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Abstract：
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 of 99Tc-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.
摘要：
前列腺癌是全球最普遍的肿瘤之一。虽然早期检测降低了转移的可能性，管理晚期病例对诊断和治疗提出了挑战。当前的国际指南支持同时使用99Tc骨闪烁显像和对比增强的胸部和腹部CT来进行转移性疾病的分期和反应评估。然而,新出现的证据强调了包括PSMA-PET/CT和全身MRI（WB-MRI）在内的下一代成像技术的优越性。这篇综述探讨了有关WB-MRI在转移性前列腺癌中的作用的相关科学文献。这种多参数成像技术，将标准MRI序列的高解剖分辨率与弥散加权成像（DWI）和骨髓相对脂肪分数（rFF%）等功能序列相结合，已被证明在全面的患者评估中有效。评估局部疾病，大部分节点参与，骨转移及其并发症，并检测前列腺癌内脏转移的增加。它确实具有避免注射造影剂/放射性核素给药的优点，让病人免于接触电离辐射，并且缺乏用核医学技术描述的FLARE的混淆者。关于WB-MRI诊断能力的最新文献，尽管与PSMA-PET/CT相比仍然有限，强烈支持将其广泛纳入标准临床实践，最新的核医学技术.
