Cancer prevalence rates put emphasis on imaging know-how

Statistics about the projected increase of cancer rates in the Asia Pacific region are, to put it mildly, thought-provoking. The World Health Organization, for instance, estimates that South-Central Asia, East Asia, and Australasia are likely to experience a rise of between 50% and 75% in cancer occurrence by 2020. Its estimate of 75% to 100% for Southeastern Asia is even more alarming.

Most experts agree lifestyle and dietary changes that have followed rapid industrialization and high economic growth in the region during the past two or three decades have contributed to the increasing risk of cancer, particularly in the breast, prostate, colon, kidney, endometrium, and esophagus.

Compared with their counterparts in the north of Europe, about twice as many men in Asia are regular smokers, and this means that tobacco-related cancers are growing faster in Asia than in the U.S. and Europe. Liver and gastric cancers are also of great importance because of the large proportion of the population of South-Central Asia who carry Helicobacter pylori, as well as the endemic infection of hepatitis B in the Southeast Asian population.

This analysis underlines the importance of implementing measures to boost prevention and treatment of the most common cancers. Radiologists and others involved in medical imaging look set to be in the forefront of the global battle against cancer in the years ahead, and pressures on them to improve their ability to detect cancer appear certain to grow substantially.

The cover story of this issue deals with new developments in the diagnosis of prostate cancer by means of ultrasound, and the article provides valuable information for both generalists and specialist. The author, Dr. Sun Ho Kim, anticipates that 3D transrectal ultrasound may in the future be used in a number of other clinical applications. It may replace CT for the localization of brachytherapy seeds and help guide the implantation of probes during the cryoablation of localized prostate cancer. It may also be used to assess the prostate before and after treatment.

Kim thinks that 3D ultrasound has the potential to be superior to 2D ultrasound in prostate imaging. Local staging of cancers by this technique may be as accurate as MRI-based staging, and power Doppler and contrast enhancement can be used to increase diagnostic accuracy when lesions are isoechoic. Future research can help to identify additional clinical applications for this modality and refine 3D ultrasound techniques, according to the author.