臨床泌尿器科66巻3号

2012年03月発行

特集 画像診断の進歩を腫瘍手術に役立てる！

前立腺癌の手術

著者： 原智彦¹ 藤元博行¹

所属機関： ¹国立がん研究センター中央病院泌尿器・後腹膜腫瘍科

ページ範囲：P.235 - P.240

文献概要

要旨　前立腺癌の画像診断はいまだ発展途上で，臨床的に満足できる情報を提供できていない。しかし，近年さまざまな新しい画像撮影法の登場により，より正確な診断が可能になりつつある。近年注目されている3.0T-MRI拡散強調画像，apparent diffusion coefficient（ADC）map，¹¹C-choline PETなどの新しい画像診断と前立腺癌手術への応用の可能性について概説した。

参考文献

1）Partin AW, Kattan MW, Subong EN, et al：Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer：a multi-institutional update. Jama 277：1445, 1997

2）Schick F：Whole-body MRI at high field：technical limits and clinical potential. Eur Radiol 15：946, 2005

3）Turkbey B, Shah VP, Pang Y, et al：Is apparent diffusion coefficient associated with clinical risk scores for prostate cancers that are visible on 3-T MR images? Radiology 258：488, 2011

4）Louise D, Hashim UA, Clare A, et al：Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer：recommendations from a European Consensus Meeting. Eur Urol 59：477, 2010

5）原　智彦，三宅基隆，中西弘之，et al：前立腺がん神経温存手術の適応選択に3T MRI拡散強調画像を用いた術前局在診断はどの程度有用か?　日泌尿会誌 101：290，2010

6）Miyake H, Fujimoto H, Komiyama M, et al：Development of“extended radical retropubic prostatectomy”：a surgical technique for improving margin positive rates in prostate cancer. Eur J Surg Oncol 36：281, 2010

7）Walz J, Burnett AL, Costello AJ, et al：A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol 57：179, 2010

8）Preston MA, Carriere M, Raju G, et al：The prognostic significance of capsular incision into tumor during radical prostatectomy. Eur Urol 59：613, 2011

9）Gontero P and Kirby RS：Nerve-sparing radical retropubic prostatectomy：techniques and clinical considerations. Prostate Cancer Prostatic Dis 8：133, 2005

10）原　智彦，中西弘之，尾形吉彦，他：3T-MRIの前立腺がん神経温存手術の適応選択における有用性の検討．日泌尿会誌 102：492，2011

11）Mouli SK, Zhao LC, Omary RA, et al：Lymphotropic nanoparticle enhanced MRI for the staging of genitourinary tumors. Nat Rev Urol 7：84, 2010

C-choline positron emission tomography/computed tomography and diffusion-weighted magnetic resonance imaging for the nodal staging of prostate cancer with a high risk of lymph node metastases. Eur Urol 60：125, 2011

C-choline positron emission tomography/computerized tomography for preoperative lymph-node staging in intermediate-risk and high-risk prostate cancer：comparison with clinical staging nomograms. Eur Urol 54：392, 2008

14）Eiber M, Beer AJ, Holzapfel K, et al：Preliminary results for characterization of pelvic lymph nodes in patients with prostate cancer by diffusion-weighted MR-imaging. Invest Radiol 45：15, 2010

15）Heidenreich A, Ohlmann CH and Polyakov S：Anatomical extent of pelvic lymphadenectomy in patients undergoing radical prostatectomy. Eur urol 52：29, 2007

16）Engel J, Bastian PJ, Baur H, et al：Survival benefit of radical prostatectomy in lymph node-positive patients with prostate cancer. Eur Urol 57：754, 2010

17）Warde P, Mason M, Ding K, et al：Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer：a randomised, phase 3 trial. Lancet 378：2104, 2011

18）Picchio M, Briganti A, Fanti S, et al：The role of choline positron emission tomography/computed tomography in the management of patients with prostate-specific antigen progression after radical treatment of prostate cancer. Eur Urol 59：51, 2011

C］choline positron emission tomography/computed tomography. Eur Urol 60：935, 2011