Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Use of Imaging and Biopsy in Prostate Cancer Diagnosis: A Survey From the Asian Prostate Imaging Working Group

  • Li-Jen Wang (Department of Medical Imaging and Intervention, New Taipei Municipal Tucheng Hospital, Chang Gung Medical Foundation) ;
  • Masahiro Jinzaki (Department of Radiology, Keio University, School of Medicine) ;
  • Cher Heng Tan (Department of Diagnostic Radiology, Tan Tock Seng Hospital, National Health Care Group) ;
  • Young Taik Oh (Department of Radiology, Severance Hospital, Yonsei University College of Medicine) ;
  • Hiroshi Shinmoto (Department of Radiology, National Defense Medical College) ;
  • Chau Hung Lee (Department of Diagnostic Radiology, Tan Tock Seng Hospital, National Health Care Group) ;
  • Nayana U. Patel (Department of Radiology, UNM Health Sciences Center, University of New Mexico) ;
  • Silvia D. Chang (Department of Radiology, Vancouver General Hospital, University of British Columbia) ;
  • Antonio C. Westphalen (Department of Radiology, University of Washington) ;
  • Chan Kyo Kim (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2023.07.10
  • Accepted : 2023.08.25
  • Published : 2023.11.01
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Abstract

Objective: To elucidate the use of radiological studies, including nuclear medicine, and biopsy for the diagnosis and staging of prostate cancer (PCA) in clinical practice and understand the current status of PCA in Asian countries via an international survey. Materials and Methods: The Asian Prostate Imaging Working Group designed a survey questionnaire with four domains focused on prostate magnetic resonance imaging (MRI), other prostate imaging, prostate biopsy, and PCA backgrounds. The questionnaire was sent to 111 members of professional affiliations in Korea, Japan, Singapore, and Taiwan who were representatives of their working hospitals, and their responses were analyzed. Results: This survey had a response rate of 97.3% (108/111). The rates of using 3T scanners, antispasmodic agents, laxative drugs, and prostate imaging-reporting and data system reporting for prostate MRI were 21.6%-78.9%, 22.2%-84.2%, 2.3%-26.3%, and 59.5%-100%, respectively. Respondents reported using the highest b-values of 800-2000 sec/mm2 and fields of view of 9-30 cm. The prostate MRI examinations per month ranged from 1 to 600, and they were most commonly indicated for biopsy-naïve patients suspected of PCA in Japan and Singapore and staging of proven PCA in Korea and Taiwan. The most commonly used radiotracers for prostate positron emission tomography are prostate-specific membrane antigen in Singapore and fluorodeoxyglucose in three other countries. The most common timing for prostate MRI was before biopsy (29.9%). Prostate-targeted biopsies were performed in 63.8% of hospitals, usually by MRI-ultrasound fusion approach. The most common presentation was localized PCA in all four countries, and it was usually treated with radical prostatectomy. Conclusion: This survey showed the diverse technical details and the availability of imaging and biopsy in the evaluation of PCA. This suggests the need for an educational program for Asian radiologists to promote standardized evidence-based imaging approaches for the diagnosis and staging of PCA.

Keywords

Acknowledgement

The authors thank the administrative support of the Korean Society of Urogenital Radiology Society, the Japanese Society of Abdominal Radiology, the Singapore Radiological Society and Taiwan Radiological Society and their certificated abdominal radiologists or councilors for their kind replies to this survey.

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