前列腺癌骨转移的影像学诊断研究进展
Research Progress in Imaging Diagnosis of Bone Metastasis of Prostate Cancer
DOI: 10.12677/acm.2025.1561818, PDF,    科研立项经费支持
作者: 王怡之*, 王佳强, 贾海云, 王胜利#:延安大学附属医院超声医学科,陕西 延安
关键词: 前列腺癌骨转移诊断Prostate Cancer Bone Metastasis Diagnose
摘要: 前列腺癌是全球成年男性发病率最高的恶性肿瘤之一,约70%的晚期患者都会发生骨转移,从而导致一系列骨骼相关事件,这降低了患者的生活质量并增加了死亡风险。因此,前列腺癌及前列腺癌骨转移的早期诊断和预测至关重要,这对协助临床医生判断病情和选择治疗方案有较高的临床意义。本文从前列腺癌骨转移发生的机制和影像学检查技术等方面进行总结,重点介绍了单光子发射计算机断层显像、CT/X线、MRI扫描、正电子发射断层扫描/计算机断层扫描、超声及影像组学在前列腺癌骨转移早期诊断中的应用价值。
Abstract: Prostate cancer is one of the malignant tumors with the highest incidence among adult males in the world. About 70% of patients in advanced stage will have bone metastasis, which will lead to a series of bone-related events, which will reduce the quality of life of patients and increase the risk of death. Therefore, early diagnosis and prediction of prostate cancer and bone metastasis of prostate cancer are very important. It is of high clinical significance to assist clinicians to judge the condition and choose the treatment plan. In this paper, the mechanism and imaging techniques of bone metastasis of prostate cancer are summarized, and the application values of single photon emission computed tomography, CT/X-ray, MRI scanning, positron emission tomography/computed tomography, ultrasound and imaging in the early diagnosis of bone metastasis of prostate cancer are emphatically introduced.
文章引用:王怡之, 王佳强, 贾海云, 王胜利. 前列腺癌骨转移的影像学诊断研究进展[J]. 临床医学进展, 2025, 15(6): 1007-1014. https://doi.org/10.12677/acm.2025.1561818

参考文献

[1] 李宁, 肖国有. 前列腺癌骨转移治疗的研究进展[J]. 肿瘤防治研究, 2020, 47(8): 641-646.
[2] Huang, S., Kao, Y., Muller, C.J.F., Joubert, E. and Chuu, C. (2020) Aspalathin-Rich Green Aspalathus Linearis Extract Suppresses Migration and Invasion of Human Castration-Resistant Prostate Cancer Cells via Inhibition of YAP Signaling. Phytomedicine, 69, Article ID: 153210. [Google Scholar] [CrossRef] [PubMed]
[3] Xu, Y., Zhang, G., Liu, Y., Liu, Y., Tian, A., Che, J., et al. (2024) Molecular Mechanisms and Targeted Therapy for the Metastasis of Prostate Cancer to the Bones (Review). International Journal of Oncology, 65, Article No. 104. [Google Scholar] [CrossRef] [PubMed]
[4] Baldessari, C., Pipitone, S., Molinaro, E., Cerma, K., Fanelli, M., Nasso, C., et al. (2023) Bone Metastases and Health in Prostate Cancer: From Pathophysiology to Clinical Implications. Cancers, 15, Article 1518. [Google Scholar] [CrossRef] [PubMed]
[5] Park, S.H., Keller, E.T. and Shiozawa, Y. (2017) Bone Marrow Microenvironment as a Regulator and Therapeutic Target for Prostate Cancer Bone Metastasis. Calcified Tissue International, 102, 152-162. [Google Scholar] [CrossRef] [PubMed]
[6] Karim, F., Jun, Y., Sara, P., et al. (2003) Prostate Cancer Cells-Osteoblast Interaction Shifts Expression of Growth/Survival-Related Genes in Prostate Cancer and Reduces Expression of Osteoprotegerin in Osteoblasts. Clinical Cancer Research: An Official Journal of the American Association for Cancer Research, 9, 2587-2597.
[7] Huang, H., Qin, J., Wen, Z., Liu, Y., Chen, C., Wang, C., et al. (2024) Effects of Natural Extract Interventions in Prostate Cancer: A Systematic Review and Network Meta-Analysis. Phytomedicine, 129, Article ID: 155598. [Google Scholar] [CrossRef] [PubMed]
[8] Koistinen, H., Kovanen, R., Hollenberg, M.D., Dufour, A., Radisky, E.S., Stenman, U., et al. (2023) The Roles of Proteases in Prostate Cancer. IUBMB Life, 75, 493-513. [Google Scholar] [CrossRef] [PubMed]
[9] Horger, M., Eschmann, S.M., Pfannenberg, C., Vonthein, R., Besenfelder, H., Claussen, C.D., et al. (2004) Evaluation of Combined Transmission and Emission Tomography for Classification of Skeletal Lesions. American Journal of Roentgenology, 183, 655-669. [Google Scholar] [CrossRef] [PubMed]
[10] Helyar, V., Mohan, H.K., Barwick, T., Livieratos, L., Gnanasegaran, G., Clarke, S.E.M., et al. (2009) The Added Value of Multislice SPECT/CT in Patients with Equivocal Bony Metastasis from Carcinoma of the Prostate. European Journal of Nuclear Medicine and Molecular Imaging, 37, 706-713. [Google Scholar] [CrossRef] [PubMed]
[11] 翟威豪, 何薇. SPECT/CT骨定量SUVmax分析在老年前列腺癌骨转移中的鉴别诊断价值[J]. 分子影像学杂志, 2021, 44(6): 983-987.
[12] Rybak, L.D. and Rosenthal, D.I. (2001) Radiological Imaging for the Diagnosis of Bone Metastases. The Quarterly Journal of Nuclear Medicine and Molecular Imaging, 45, 53-64.
[13] Yamaguchi, T. (2001) Intertrabecular Vertebral Metastases: Metastases Only Detectable on MR Imaging. Seminars in Musculoskeletal Radiology, 05, 171-176. [Google Scholar] [CrossRef] [PubMed]
[14] 白振明. CT对转移性骨肿瘤尤其是椎体转移的应用价值[J]. 国际医学放射学杂志, 1987(3): 176.
[15] 中国抗癌协会癌症康复与姑息治疗专业委员会. 恶性肿瘤骨转移及骨相关疾病临床诊疗专家共识: 2014版[M]. 北京: 北京大学医学出版社, 2014.
[16] Tilki, D., van den Bergh, R.C.N., Briers, E., Van den Broeck, T., Brunckhorst, O., Darraugh, J., et al. (2024) EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer. Part II—2024 Update: Treatment of Relapsing and Metastatic Prostate Cancer. European Urology, 86, 164-182. [Google Scholar] [CrossRef] [PubMed]
[17] Takahara, T., Imai, Y., Yamashita, T., et al. (2004) Diffusion Weighted Whole Body Imaging with Background Body Signal Suppression (DWIBS): Technical Improvement Using Free Breathing, STIR and High Resolution 3D Display. Radiation Medicine, 22, 275-282.
[18] Sun, G., Zhang, Y.X., Liu, F., et al. (2020) Whole-Body Magnetic Resonance Imaging Is Superior to Skeletal Scintigraphy for the Detection of Bone Metastatic Tumors: A Meta-Analysis. European Review for Medical & Pharmacological Sciences, 24, 7240-7252.
[19] Padhani, A.R., Lecouvet, F.E., Tunariu, N., Koh, D., De Keyzer, F., Collins, D.J., et al. (2017) Rationale for Modernising Imaging in Advanced Prostate Cancer. European Urology Focus, 3, 223-239. [Google Scholar] [CrossRef] [PubMed]
[20] Hofman, M.S., Hicks, R.J., Maurer, T. and Eiber, M. (2018) Prostate-Specific Membrane Antigen PET: Clinical Utility in Prostate Cancer, Normal Patterns, Pearls, and Pitfalls. RadioGraphics, 38, 200-217. [Google Scholar] [CrossRef] [PubMed]
[21] Houshmand, S., Lawhn-Heath, C. and Behr, S. (2023) PSMA PET Imaging in the Diagnosis and Management of Prostate Cancer. Abdominal Radiology, 48, 3610-3623. [Google Scholar] [CrossRef] [PubMed]
[22] Oliveira, J., Gomes, C., Faria, D., Vieira, T., Silva, F., Vale, J., et al. (2017) 68Ga-Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Prostate Cancer Imaging: A Narrative Literature Review. World Journal of Nuclear Medicine, 16, 3-7. [Google Scholar] [CrossRef] [PubMed]
[23] Chen, R., Ng, Y.L., Yang, X., Zhu, Y., Li, L., Zhao, H., et al. (2023) Comparison of Parametric Imaging and SUV Imaging with [68Ga]ga-Psma-11 Using Dynamic Total-Body PET/CT in Prostate Cancer. European Journal of Nuclear Medicine and Molecular Imaging, 51, 568-580. [Google Scholar] [CrossRef] [PubMed]
[24] Simsek, D.H., Sanli, Y., Civan, C., Engin, M.N., Isik, E.G., Ozkan, Z.G., et al. (2020) Does Bone Scintigraphy Still Have a Role in the Era of 68 Ga-PSMA PET/CT in Prostate Cancer? Annals of Nuclear Medicine, 34, 476-485. [Google Scholar] [CrossRef] [PubMed]
[25] Radzina, M., Tirane, M., Roznere, L., et al. (2020) Accuracy of 68Ga-PSMA-11 PET/CT and Multiparametric MRI for the Detection of Local Tumor and Lymph Node Metastases in Early Biochemical Recurrence of Prostate Cancer. American Journal of Nuclear Medicine and Molecular Imaging, 10, 106-118.
[26] Regula, N., Kostaras, V., Johansson, S., Trampal, C., Lindström, E., Lubberink, M., et al. (2022) Comparison of 68Ga-Psma PET/CT with Fluoride PET/CT for Detection of Bone Metastatic Disease in Prostate Cancer. European Journal of Hybrid Imaging, 6, Article No. 5. [Google Scholar] [CrossRef] [PubMed]
[27] von Eyben, F.E., Picchio, M., von Eyben, R., Rhee, H. and Bauman, G. (2018) 68Ga-Labeled Prostate-Specific Membrane Antigen Ligand Positron Emission Tomography/Computed Tomography for Prostate Cancer: A Systematic Review and Meta-Analysis. European Urology Focus, 4, 686-693. [Google Scholar] [CrossRef] [PubMed]
[28] Sheikhbahaei, S., Jones, K.M., Werner, R.A., Salas-Fragomeni, R.A., Marcus, C.V., Higuchi, T., et al. (2019) 18F-NaF-PET/CT for the Detection of Bone Metastasis in Prostate Cancer: A Meta-Analysis of Diagnostic Accuracy Studies. Annals of Nuclear Medicine, 33, 351-361. [Google Scholar] [CrossRef] [PubMed]
[29] Dyrberg, E., Hendel, H.W., Huynh, T.H.V., Klausen, T.W., Løgager, V.B., Madsen, C., et al. (2018) 68Ga-PSMA-PET/CT in Comparison with 18F-Fluoride-PET/CT and Whole-Body MRI for the Detection of Bone Metastases in Patients with Prostate Cancer: A Prospective Diagnostic Accuracy Study. European Radiology, 29, 1221-1230. [Google Scholar] [CrossRef] [PubMed]
[30] Hilund-Carlsen, P.F. and Alavi, A. (2020) Simultaneous PET/MRI in the Evaluation of Breast and Prostate Cancer Using Combined Na[18F]F and [18F]FDG: A Focus on Skeletal Lesions. Molecular Imaging & Biology, 22, 219-220.
[31] Zhou, J., Gou, Z., Wu, R., Yuan, Y., Yu, G. and Zhao, Y. (2019) Comparison of PSMA-PET/CT, Choline-PET/CT, NaF-PET/CT, MRI, and Bone Scintigraphy in the Diagnosis of Bone Metastases in Patients with Prostate Cancer: A Systematic Review and Meta-Analysis. Skeletal Radiology, 48, 1915-1924. [Google Scholar] [CrossRef] [PubMed]
[32] Evangelista, L., Guttilla, A., Zattoni, F., Muzzio, P.C. and Zattoni, F. (2013) Utility of Choline Positron Emission Tomography/Computed Tomography for Lymph Node Involvement Identification in Intermediate-to High-Risk Prostate Cancer: A Systematic Literature Review and Meta-Analysis. European Urology, 63, 1040-1048. [Google Scholar] [CrossRef] [PubMed]
[33] Kimura, K., Kitajima, K., Kawanaka, Y., Yokoyama, H., Komoto, H., Fujiwara, M., et al. (2022) Evaluation of 11C‐Choline Positron Emission Tomography/computed Tomography for Determining Treatment Response in Castration‐Resistant Prostate Cancer Patients. International Journal of Urology, 29, 1072-1078. [Google Scholar] [CrossRef] [PubMed]
[34] Hong, H., Liang, D., Liu, Q., Wu, G., Sun, R., Liu, J., et al. (2022) Value of Transrectal Contrast-Enhanced Ultrasound with Clinical Indicators in the Prediction of Bone Metastasis in Prostate Cancer. Quantitative Imaging in Medicine and Surgery, 12, 1750-1761. [Google Scholar] [CrossRef] [PubMed]
[35] 龙玉屏, 黄珊珊, 赵中千, 等. 经直肠常规超声, 实时组织弹性成像及超声造影联合应用对侵袭性前列腺癌的诊断价值[J]. 临床超声医学杂志, 2022, 24(4): 291-294.
[36] 王雅丽, 红华, 吴国柱, 等. 前列腺钙化、PSA、Gleason评分与前列腺癌骨转移的相关性分析[J]. 中国超声医学杂志, 2020, 36(5): 458-462.
[37] Gillies, R.J., Kinahan, P.E. and Hricak, H. (2016) Radiomics: Images Are More than Pictures, They Are Data. Radiology, 278, 563-577. [Google Scholar] [CrossRef] [PubMed]
[38] Bernatz, S., Ackermann, J., Mandel, P., Kaltenbach, B., Zhdanovich, Y., Harter, P.N., et al. (2020) Comparison of Machine Learning Algorithms to Predict Clinically Significant Prostate Cancer of the Peripheral Zone with Multiparametric MRI Using Clinical Assessment Categories and Radiomic Features. European Radiology, 30, 6757-6769. [Google Scholar] [CrossRef] [PubMed]
[39] 姬健智, 张倩, 牛猛, 等. 联合临床, MR T2WI及表观弥散系数图影像组学特征列线图预测初发前列腺癌骨转移[J]. 中国医学影像技术, 2022, 38(7): 1050-1055.
[40] 宋鑫洋, 张甜, 王洋洋, 等. 临床和MRI影像组学及深度学习联合模型预测初发前列腺癌骨转移[J]. 中国介入影像与治疗学, 2023, 20(4): 212-217.
[41] Zhou, C., Zhang, Y., Guo, S., Wang, D., Lv, H., Qiao, X., et al. (2023) Multiparametric MRI Radiomics in Prostate Cancer for Predicting Ki-67 Expression and Gleason Score: A Multicenter Retrospective Study. Discover Oncology, 14, Article No. 133. [Google Scholar] [CrossRef] [PubMed]