Background/Objectives: Prostate cancer is a prevalent malignancy often presenting without early symptoms. Advanced imaging technologies have revolutionized its diagnosis and management. This review discusses the principles, benefits, and clinical applications of multiparametric magnetic resonance imaging (mpMRI), micro-ultrasound (microUS), and prostate-specific membrane antigen positron emission tomography–computed tomography (PSMA PET/CT) in localized prostate cancer. Methods: We conducted a comprehensive literature review of recent studies and guidelines on mpMRI, microUS, and PSMA PET/CT in prostate cancer diagnosis, focusing on their applications in biopsy-naïve patients, those with previous negative biopsies, and patients under active surveillance. Results: MpMRI has demonstrated high sensitivity and negative predictive value in detecting clinically significant prostate cancer (csPCa). MicroUS, a newer technology, has shown promising results in early studies, with sensitivity and specificity comparable to mpMRI. PSMA PET/CT has emerged as a highly sensitive and specific imaging modality, particularly valuable for staging and detecting metastatic disease. All three technologies have been incorporated into urologic practice for prostate cancer diagnosis and management, with each offering unique advantages in different clinical scenarios. Conclusions: Advanced imaging techniques, including mpMRI, microUS, and PSMA PET/CT, have significantly improved the accuracy of prostate cancer diagnosis, staging, and management. These technologies enable more precise targeting of suspicious lesions during biopsy and therapy planning. However, further research, especially randomized controlled trials, is needed to fully establish the optimal use and inclusion of these imaging modalities in various stages of prostate cancer care.
背景/目的：前列腺癌是一种常见的恶性肿瘤，早期常无明显症状。先进的影像技术已彻底改变了其诊断与管理方式。本综述探讨了多参数磁共振成像（mpMRI）、微超声（microUS）以及前列腺特异性膜抗原正电子发射断层扫描-计算机断层扫描（PSMA PET/CT）在局限性前列腺癌中的原理、优势及临床应用。方法：我们对近期关于mpMRI、microUS和PSMA PET/CT在前列腺癌诊断中的研究及指南进行了全面的文献回顾，重点关注这些技术在初次活检患者、既往活检阴性患者以及主动监测患者中的应用。结果：MpMRI在检测具有临床意义的前列腺癌（csPCa）方面表现出高敏感性和阴性预测价值。较新的技术microUS在早期研究中显示出与mpMRI相当的敏感性和特异性，结果令人鼓舞。PSMA PET/CT已成为一种高敏感性和高特异性的影像学方法，尤其在分期和检测转移性疾病方面具有重要价值。这三种技术均已融入泌尿外科临床实践，用于前列腺癌的诊断和管理，各自在不同的临床场景中具有独特优势。结论：包括mpMRI、microUS和PSMA PET/CT在内的先进影像技术显著提高了前列腺癌诊断、分期和管理的准确性。这些技术能够在活检和治疗规划过程中更精确地定位可疑病灶。然而，仍需进一步研究，特别是随机对照试验，以全面确立这些影像学方法在前列腺癌诊疗各阶段中的最佳使用方式和纳入标准。
肿瘤(癌症)患者之家