PMID: 26793874Jan 23, 2016Paper

Recent advances in diagnosis of prostate cancer

Nihon rinsho. Japanese journal of clinical medicine
Isao Hara

Abstract

Most valuable tool for diagnosis of prostate cancer is PSA. Although PSA is highly specific for organ, it is not so specific for disease. Therefore, about 70% of patients whose PSA value is 4-10 ng/mL are forced to undergo unnecessary prostate biopsy. In order to discriminate the unnecessary biopsies, several markers such as free/total PSA ratio, PSA density, and PSA velocity have been developed. However, none of these markers were widely approved in daily clinical settings. Prostate cancer antigen 3 (PCA3) is thought to be a useful marker for necessity of repeat biopsy. Functional MR imaging such as dynamic contrast enhancement (DCE), diffusion weighted imaging(DWI), MR spectroscopy (MRS) have been developed. Recently MRI-TRUS fusion biopsy is gathering attention. In terms of pathology, atypical glands but not high grade PIN require repeat biopsy after 3 to 6 months from initial biopsy.

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