Bildgestützte Prostatastanzbiopsie

Zusammenfassung

Die Diagnose Prostatakarzinom wird nach wie vor über eine Probeentnahme aus der Prostata gestellt. Nach klinischer Einführung des transrektalen Ultraschalls vor beinahe 30 Jahren hat diese Technik einige Innovationen und Änderungen bei der Durchführung erlebt. Die Verbesserung der Schallköpfe und der Ultraschallgeneratoren ist nicht abgeschlossen. Inzwischen stehen auch zum B-mode Verfahren ergänzende Methoden zur Verfügung, die eine Verbesserung der Diagnose ermöglichen. Neben ultraschallbasierten Verfahren, wie C-TRUS/ANNA, Kontrastmittel-verstärktem Ultraschall (CEUS) und Sonoelastografie, stehen MRT-basierte Verfahren zur Auswahl, um die Diagnose Prostatakarzinom zu verbessern. Letztlich wird sich zeigen, welches Verfahren in der Zukunft die höchste diagnostische Sicherheit mit einer angemessenen Kosteneffizienz vereint. Aus urologischer Sicht muss allerdings die Diagnostik und Therapie in der urologischen Hand bleiben.

Abstract

The diagnnosis of prostate cancer is still being made on the basis of biopsy samples taken from the prostate. After the clinical introduction of transrectal sonography almost 30 years ago, this technique has undergone some innovations and changes in its methods of performance. Improvements in the transponder and ultrasound generator are not yet at an end. In the mean time supplementary methods to the B-mode imaging are available that enable improvements in the diagnosis. Apart from ultrasound-based procedure such as C-TRUS/ANNA, contrast medium-enhanced ultrasound (CEUS) and sonoelastography, MRI-based methods are now available to further improve the diagnosis of prostate cancer. It remains to be seen which method will establish itself in the future with the highest degree of diagnostic certainty and an appropriate cost-use relationship. From the urologist’s point, however, diagnosis of and therapy for prostate cancer must remain in the domaine of urology.

Schlüsselwörter

Diagnostik - Prostata - Prostatakarzinom - Prostatastanzbiopsie - Kontrastmittel-verstärktem Ultraschall (CEUS) - Sonoelastografie

Key words

diagnostics - prostate - prostate cancer - punch biopsy of the prostate - contrast medium enhance ultrasound (CEUS) - sonoelastography

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