Prostate cancer ranks among the most prevalent tumours globally. While early detection reduces the likelihood of metastasis, managing advanced cases poses challenges in diagnosis and treatment. Current international guidelines support the concurrent use of99Tc-Bone Scintigraphy and Contrast-Enhanced Chest and Abdomen CT for the staging of metastatic disease and response assessment. However, emerging evidence underscores the superiority of next-generation imaging techniques including PSMA-PET/CT and whole-body MRI (WB-MRI). This review explores the relevant scientific literature on the role of WB-MRI in metastatic prostate cancer. This multiparametric imaging technique, combining the high anatomical resolution of standard MRI sequences with functional sequences such as diffusion-weighted imaging (DWI) and bone marrow relative fat fraction (rFF%) has proved effective in comprehensive patient assessment, evaluating local disease, most of the nodal involvement, bone metastases and their complications, and detecting the increasing visceral metastases in prostate cancer. It does have the advantage of avoiding the injection of contrast medium/radionuclide administration, spares the patient the exposure to ionizing radiation, and lacks the confounder of FLARE described with nuclear medicine techniques. Up-to-date literature regarding the diagnostic capabilities of WB-MRI, though still limited compared to PSMA-PET/CT, strongly supports its widespread incorporation into standard clinical practice, alongside the latest nuclear medicine techniques.
前列腺癌是全球范围内最常见的肿瘤之一。早期检测虽可降低转移风险，但晚期病例的诊断与治疗仍面临挑战。当前国际指南推荐将99Tc骨扫描与增强胸腹部CT联合用于转移性疾病的分期及疗效评估。然而，新兴证据表明以PSMA-PET/CT和全身磁共振成像（WB-MRI）为代表的下一代影像技术更具优势。本文综述了WB-MRI在转移性前列腺癌中应用的相关科学文献。这种多参数成像技术融合了标准MRI序列的高解剖分辨率与扩散加权成像（DWI）、骨髓相对脂肪分数（rFF%）等功能序列，已被证实能有效实现全面病情评估，包括局部病灶、多数淋巴结受累、骨转移及其并发症的评估，并能检测前列腺癌中日益增多的内脏转移。该技术具有无需注射造影剂/放射性核素、避免患者电离辐射暴露、且不受核医学技术中FLARE伪影干扰的优势。尽管与PSMA-PET/CT相比，关于WB-MRI诊断能力的现有文献仍有限，但最新研究强烈支持将其与前沿核医学技术共同纳入标准临床实践。
Multiparametric Whole-Body MRI: A Game Changer in Metastatic Prostate Cancer
肿瘤(癌症)患者之家