendations on a standardised method for the conduct, diagnosis carcinoma prostatico linee guida pdf, and reporting of prostate mpMRI for prostate cancer detection and localisation.
Before the meeting, items were scored for "appropriateness" by panel members, discussed face to face, and rescored. T2-weighted, dynamic contrast-enhanced, and diffusion-weighted MRI were the key sequences incorporated into the minimum requirements. A 5-point scale was agreed on for communicating the probability of malignancy, with a minimum of 16 prostatic regions of interest, to include a pictorial representation of suspicious foci.
Limitations relate to consensus methodology. Dominant personalities are known to affect the opinions of the group and were countered by a neutral chairperson.