BK Medical Italia S. AUDI publishes original articles, reviews, case reports, position papers, guidelines, editorials, abstracts prezzo MRI della prostata meeting proceedings.
Because it shares science at your finger tips with no payment. It is a new approach to medical literature, offering accessible information to all readers, becoming a fundamental tool, improving innovation, efficiency and interaction among scientists. Price for single printed issue: Euro 20,00 Annual subscription rate for the printed version 3 issues is Euro 52, Subscription orders should be sent to: Edizioni Scripta Manent s. Papers are accepted for publication with the understanding that prezzo MRI della prostata substantial part has been, or will be published elsewhere.
By submitting a manuscript, the authors agree that the copyright is transferred to prezzo MRI della prostata publisher if and when the article is accepted prezzo MRI della prostata publication. The copyright covers the exclusive rights to reproduce and distribute the article, including reprints, photographic reproduction and translation. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the Publisher.
The total prezzo MRI della prostata partial reproduction, by any means, is forbidden without the written authorization of the Publisher. The Publisher is not liable for the opinion expressed by the Authors of the articles and for images used by them. The diffusion of transrectal ultrasound TRUS has rapidly given rise to ultrasound-guided prostatic biopsy to detect prostate cancer PCa. It is still considered today as being the gold standard for PCa prezzo MRI della prostata.
However, TRUS has several diagnostic limitations. Over the years several methods of performing prostate biopsy have been proposed in order to improve cancer detection. There is a need to standardize the routine clinical practice both concerning the adoption of optimal imaging and the various therapeutic approaches in different phases of PCa history.
As a consequence of good diagnostic performance and low economic impact, the worldwide diffusion of TRUS has rapidly given rise to ultrasound-guided prezzo MRI della prostata biopsy to detect prostate cancer PCawhich is still considered today as being the gold standard for PCa diagnosis 1.
However, TRUS has several diagnostic limitations i. The Italian group for prostatic biopsy, during a Consensus Conference inproposed to standardize the techniques for prostatic biopsy Figure 1. To overcome these limitations, we proposed a novel ultra.
Nava, et al. Gore, et al. Advances in Urological Diagnosis and Imaging - ; 2,1. Martorana, L. Bianchi, F. Chessa, M. Borghesi, R. Schiavina, E. Brunocilla Figure 2. A novel spectral ultrasonic differentiation method for marking regions of interest in biological tissues. In vivo preliminary results.
Archivio italiano di urologia, andrologia: organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. Together with other centers, at the initial stage, the urology department of Bologna firstly defined the future perspectives and the role of these imaging techniques in PCa patients Figure 3. Contrarily, cross sectional imaging and bone scan are recommended. Recent evidence underlines how CT scan and bone scan have no role for PCa staging proposal, but, nevertheless, these traditional methods continue to be routinely used in patients with intermediate and high risk, as according to international guidelines….
Concerning spectroscopy MRI, after initial encouraging Figure 3. Conference on prostate cancer imaging in Bologna Moreover, the international definition and standardization of parameters essential to carry out accurate mpMRI exams has progressively given less feasibility to the role of spectroscopy in favour of anatomic phase T2 weighed and functional phases diffusion and perfusion Thanks to this initial step, nowadays mpMRI represents the most accurate imaging technique to detect PCa.
Notably, mpMRI is essential both for diagnostic proposal and for local staging proposal. Furthermore, in a series of men referred to PCa imaging has been primarily focused on spectroscopy robotic prostatectomy, we found that the preoperative magnetic resonance imaging MRI prezzo MRI della prostata and positron emisuse of mpMRI was able to modify the nerve sparing.
Evolution of imaging in prostate cancer: The University of Bologna contribution Figure 4. J Urol. Figure 5. European Urology. Figure 6. Brunocilla Figure 7. Figure 9. Clinical genitourinary cancer. Besides surgical planning, mpMRI is an essential tool for diagnostic proposal, due to significant higher sensitivity and specificity compared to random biopsy In fact, in the near future each man with suspect PCa even in cases of. So, men with negative mpMRI could be spared from potential side effects of random biopsy and potential diagnosis of not clinically significant PCa; while men with positive mpMRI could be referred to targeted biopsy with higher chances of correctly detecting the significant index lesion and an accurate diagnosis In line with interna.
Another important issue in PCa, is how to detect PCa recurrence, since an accurate and early detection of cancer prezzo MRI della prostata would result in higher chances of prezzo MRI della prostata patients. In fact, prezzo MRI della prostata the time conventional imaging is able to identify the site of recurrence, the PSA levels are already too high, and we risk missing the possibility of taking curable action The main goal of modern imaging is to identify the site of recurrence for low PSA levels European journal of nuclear medicine and molecular imaging.
Figure Journal of nuclear medicine: official publication, Society of Nuclear Medicine. Thus, taking into account such different imaging techniques available for PCa patients, there is a need to standardize the routine clinical practice both concerning the adoption of optimal imaging and the various therapeutic approaches in different phases of PCa history. For this reason, following other international experiences, in the Prostate Cancer Unit a multidisciplinary team including urologists, radiation oncologists, medical oncologists, nuclear medicine physicians, radiologists and pathologists was established in Bologna to discuss weekly the best options for each PCa patient Figure Moreover, the continuous exchange prezzo MRI della prostata experience and knowledge between prezzo MRI della prostata physicians has given rise to several perspectives for clinical studies.
For example, some local and multicentric protocols are ongoing: randomized control trial to evaluate the role of mpMRI prezzo MRI della prostata the early re-classification of men with low and very low risk PCa during active surveillance protocols, strict PSA surveillance and early salvage radiotherapy vs. Looking towards the future, in collaboration with the local Bioengineering Laboratory, the prostatic mpMRI imaging can be elaborated with dedicated, specific software and 3D models can be created and printed including prostatic gland, prostatic capsule, neurovascular bundle and the tumour Figures 14, This should improve the knowledge of the tumour correlated with the healthy tissue prostatic capsule and neurovascular bundle for better surgical planning before RP.
Furthermore, we are developing the realization of enhancing robotic surgery: the 3D virtual models elaborated from mpMRI prezzo MRI della prostata can be introduced inside the DaVinci surgical system to augment the normal 3D intraoperative vision with the overlapping 3D virtual model of the prostate and the tumour Figure This should improve the intraoperative knowledge of the anatomy of prostatic glands related prezzo MRI della prostata the tumour, in order to meliorate the surgical dissection with adequate prezzo MRI della prostata dissection in the areas surrounding the tumour and subsequent optimal preservation of neurovascular bundle in order to reduce the positive surgical margins rate and to improve the erectile function recovery.
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. Accuracy of a new echographic method RULES, radiofrequency ultrasonic local estimators in prostate cancer diagnosis. Anticancer research. NMR in biomedicine. State-of-the-art imaging techniques in the management of preoperative staging and re-staging of prostate cancer.
International journal of urology: official journal of the Japanese Urological Association. The role of magnetic resonance imaging in the diagnosis and management of prostate cancer. BJU international. Updated prostate imaging reporting and data system PIRADS v2 recommendations for the detection of clinically significant prostate cancer using multiparametric MRI: critical evaluation using whole-mount pathology as standard of reference.
European radiology. Eur Urol. Evolution of imaging in prostate cancer: The University of Bologna contribution Figure Conference on novel prostate cancer imaging in Bologna Results from 4, scans in a single-centre patient series.
The dilemma of localizing disease relapse after radical treatment for prostate cancer: which is the value of the actual imaging techniques? Current radiopharmaceuticals. Brunocilla Efficacy and impact on treatment strategy. Prostate-specific mem. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. Introduction: We analysed revision by the same radiologist of the multiparametric magnetic resonance imaging mpRMI images after comparison with pathological sections after radical prostatectomy.
Our objective is to evaluate the reliability of mpRMI in identification of prostate cancer PCa foci through the comparison with pathological report of index and not-index lesions using maps. Materials and Methods: We evaluated 23 patients underwent radical prostatectomy in a single urological department. All specimens have been reviewed by a single dedicated uropathologist. All mpRMI 1,5 T, 32 channels external coil have been evaluated by a single dedicated radiologist.
Two maps of cancer lesions have been created based respectively on pathological sections gold prezzo MRI della prostata and mpRMI findings. Tumor volume and Prostate cancer grade group GG have been evaluated for each single cancer focus. Images have been newly reviewed by the same radiologist comparing the histological map after radical prostatectomy. At the revision of mpRMI with the histological maps, we identified 3 foci more than pre-operative evaluation respectively of GG 1, 4 and 5 and 2 of these were index lesions.
The In case of multifocality at mpRMI in different sections on the same side, sagittal sections are useful to characterizing lesions of longitudinal development in the same lobe.