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1、CASEPRESENTATIONANDMINI-REVIEWMRImagingofProstateCancer:PresentLimitationsandFutureDirectionsDavidA.BoyajianHMS4,GillianB.LiebermanM.D.Thursday,18September2003BethIsraelDeaconessMedicalCenterDavidA.BoyajianHMS4GillianB.LiebermanM.D.Prostate:Functionlargestaccessoryglandofmalerep
2、roductivesystemproducesathin,milky,slightlyalkalinefluidthatprovidesapproximately20%ofthevolumeofsemenprostaticfluidaidsinmotilityandfertilityofsperm2DavidA.BoyajianHMS4GillianB.LiebermanM.D.Prostate:RelationalAnatomysagitalcoronalfrom:http://www.types-of-incontinence.comfrom:ht
3、tp://images.webmd.com3DavidA.BoyajianHMS4GillianB.LiebermanM.D.Prostate:InherentAnatomytwo-thirdsglandular,one-thirdfibromuscularhasadense,fibrouscapsulethatissurroundedbyafibrousprostaticsheath,whichiscontinuouswiththepuboprostaticligamentscoronalobliqueaxialImagesfrom:http://m
4、edocs.ucdavis.eduisdividedbyurologistsandradiologistsintozonalanatomy,althoughlobaranatomyismorecommonlydescribed.4DavidA.BoyajianHMS4GillianB.LiebermanM.D.ProstateCancer190,000newcasesperyearintheUSearlieridentificationmaypresentanopportunityformoreeffectivetreatment,but…hugera
5、ngeofbiologicalmalignancylackofaccurateprognostics:currenttoolsincludeDRE,serumPSA,histologicalgrading(Gleasonscore),biopsy,stagingschemata,andimagingtechniques5DavidA.BoyajianHMS4GillianB.LiebermanM.D.ProstateCancerGrading:performedatbiopsythesumofdominantandsecondaryGleasongra
6、depatternscorrelateslooselywithclinicaloutcomefrom:http://www.rmg.md6DavidA.BoyajianHMS4GillianB.LiebermanM.D.ProstateCancerStaging:theTNMandtheWhitmore-Jewettsystemshavebeenusedwidelymodifiedtoincorporateresultsofimagingstudies(US,MR)manygroupsarenowusingmultiplexstagingmodelst
7、hevaluetoprognosisandtreatmentrecommendationsremainscontroversial.from:Dillioglugiletal,EuropeanUrology28(2):85-101,1995.7DavidA.BoyajianHMS4GillianB.LiebermanM.D.PatientPresentation49y.o.CaucasianmaleingoodhealthPSAvaluesatannualphysicalexam:Dec20002.1μg/LDec20012.3μg/LJuly2002
8、1.8μg/LJuly20035.4μg/LTRUS-guidedbiopsyinJuly20
