{"id":6981,"date":"2025-05-19T19:06:07","date_gmt":"2025-05-19T16:06:07","guid":{"rendered":"https:\/\/prostatefocaltherapies.com\/multiparametik-prostat-mri\/"},"modified":"2025-10-17T10:31:33","modified_gmt":"2025-10-17T07:31:33","slug":"multiparametik-prostat-mri","status":"publish","type":"page","link":"https:\/\/prostatefocaltherapies.com\/tr\/multiparametik-prostat-mri\/","title":{"rendered":"Multiparametik Prostat MRI"},"content":{"rendered":"\t\t
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Multiparametik Prostat MR<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Prostat kanseri erkeklerde en s\u0131k g\u00f6r\u00fclen ikinci kanserdir. Her y\u0131l d\u00fcnya \u00e7ap\u0131nda 300.0000’den fazla erkek prostat kanseri nedeniyle \u00f6l\u00fcyor. Prostat spesifik antijen (PSA) ve parmakla rektal muayene (DRE) prostat kanseri tan\u0131s\u0131nda en s\u0131k kullan\u0131lan y\u00f6ntemlerdir. PSA \u00e7ok hassast\u0131r ancak prostat kanserine \u00f6zg\u00fc de\u011fildir. T\u0131pk\u0131 iyi huylu prostat hiperplazisi gibi, iyi huylu patolojiler de PSA d\u00fczeylerini art\u0131rabilir ancak normal PSA d\u00fczeyleri yine de prostat kanserini d\u0131\u015flamaz. Prostat biyopsileri, prostat kanserinin prognostik bir fakt\u00f6r\u00fc olan ve t\u00fcm\u00f6r\u00fcn agresiflik d\u00fczeyi hakk\u0131nda bilgi veren Gleason skoru kullan\u0131larak histolojik olarak de\u011ferlendirilir. Bu bulgulara ek olarak prostat tan\u0131s\u0131nda transrektal ultrasonografi (TRUS) e\u015fli\u011finde \u00e7oklu prostat biyopsileri kullan\u0131lacakt\u0131r. Baz\u0131 hastalarda TRUS biyopsisi negatif olduktan sonra klinik ve patolojik sonu\u00e7lar ba\u015fka bir biyopsiye i\u015faret eder. <\/p>

Bunlar \u015fu \u015fekildedir;<\/p>

  • Artan veya s\u00fcrekli y\u00fcksek PSA seviyeleri<\/li>
  • \u015e\u00fcpheli DRE sonu\u00e7lar\u0131<\/li>
  • \u00c7oklu, y\u00fcksek d\u00fczeyde prostat intraepitelyal neoplazisi (HGPIN \u22653)<\/li>
  • Atipik, k\u00fc\u00e7\u00fck, asiner proliferasyon (ASAP) HGPIN’e kom\u015fu atipik bezlerin varl\u0131\u011f\u0131.<\/li>
  • \u0130zole bir bulgu olarak intraduktal karsinom<\/li><\/ul>

    \u0130kinci biyopsi yap\u0131lmas\u0131 gereken hastalar i\u00e7in multiparametrik MRG (Mp-MRG) \u00f6nerilir. Mp-MRI, prostat kanseri tan\u0131s\u0131ndaki kullan\u0131mlar\u0131n\u0131n yan\u0131 s\u0131ra a\u015famaland\u0131rma ve aktif izleme a\u00e7\u0131s\u0131ndan da \u00f6nemlidir. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    \u00c7ok Parametrik MRG (MP-MRG) Nedir?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    \n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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    MP-MRG, prostat bezinin m\u00fckemmel bir anatomik ve fonksiyonel taramas\u0131na izin vermekle kalmaz, ayn\u0131 zamanda prostat kanserinin tan\u0131 ve evrelemesinde de bir ara\u00e7 g\u00f6revi g\u00f6r\u00fcr. Ayr\u0131ca pelvisteki b\u00f6lgesel geni\u015flemeyi, pelvik lenf d\u00fc\u011f\u00fcmlerini ve kemik metastaz\u0131n\u0131 anlamaya yard\u0131mc\u0131 olur. <\/p>

    Ultrasonun \u00e7\u00f6z\u00fcn\u00fcrl\u00fc\u011f\u00fc zay\u0131ft\u0131r ve bu da tek ba\u015f\u0131na prostat tan\u0131s\u0131 i\u00e7in yeterli olmayacakt\u0131r. C11- ve F18- kolin pozitron emisyon tomografisi (PET), metastatik hastal\u0131\u011f\u0131n tekrar\u0131n\u0131 ve varl\u0131\u011f\u0131n\u0131 belirlemek i\u00e7in kullan\u0131lan di\u011fer g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemleridir, ancak primer t\u00fcm\u00f6r\u00fcn belirlenmesi veya lokal faz verilmesi i\u00e7in kullan\u0131lamazlar. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    Multi-Parametrik MRG Kimlere Yap\u0131lmal\u0131d\u0131r?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    Biyopsi \u00f6ncesi prostat kanseri \u015f\u00fcphesi olan (PSA> 4.0 ng\/mL y\u00fcksekli\u011fi ve\/veya DRE \u015f\u00fcphesi), prostat kanseri oldu\u011fu bilinen ve fazlama yap\u0131lmas\u0131 gereken hastalar (planl\u0131 k\u00fcratif tedavi veya aktif izlem i\u00e7in) ve klinik olarak prostat kanseri \u015f\u00fcphesi olan ancak biyopsileri negatif olan hastalar prostat MRG’sine ihtiya\u00e7 duyarlar.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    Prostat Kanseri Tan\u0131s\u0131nda Mp-MR'\u0131n Yeri\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    Bir radikal prostatektomi (RP) spesmeninde Mp-MRG ile kanser saptanma oran\u0131n\u0131n gleason skoru ve tumer boyutuna g\u00f6re analiz edildi\u011fi iyi tasarlanm\u0131\u015f bir \u00e7al\u0131\u015fmada, gleason skoru > 7 ve t\u00fcm\u00f6r hacmi 2 ml ise > kanser saptanma oran\u0131n\u0131n %100 oldu\u011fu g\u00f6zlenmi\u015ftir. Mp-MRG’nin kanser tespitindeki duyarl\u0131l\u0131\u011f\u0131n\u0131n gleason skoru ile artt\u0131\u011f\u0131, indeks t\u00fcm\u00f6r durumu ve t\u00fcm\u00f6r hacminin t\u00fcm\u00f6r tespitinde en g\u00fc\u00e7l\u00fc ara\u00e7lar oldu\u011fu bilinmektedir. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    Prostat Kanseri Tedavi Yakla\u015f\u0131m\u0131 ve Multiparametrik MRG\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    TRUS biyopsisi primer hastalarda standart yakla\u015f\u0131m olarak kabul edilir. Ancak TRUS ile hedeflenen lezyonlardan \u00f6rnek alman\u0131n her zaman m\u00fcmk\u00fcn olmamas\u0131 ve bazen \u00f6rneklerin radikal prostatektomi \u00f6rnekleri ile uyumsuz olmas\u0131, TRUS biyopsisinin sonu\u00e7lar\u0131n\u0131 do\u011frulamak i\u00e7in ek y\u00f6ntemlere ihtiya\u00e7 duyulabilece\u011fini d\u00fc\u015f\u00fcnd\u00fcrmektedir. Ba\u015fka bir \u00e7al\u0131\u015fma, TRUS biyopsisinin prostat kanserinin tan\u0131s\u0131, t\u00fcm\u00f6r\u00fcn yeri, derecesi veya yayg\u0131nl\u0131\u011f\u0131 hakk\u0131nda yeterli bilgi vermedi\u011fini g\u00f6sterdi. TRUS biyopsisi ile \u00f6zellikle santral lobda ve prostat apeksinde olan kanserlerin tan\u0131s\u0131n\u0131n m\u00fcmk\u00fcn olmad\u0131\u011f\u0131 anla\u015f\u0131ld\u0131. G\u00fcn\u00fcm\u00fczde TRUS biyopsi sonu\u00e7lar\u0131 negatif olan ancak \u015f\u00fcpheleri devam eden hastalar i\u00e7in Mp-MR sonu\u00e7lar\u0131na g\u00f6re hedefe y\u00f6nelik biyopsi yap\u0131lmaktad\u0131r. Bu y\u00f6ntem sat\u00fcrasyon biyopsisine ciddi bir alternatif haline geldi. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    Multiparametrik Prostat MR Neden \u00d6nemlidir?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    • En hassas prostat kanseri tan\u0131 y\u00f6ntemi olmas\u0131 ve en erken evrede tan\u0131 konulmas\u0131n\u0131 sa\u011flamas\u0131 a\u00e7\u0131s\u0131ndan \u00f6nemlidir.<\/li>
    • Bu g\u00f6r\u00fcnt\u00fcler prostat biyopsisi s\u0131ras\u0131nda kullan\u0131labilece\u011fi i\u00e7in de \u00f6nemlidir.<\/li>
    • Prostat biyopsisi \u00f6ncesinde prostat t\u00fcm\u00f6r\u00fcn\u00fcn yerini belirler ve do\u011fru biyopsi pozisyonu (f\u00fczyon prostat biyopsisi) sayesinde kesin tan\u0131 konulmas\u0131n\u0131 sa\u011flar.<\/li>
    • \u00d6zellikle PSA d\u00fczeyi y\u00fcksek olan veya ailesinde prostat kanseri \u00f6yk\u00fcs\u00fc olan erkeklerde prostat kanserinin erken te\u015fhisini sa\u011flar.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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      Multiparametrik MR s\u00fcreci ve hastan\u0131n haz\u0131rlanmas\u0131\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      T\u00fcm\u00f6ral lezyonun tan\u0131s\u0131nda kanama genellikle lezyonun g\u00f6r\u00fcn\u00fcrl\u00fc\u011f\u00fcn\u00fc etkilemedi\u011finden, biyopsiden hemen sonra Mp-MR \u00e7ekilebilir. Bununla birlikte, yerel a\u015famaland\u0131rma ama\u00e7lar\u0131 i\u00e7in 6-8 haftal\u0131k bir bekleme s\u00fcresi \u00f6nerilir. Mp-MR’da i\u015flem \u00f6ncesi hasta tuvalete gitmelidir. Ayr\u0131ca ba\u011f\u0131rsak hareketi artefakt\u0131n\u0131 \u00f6nlemek i\u00e7in i\u015flemden \u00f6nceki g\u00fcn s\u0131v\u0131 diyeti \u00f6nerilir. Anti-spazmodik kullan\u0131m\u0131n\u0131n hastalar\u0131n \u00fc\u00e7te ikisinden fazlas\u0131nda g\u00f6r\u00fcnt\u00fcleme kalitesini artt\u0131rd\u0131\u011f\u0131 g\u00f6sterilmi\u015ftir. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      Multiparametrik MR Ka\u00e7 Seanst\u0131r?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      Multiparametrik MR 4 sekanstan olu\u015fur ve tek seansta ger\u00e7ekle\u015ftirilir.<\/p>

      Y\u00fcksek \u00e7\u00f6z\u00fcn\u00fcrl\u00fckl\u00fc MR incelemesi, dif\u00fczyon a\u011f\u0131rl\u0131kl\u0131 MRG incelemesi, ADC haritalamas\u0131 ve dif\u00fczyon-kontrastl\u0131 MRG incelemelerinden olu\u015fur.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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      Mp-MRI Dizileri<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      Anatomik Diziler\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      T1 a\u011f\u0131rl\u0131kl\u0131 g\u00f6r\u00fcnt\u00fcleme:<\/strong> T\u00fcm\u00f6r alan\u0131n\u0131 ve b\u00f6lgesel anatomiyi kesin olarak belirleyemedi\u011fi i\u00e7in prostat mp-MR’\u0131nda s\u0131n\u0131rl\u0131 bir de\u011fere sahiptir. Lezyonu belirlemek i\u00e7in kullan\u0131lmaz. T1A g\u00f6r\u00fcnt\u00fcleme biyopsiye ba\u011fl\u0131 kanamalarda tan\u0131ya yard\u0131mc\u0131 olur. Kanamal\u0131 alanlar T1A incelemesinde hiperintens g\u00f6r\u00fcn\u00fcr. <\/p>

      T2 a\u011f\u0131rl\u0131kl\u0131 g\u00f6r\u00fcnt\u00fcleme:<\/strong> Y\u00fcksek \u00e7\u00f6z\u00fcn\u00fcrl\u00fckl\u00fc T2A incelemesi, prostat anatomisinin belirlenmesi ve ayr\u0131ca t\u00fcm\u00f6rlerin saptanmas\u0131 i\u00e7in kullan\u0131l\u0131r. MP-MRG’nin en \u00f6nemli bile\u015fenidir. T2A incelemesinde periferik b\u00f6lgede prostat kanseri genellikle hipointensite ile g\u00f6r\u00fcl\u00fcr. Ancak hiperintensite ile kronik prostatit, kalsifikasyon, atrofi ve radyoterapi sonras\u0131 de\u011fi\u015fiklikler de g\u00f6r\u00fclebildi\u011finden yan\u0131lt\u0131c\u0131 olumlu sonu\u00e7lara neden olabilmektedir. Bu gibi durumlarda fonksiyonel sekanslara g\u00f6re t\u00fcm\u00f6r\u00fcn varl\u0131\u011f\u0131na karar verilir. T2A incelemesi, prostat kanserinin saptanmas\u0131nda benzersizli\u011fi d\u00fc\u015f\u00fck oldu\u011fu i\u00e7in fonksiyonel sekanslarla birlikte kullan\u0131lmal\u0131d\u0131r. <\/p>

      Fonksiyonel diziler<\/h5>

      Dif\u00fczyon a\u011f\u0131rl\u0131kl\u0131 g\u00f6r\u00fcnt\u00fcleme:<\/strong>Su molek\u00fcllerinin h\u00fccre i\u00e7i ve h\u00fccre d\u0131\u015f\u0131 b\u00f6lgelerdeki hareketlerini inceler. Prostat kanserinde h\u00fccre zarlar\u0131 suyun ge\u00e7irgenli\u011fini engeller ve bu nedenle su molek\u00fcllerinin dif\u00fczyonu s\u0131n\u0131rl\u0131 olacakt\u0131r. Dif\u00fczyon s\u0131n\u0131rlamas\u0131, Mp-MRG’deki b de\u011feri (dif\u00fczyon a\u011f\u0131rl\u0131\u011f\u0131 miktar\u0131) ve g\u00f6r\u00fcn\u00fcr dif\u00fczyon katsay\u0131s\u0131 (ADC) ile \u00f6l\u00e7\u00fclecektir. ADC su molek\u00fcllerinin kantitatif \u00f6l\u00e7\u00fcm\u00fcd\u00fcr. Prostat kanserinde b de\u011feri normal dokuya g\u00f6re daha y\u00fcksektir; ve ADC de\u011feri normal dokuya g\u00f6re daha d\u00fc\u015f\u00fckt\u00fcr. <\/p>

      Dinamik kontrastl\u0131 g\u00f6r\u00fcnt\u00fcleme:<\/strong> Prostat kanserinin damarlanmas\u0131 hakk\u0131nda bilgi verir. Prostat kanserinde d\u00fczensiz, k\u0131r\u0131lgan ve y\u00fcksek ge\u00e7irgenli\u011fe sahip neoanjiyojenler olu\u015fur. DCE-MRG gadolinyum bazl\u0131 kontrast madde uygulamas\u0131ndan \u00f6nce ve sonra y\u00fcksek \u00e7\u00f6z\u00fcn\u00fcrl\u00fckl\u00fc T1A sekanslar\u0131 kullan\u0131l\u0131r. Prostat kanserinin kontrast dinami\u011fi \u00e7ok heterojeniktir. DCE-MRG’de prostat kanseri normal dokudan daha erken kontrastlan\u0131r ve daha sonra y\u00fcksek konsantrasyona ula\u015f\u0131r. DCE-MRG’nin en b\u00fcy\u00fck sorunu, y\u00fcksek vask\u00fclarizasyona sahip BPH nod\u00fcllerini ay\u0131rt etmenin zor olmas\u0131d\u0131r. <\/p>

      MR spektroskopu:<\/strong> Dokulardaki baz\u0131 kimyasal metabolitlerin tayini esas\u0131na dayanan g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemidir. Prostat kanserinde kolin seviyeleri artarken sitrat seviyeleri d\u00fc\u015fer. Kolin\/sitrat oran\u0131 Gleason skoru ile ili\u015fkilidir. Ancak MRG’yi uzatt\u0131\u011f\u0131, 1.5 Tesla MR’da endorektal bobin ve y\u00fcksek d\u00fczeyde deneyim gerektirdi\u011fi i\u00e7in Mp-MRG’de rutin olarak kullan\u0131lmamaktad\u0131r. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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      Prostat Kanseri Skorlar\u0131nda Multiparametrik MRG<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      Multiparametrik MRG sonu\u00e7lar\u0131na g\u00f6re prostat kanseri i\u00e7in PI-RADS skorlamas\u0131 (prostat g\u00f6r\u00fcnt\u00fcleme, raporlama ve veri sistemi) kullan\u0131lmaktad\u0131r. PI-RADS v2.1, k\u00fcresel standardizasyonu motive etmeyi, prostat Mp-MRI incelemelerinin yorumlanmas\u0131 ve raporlanmas\u0131ndaki \u00e7e\u015fitlili\u011fi azaltmay\u0131 ve \u015f\u00fcpheli kanser hastalar\u0131nda belirleme, lokalizasyon ve risk s\u0131n\u0131fland\u0131rmas\u0131n\u0131 iyile\u015ftirmeyi ama\u00e7lamaktad\u0131r. Ancak, aktif izleme s\u0131ras\u0131nda tekrar meydana gelme veya ilerlemenin belirlenmesi ile ilgilenmez. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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      PI-RADS skoru 1 ile 5 aras\u0131ndad\u0131r.<\/p>

      • PI-RADS 1 \u2013 \u00c7ok d\u00fc\u015f\u00fck risk<\/li>
      • PI-RADS 2 \u2013 D\u00fc\u015f\u00fck risk<\/li>
      • PI-RADS 3 \u2013 Orta risk<\/li>
      • PI-RADS 4 \u2013 Y\u00fcksek risk<\/li>
      • PI-RADS 5 \u2013 \u00c7ok y\u00fcksek risk<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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        PI-RADS v2.1’de periferik b\u00f6lge ve ge\u00e7i\u015f b\u00f6lgesi i\u00e7in ayr\u0131 birincil belirleme dizileri tan\u0131mlanm\u0131\u015ft\u0131r; periferik b\u00f6lge ve ge\u00e7i\u015f b\u00f6lgesi i\u00e7in s\u0131ras\u0131yla DAG ve T2A dizileri birincil g\u00f6sterge dizileri olarak kabul edilir. PI-RADS 4-5 lezyonlar\u0131 i\u00e7in biyopsi \u00f6nerilir. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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        \n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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        PI-RADS 3 lezyonlar\u0131nda biyopsi karar\u0131 hala tart\u0131\u015fmal\u0131d\u0131r. Karar, hem klinik hem de laboratuvar sonu\u00e7lar\u0131 dikkate al\u0131narak verilmelidir. <\/p>

        PI-RADS 1-2 lezyonlar\u0131nda kanser \u015f\u00fcpheleri devam ediyorsa, PSA \u00fcretim s\u00fcresi, PSA h\u0131z\u0131 prostat sa\u011fl\u0131\u011f\u0131 indeksi (PHI), idrar PCA3 veya 4K testleri kullan\u0131larak ba\u015fka bir ‘sistematik biyopsi’ gerekip gerekmedi\u011fine karar verilebilir. Mp-MRG de\u011ferlendirmesinde kullan\u0131lan PI-RADS v2.1 subjektif kriterlere sahip oldu\u011fu i\u00e7in tetkikin duyarl\u0131l\u0131\u011f\u0131 hekimin tecr\u00fcbesine ba\u011fl\u0131d\u0131r. <\/p>

        Radyoloji uzman\u0131 Mp-MRG’yi inceledikten sonra raporu \u015fematik bir resim ile sunmal\u0131 ve \u00fczerindeki lezyon i\u015faretlenmelidir. Bu, bili\u015fsel biyopsi s\u0131ras\u0131nda lezyonun yerinin daha kolay belirlenmesi ve radyolo\u011fun raporu patoloji sonu\u00e7lar\u0131yla kar\u015f\u0131la\u015ft\u0131rabilmesi i\u00e7in gereklidir. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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        Multiparametrik MRG Prostat Biyopsisi \u0130\u00e7in Yol G\u00f6sterici Olabilir mi?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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        Evet. PSA y\u00fcksek oldu\u011funda yap\u0131lan multiparametrik MRG, malign ve benign dokular\u0131n h\u0131zl\u0131 bir \u015fekilde ay\u0131rt edilmesini sa\u011flar. Prostat kanserinde PSA y\u00fckselse de Benign prostat hiperplazisi gibi iyi huylu b\u00fcy\u00fcmelerde de artabilir. Yani bu i\u015flem sayesinde gereksiz biyopsiler art\u0131k sorun olmaktan \u00e7\u0131kacakt\u0131r. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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        Multiparametrik Prostat MR Normal PSA De\u011ferlerinde Bile Kullan\u0131labilir mi?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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        Uzman\u0131n\u0131z gerekli g\u00f6r\u00fcrse PSA de\u011ferleri normal olan hastalarda bile bu y\u00f6ntemle kanser taramas\u0131 yap\u0131labilir.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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        Prostat Kanserinin Aktif \u0130zlenmesinde MpMRG\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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        Klinik olarak \u00f6nemsiz prostat kanseri, tarama yoluyla te\u015fhis edilen ve semptomatik hale gelmeyen kanseri ifade eder. Hastal\u0131\u011f\u0131n ilerlemedi\u011fi ve k\u00fcratif tedavinin gerekmedi\u011fi durumlarda aktif izlem tercih edilir. Bu sayede hasta tedavinin komplikasyonlar\u0131ndan korunmu\u015f olur. Aktif izleme, se\u00e7ilen d\u00fc\u015f\u00fck risk grubundaki hastalar i\u00e7in uygundur: <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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        • > 10 y\u0131ll\u0131k ya\u015fam beklentisi<\/li>
        • PSA \u2264 10 ng\/ml<\/li>
        • T1c veya T2a<\/li>
        • Gleason skoru \u2264 6<\/li>
        • Pozitif \u00e7ekirdek say\u0131s\u0131 \u2264 2<\/li>
        • Her pozitif \u00e7ekirdek i\u00e7in kanser i\u00e7eri\u011fi %50\u2264dir<\/li>
        • PSA yo\u011funlu\u011fu < 0,15 ng\/ml<\/li><\/ul>

          Aktif izlem protokollerinin bir par\u00e7as\u0131 olarak d\u00fczenli PSA, DRE ve y\u0131ll\u0131k biyopsiler yap\u0131lmaktad\u0131r. \u00d6rnekleme hatalar\u0131n\u0131 ekarte etmek i\u00e7in 6-12 ay i\u00e7inde do\u011frulama biyopsisi gereklidir. <\/p>

          Mp-MR, hasta se\u00e7imi ve hasta takibi i\u00e7in \u00f6nemli katk\u0131lar sa\u011flar:<\/p>

          • Ba\u015flang\u0131\u00e7ta ve izleme s\u00fcrecinde yanl\u0131\u015f s\u0131n\u0131fland\u0131rmay\u0131 azaltmak,<\/li>
          • Gereksiz biyopsilerin azalt\u0131lmas\u0131 ve hasta takibinin kolayla\u015ft\u0131r\u0131lmas\u0131<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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            Multiparametrik Prostat MR Nas\u0131l Yap\u0131l\u0131r?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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            Normal bir MRI prosed\u00fcr\u00fc ile ayn\u0131d\u0131r. Hasta MR cihaz\u0131n\u0131n i\u00e7ine uzan\u0131r ve i\u015flem 40-45 dakika s\u00fcrer. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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            Multiparametrik MR \u0130\u015fleminde Hasta Radyasyona Maruz Kal\u0131r m\u0131?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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            Hay\u0131r, radyasyona maruz kalma olmayacakt\u0131r.<\/p><\/div><\/div>

            Sayfam\u0131z bilgilendirme ama\u00e7l\u0131d\u0131r. Tan\u0131 ve Tedavi i\u00e7in doktorunuza ba\u015fvurunuz. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

            Multiparametik Prostat MR Prostat kanseri erkeklerde en s\u0131k g\u00f6r\u00fclen ikinci kanserdir. Her y\u0131l d\u00fcnya \u00e7ap\u0131nda 300.0000’den fazla erkek prostat kanseri nedeniyle \u00f6l\u00fcyor. Prostat spesifik antijen (PSA) ve parmakla rektal muayene (DRE) prostat kanseri tan\u0131s\u0131nda en s\u0131k kullan\u0131lan y\u00f6ntemlerdir. PSA \u00e7ok hassast\u0131r ancak prostat kanserine \u00f6zg\u00fc de\u011fildir. T\u0131pk\u0131 iyi huylu prostat hiperplazisi gibi, iyi huylu patolojiler […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6981","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/prostatefocaltherapies.com\/tr\/wp-json\/wp\/v2\/pages\/6981","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/prostatefocaltherapies.com\/tr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/prostatefocaltherapies.com\/tr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/prostatefocaltherapies.com\/tr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/prostatefocaltherapies.com\/tr\/wp-json\/wp\/v2\/comments?post=6981"}],"version-history":[{"count":2,"href":"https:\/\/prostatefocaltherapies.com\/tr\/wp-json\/wp\/v2\/pages\/6981\/revisions"}],"predecessor-version":[{"id":7646,"href":"https:\/\/prostatefocaltherapies.com\/tr\/wp-json\/wp\/v2\/pages\/6981\/revisions\/7646"}],"wp:attachment":[{"href":"https:\/\/prostatefocaltherapies.com\/tr\/wp-json\/wp\/v2\/media?parent=6981"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}