ABSTRACT
Introducción: En el cáncer de próstata resistente a la castración (CPRC), la detección precoz de las metástasis es fundamental para la selección del tratamiento y la prevención de complicaciones óseas. Sin embargo, la detección de metástasis incipientes sigue siendo un reto dado que las pruebas radiológicas convencionales (gammagrafía ósea o tomografía computarizada) no tienen suficiente sensibilidad. Actualmente se dispone de técnicas diagnósticas por la imagen con mayor sensibilidad y especificidad cuya implantación es sin embargo escasa, debido a discrepancias en las recomendaciones. Objetivo: Elaborar un algoritmo que indique las técnicas diagnósticas por la imagen más idóneas para diferentes perfiles de pacientes con CPRC M0 según la evidencia científica. Adquisición de la evidencia: Reuniones de 8 expertos en Urología, Anatomía Patológica, Radiodiagnóstico y Medicina Nuclear organizadas por la Asociación Andaluza de Urología en las que se revisaron las recomendaciones y la evidencia científica acerca de cada una de las técnicas diagnósticas por la imagen. Síntesis de la evidencia: Se presentan las recomendaciones actuales para la detección de metástasis en pacientes con CPRC M0, los pacientes que se beneficiarían de una detección precoz y se resume la evidencia que apoya el uso de cada una de las nuevas técnicas. Conclusiones: Técnicas como la PET/TC 18F-colina o la RMCC/D y probablemente la RMA han demostrado tener una buena sensibilidad y especificidad en pacientes con PSA bajo (< 10 ng/ml). Su incorporación en la práctica clínica habitual contribuirá a mejorar la detección precoz de metástasis en pacientes con CPRC
Introduction: In castration-resistant prostate cancer (CRPC), early detection of metastases is essential for the selection of treatment, and prevention of bone complications. However detecting incipient metastases remains a challenge as the conventional radiological tests (bone scintigraphy or computerised tomography) lack sufficient sensitivity. Diagnostic imaging techniques are currently available that have greater sensitivity and specificity, but are little used due to shortfalls in the recommendations. Objective: To create an algorithm that indicates the most suitable diagnostic imaging techniques for the different M0 CRPC patient profiles based on the scientific evidence. Evidence acquisition: Meetings were held with eight experts in Urology, Pathological Anatomy, Radiodiagnostics and Nuclear Medicine organised by the Andalusian Association of Urology, in which the recommendations and scientific evidence on each of the diagnostic imaging techniques were reviewed. Summary of the evidence: We present the current recommendations for the detection of metastasis in M0 CRPC patients, the patients that would benefit from early detection, and summarise the evidence to support the use of each of the new techniques. Conclusions: Techniques such as 18F-Choline PET/CT or DWWB MRI and probably open MRI have been demonstrated to have good sensitivity and specificity for patients with low PSA (< 10 ng/ml). Their inclusion in routine clinical practice will help improve the early detection of metastasis in CRPC patients
Subject(s)
Humans , Male , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/therapy , Neoplasm Metastasis , Algorithms , Prostatic Neoplasms, Castration-Resistant/diagnostic imaging , Early Diagnosis , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography , Prostate-Specific Antigen , Confidence IntervalsABSTRACT
Pure electrostatically stabilized aqueous alumina suspensions were prepared at various solid loadings in order to study the influence of temperature on the surface charge properties and rheology. Surface charge density at various temperatures was measured through potentiometric titration, and the analysis of the potentiometric data was accomplished using the constant capacitance surface model. Calculations of the pair-wise interaction potential between charged colloidal spheres dispersed in water were then carried out using conventional DLVO theory and a software package Stabil45, taking into account the temperature dependence of surface charge density and dielectric constant. The results showed that increasing temperature leads to a gradual diminution of alumina surface ionization, dielectric constant, and a total energy barrier for coagulation. The enhancement of the coagulation rate with increasing temperature leads to a gradual increase of both relative apparent viscosity and thixotropy. Copyright 2000 Academic Press.
