Multiparametric magnetic resonance imaging and magnetic resonance imaging fusion-guided biopsy for the diagnosis of prostate cancer: current status

Мұқаба

Дәйексөз келтіру

Толық мәтін

Аннотация

This review explains the role of multiparametric magnetic resonance imaging, particularly in prostate biopsy, in the detection of prostate cancer. The use of multiparametric magnetic resonance imaging in the diagnosis of prostate cancer has also allowed its use in magnetic resonance imaging-guided biopsies, which according to many studies present high sensitivity and specificity in early diagnosis and staging, in patients with persistently high prostate-specific antigen levels despite previous negative prostate biopsies, and in the follow-up of patients under active surveillance.

To perform a targeted prostate biopsy, three types of magnetic resonance imaging guidance are available: cognitive fusion, direct magnetic resonance imaging-guided biopsy performed within a tomograph (in-bore biopsies), and software coregistration of stored magnetic resonance images with real-time ultrasound using a fusion device, with multiparametric magnetic resonance imaging findings digitally overlaid on real-time transrectal ultrasound images for targeted biopsy.

Each method has its advantages and disadvantages. Magnetic resonance imaging-targeted biopsy improves the quality of histological results compared with other approaches, with approximately 90% correct detection of significant index lesions. Correct staging allows the selection of the best therapeutic options, adequate evaluation of the prognosis, and reduction of the incidence of new biopsies and complications. The current objective is to make magnetic resonance imaging-guided biopsy increasingly available and standardize the technique to minimize inter-operator variability depending on the available system.

Толық мәтін

##article.viewOnOriginalSite##

Авторлар туралы

Valentina Testini

Foggia University; Monsignor Raffaele Dimiccoli

Email: testinivalentina@gmail.com
ORCID iD: 0000-0003-1231-5213

MD

Италия, Foggia; Barletta

Laura Eusebi

Carlo Urbani Hospital

Email: lauraeu@virgilio.it
ORCID iD: 0000-0002-4172-5126

MD

Италия, Jesi

Francesco Guerra

Foggia University

Email: francesco.rino@gmail.com
ORCID iD: 0000-0003-3923-3429

MD

Италия, Foggia

Willy Giannubilo

Ospedale Civile

Email: willygiannubilo@virgilio.it

MD

Италия, Civitanova Marche

Manuel Di Biase

Santa Maria della Misericordia Hospital

Email: manuel.dibiase@ospedale.perugia.it

MD

Италия, Perugia

Annunziata Russo

Monsignor Raffaele Dimiccoli

Email: tittyrusso-23@libero.it

MD

Италия, Barletta

Giuseppe Guglielmi

Foggia University; Monsignor Raffaele Dimiccoli; Casa Sollievo della Sofferenza Hospital

Хат алмасуға жауапты Автор.
Email: giuseppe.guglielmi@unifg.it
ORCID iD: 0000-0002-4325-8330

MD, Professor

Италия, Foggia; Barletta; Foggia

Әдебиет тізімі

  1. Mottet N, Bellmunt J, Bolla M, et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2017;71(4):618–629. doi: 10.1016/j.eururo.2016.08.003
  2. Siddiqui MM, Rais-Bahrami S, Truong H, et al. Magnetic resonance imaging/ultrasound-fusion biopsy significantly upgrades prostate cancer versus systematic 12-core transrectal ultrasound biopsy. Eur Urol. 2013;64(5):713–719. doi: 10.1016/j.eururo.2013.05.059
  3. Bjurlin MA, Meng X, Le Nobin J, et al. Optimization of prostate biopsy: the role of magnetic resonance imaging targeted biopsy in detection, localization and risk assessment. J Urol. 2014;192(3):648–658. doi: 10.1016/j.juro.2014.03.117
  4. [WITHDRAWN] Prostate cancer risk management programme (PCRMP): benefits and risks of PSA testing (guidance) [Internet]. UK: Public Health England; 2016. Available from: https://www.gov.uk/government/publications/prostate-cancer-risk-management-programme-psa-test-benefits-and-risks
  5. Hamoen EHJ, de Rooij M, Witjes JA, Barentsz JO, Rovers MM. Use of the Prostate Imaging Reporting and Data System (PI-RADS) for Prostate Cancer Detection with Multiparametric Magnetic Resonance Imaging: A Diagnostic Meta-analysis. Eur Urol. 2015;67(6):1112–1121. doi: 10.1016/j.eururo.2014.10.033
  6. Ventrella E, Eusebi L, Carpagnano FA, et al. Multiparametric MRI of Prostate Cancer: Recent Advances. Curr Radiol Rep. 2020;8. doi: 10.1007/s40134-020-00363-1
  7. Portalez D, Mozer P, Cornud F, et al. Validation of the European Society of Urogenital Radiology scoring system for prostate cancer diagnosis on multiparametric magnetic resonance imaging in a cohort of repeat biopsy patients. Eur Urol. 2012;62(6):986–996. doi: 10.1016/j.eururo.2012.06.044
  8. Kuru TH, Roethke MC, Rieker P, et al. Histology core-specific evaluation of the European Society of Urogenital Radiology (ESUR) standardised scoring system of multiparametric magnetic resonance imaging (mpMRI) of the prostate. BJU Int. 2013;112(8):1080–1087. doi: 10.1111/bju.12259
  9. Carpagnano F, Eusebi L, Tupputi U, et al. Multiparametric MRI: Local Staging of Prostate Cancer. Current Radiology Reports. 2020;8. doi: 10.1007/s40134-020-00374-y
  10. Arsov C, Rabenalt R, Blondin D, et al. Prospective randomized trial comparing magnetic resonance imaging (MRI)-guided in-bore biopsy to MRI-ultrasound fusion and transrectal ultrasound-guided prostate biopsy in patients with prior negative biopsies. Eur Urol. 2015;68(4):713–720. doi: 10.1016/j.eururo.2015.06.008
  11. Hambrock T, Somford DM, Hoeks C, et al. Magnetic resonance imaging guided prostate biopsy in men with repeat negative biopsies and increased prostate specific antigen. J Urol. 2010;183(2):520–527. doi: 10.1016/j.juro.2009.10.022
  12. Tyson MD, Arora SS, Scarpato KR, Barocas D. Magnetic resonance-ultrasound fusion prostate biopsy in the diagnosis of prostate cancer. Urol Oncol. 2016;34(7):326–332. doi: 10.1016/j.urolonc.2016.03.005
  13. Wolters T, Montironi R, Mazzucchelli R, et al. Comparison of incidentally detected prostate cancer with screen-detected prostate cancer treated by prostatectomy. Prostate. 2012;72(1):108–115. doi: 10.1002/pros.21415
  14. Moore CM, Robertson NL, Arsanious N, et al. Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol. 2013;63(1):125–140. doi: 10.1016/j.eururo.2012.06.004
  15. Puech P, Rouvière O, Renard-Penna R, et al. Prostate cancer diagnosis: multiparametric MR-targeted biopsy with cognitive and transrectal US-MR fusion guidance versus systematic biopsy — prospective multicenter study. Radiology. 2013;268(2):461–469. doi: 10.1148/radiol.13121501
  16. Labanaris AP, Engelhard K, Zugor V, Nützel R, Kühn R. Prostate cancer detection using an extended prostate biopsy schema in combination with additional targeted cores from suspicious images in conventional and functional endorectal magnetic resonance imaging of the prostate. Prostate Cancer Prostatic Dis. 2010;13(1):65–70. doi: 10.1038/pcan.2009.41
  17. Williams IS, McVey A, Perera S, et al. Modern paradigms for prostate cancer detection and management. Med J Aust. 2022;217(8):424–433. doi: 10.5694/mja2.51722
  18. Haffner J, Lemaitre L, Puech P, et al. Role of magnetic resonance imaging before initial biopsy: comparison of magnetic resonance imaging-targeted and systematic biopsy for significant prostate cancer detection. BJU Int. 2011;108(8 Pt 2):E171–E178. doi: 10.1111/j.1464-410X.2011.10112.x
  19. Labanaris AP, Zugor V, Smiszek R, et al. Guided e-MRI prostate biopsy can solve the discordance between Gleason score biopsy and radical prostatectomy pathology. Magn Reson Imaging. 2010;28(7):943–946. doi: 10.1016/j.mri.2010.03.041
  20. Stephenson SK, Chang EK, Marks LS. Screening and detection advances in magnetic resonance image-guided prostate biopsy. Urol Clin North Am. 2014;41(2):315–326. doi: 10.1016/j.ucl.2014.01.007
  21. Vourganti S, Rastinehad A, Yerram N, et al. Multiparametric magnetic resonance imaging and ultrasound fusion biopsy detect prostate cancer in patients with prior negative transrectal ultrasound biopsies. J Urol. 2012;188(6):2152–2157. doi: 10.1016/j.juro.2012.08.025
  22. Siddiqui MM, Rais-Bahrami S, Turkbey B, et al. Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA. 2015;313(4):390–397. doi: 10.1001/jama.2014.17942
  23. Quentin M, Schimmöller L, Arsov C, et al. 3-T in-bore MR-guided prostate biopsy based on a scoring system for target lesions characterization. Acta Radiol. 2013;54(10):1224–1229. doi: 10.1177/0284185113492972
  24. Hoeks CM, Schouten MG, Bomers JG, et al. Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol. 2012;62(5):902–909. doi: 10.1016/j.eururo.2012.01.047
  25. Marks L, Young S, Natarajan S. MRI-ultrasound fusion for guidance of targeted prostate biopsy. Curr Opin Urol. 2013;23(1):43–50. doi: 10.1097/MOU.0b013e32835ad3ee
  26. Monni F, Fontanella P, Grasso A, et al. Magnetic resonance imaging in prostate cancer detection and management: a systematic review. Minerva Urol Nefrol. 2017;69(6):567–578. doi: 10.23736/S0393-2249.17.02819-3
  27. Schlaier JR, Warnat J, Dorenbeck U, et al. Image fusion of MR images and real-time ultrasonography: evaluation of fusion accuracy combining two commercial instruments, a neuronavigation system and a ultrasound system. Acta Neurochir (Wien). 2004;146(3):271–276. doi: 10.1007/s00701-003-0155-6
  28. Pokorny MR, de Rooij M, Duncan E, et al. Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol. 2014;66(1):22–29. doi: 10.1016/j.eururo.2014.03.002
  29. Kuru TH, Roethke MC, Seidenader J, et al. Critical evaluation of magnetic resonance imaging targeted, transrectal ultrasound guided transperineal fusion biopsy for detection of prostate cancer. J Urol. 2013;190(4):1380–1386. doi: 10.1016/j.juro.2013.04.043
  30. Serefoglu EC, Altinova S, Ugras NS, et al. How reliable is 12-core prostate biopsy procedure in the detection of prostate cancer. Can Urol Assoc J. 2013;7(5-6):E293–E298. doi: 10.5489/cuaj.11224
  31. Baco E, Ukimura O, Rud E, et al. Magnetic resonance imaging-transectal ultrasound image-fusion biopsies accurately characterize the index tumor: correlation with step-sectioned radical prostatectomy specimens in 135 patients. Eur Urol. 2015;67(4):787–794. doi: 10.1016/j.eururo.2014.08.077
  32. Cerantola Y, Dragomir A, Tanguay S, et al. Cost-effectiveness of multiparametric magnetic resonance imaging and targeted biopsy in diagnosing prostate cancer. Urol Oncol. 2016;34(3):119.e1–119.e9. doi: 10.1016/j.urolonc.2015.09.010
  33. Delongchamps NB, Peyromaure M, Schull A, et al. Prebiopsy magnetic resonance imaging and prostate cancer detection: comparison of random and targeted biopsies. J Urol. 2013;189(2):493–499. doi: 10.1016/j.juro.2012.08.195
  34. Bax J, Cool D, Gardi L, et al. Mechanically assisted 3D ultrasound guided prostate biopsy system. Med Phys. 2008;35(12):5397–5410. doi: 10.1118/1.3002415
  35. US Preventive Services Task Force; Grossman DC, Curry SJ, et al. Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(18):1901–1913. Erratum in: JAMA. 2018;319(23):2443. doi: 10.1001/jama.2018.3710
  36. Arnsrud Godtman R, Holmberg E, Lilja H, Stranne J, Hugosson J. Opportunistic testing versus organized prostate-specific antigen screening: outcome after 18 years in the Göteborg randomized population-based prostate cancer screening trial. Eur Urol. 2015;68(3):354–360. doi: 10.1016/j.eururo.2014.12.006
  37. Engler J, Dahlhaus A, Güthlin C. The readiness of German GPs to recommend and conduct cancer screening is associated with patient-physician gender concordance. Results of a survey. Eur J Gen Pract. 2017;23(1):11–19. doi: 10.1080/13814788.2016.1240166
  38. Nordström T, Aly M, Clements MS, et al. Prostate-specific antigen (PSA) testing is prevalent and increasing in Stockholm County, Sweden, Despite no recommendations for PSA screening: results from a population-based study, 2003-2011. Eur Urol. 2013;63(3):419–425. doi: 10.1016/j.eururo.2012.10.001
  39. Van Poppel H, Roobol MJ, Chapple CR, et al. Prostate-specific Antigen Testing as Part of a Risk-Adapted Early Detection Strategy for Prostate Cancer: European Association of Urology Position and Recommendations for 2021. Eur Urol. 2021;80(6):703–711. doi: 10.1016/j.eururo.2021.07.024
  40. Mottet N, van den Bergh RCN, Briers E, et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2021;79(2):243–262. doi: 10.1016/j.eururo.2020.09.042
  41. Collen S, Van Poppel H. Early detection and diagnosis of prostate cancer in well informed men: the way forward for Europe. Belg J Med Oncol. 2020;14:321–326.
  42. Louie KS, Seigneurin A, Cathcart P, Sasieni P. Do prostate cancer risk models improve the predictive accuracy of PSA screening? A meta-analysis. Ann Oncol. 2015;26(5):848–864. doi: 10.1093/annonc/mdu525
  43. Ahmed HU, El-Shater Bosaily A, Brown LC, et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017;389(10071):815–822. doi: 10.1016/S0140-6736(16)32401-1
  44. Alberts AR, Schoots IG, Bokhorst LP, et al. Characteristics of Prostate Cancer Found at Fifth Screening in the European Randomized Study of Screening for Prostate Cancer Rotterdam: Can We Selectively Detect High-grade Prostate Cancer with Upfront Multivariable Risk Stratification and Magnetic Resonance Imaging. Eur Urol. 2018;73(3):343–350. doi: 10.1016/j.eururo.2017.06.019
  45. Palsdottir T, Nordstrom T, Karlsson A, et al. The impact of different prostate-specific antigen (PSA) testing intervals on Gleason score at diagnosis and the risk of experiencing false-positive biopsy recommendations: a population-based cohort study. BMJ Open. 2019;9(3):e027958. doi: 10.1136/bmjopen-2018-027958
  46. Wynants L, van Smeden M, McLernon DJ, et al. Three myths about risk thresholds for prediction models. BMC Med. 2019;17(1):192. doi: 10.1186/s12916-019-1425-3
  47. Sonn GA, Margolis DJ, Marks LS. Target detection: magnetic resonance imaging-ultrasound fusion-guided prostate biopsy. Urol Oncol. 2014;32(6):903–911. doi: 10.1016/j.urolonc.2013.08.006
  48. Sonn GA, Natarajan S, Margolis DJ, et al. Targeted biopsy in the detection of prostate cancer using an office based magnetic resonance ultrasound fusion device. J Urol. 2013;189(1):86–91. doi: 10.1016/j.juro.2012.08.095
  49. Robertson NL, Hu Y, Ahmed HU, et al. Prostate cancer risk inflation as a consequence of image-targeted biopsy of the prostate: a computer simulation study. Eur Urol. 2014;65(3):628–634. doi: 10.1016/j.eururo.2012.12.057
  50. Radtke JP, Schwab C, Wolf MB, et al. Multiparametric magnetic resonance imaging (MRI) and MRI — transrectal ultrasound fusion biopsy for index tumor detection: correlation with radical prostatectomy specimen. Eur Urol. 2016;70:846–853. doi: 10.1016/j.eururo.2015.12.052
  51. Schröder FH, Hugosson J, Roobol MJ, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014;384(9959):2027–2035. doi: 10.1016/S0140-6736(14)60525-0
  52. Roobol MJ, Steyerberg EW, Kranse R, et al. A risk-based strategy improves prostate-specific antigen-driven detection of prostate cancer. Eur Urol. 2010;57(1):79–85. doi: 10.1016/j.eururo.2009.08.025
  53. Meng X, Rosenkrantz AB, Mendhiratta N, et al. Relationship Between Prebiopsy Multiparametric Magnetic Resonance Imaging (MRI), Biopsy Indication, and MRI-ultrasound Fusion-targeted Prostate Biopsy Outcomes. Eur Urol. 2016;69(3):512–517. doi: 10.1016/j.eururo.2015.06.005
  54. Vargas HA, Hötker AM, Goldman DA, et al. Updated prostate imaging reporting and data system (PIRADS v2) recommendations for the detection of clinically significant prostate cancer using multiparametric MRI: critical evaluation using whole-mount pathology as standard of reference. Eur Radiol. 2016;26(6):1606–1612. doi: 10.1007/s00330-015-4015-6
  55. Radtke JP, Wiesenfarth M, Kesch C, et al. Combined Clinical Parameters and Multiparametric Magnetic Resonance Imaging for Advanced Risk Modeling of Prostate Cancer-Patient-tailored Risk Stratification Can Reduce Unnecessary Biopsies. Eur Urol. 2017;72(6):888–896. doi: 10.1016/j.eururo.2017.03.039
  56. van Leeuwen PJ, Hayen A, Thompson JE, et al. A multiparametric magnetic resonance imaging-based risk model to determine the risk of significant prostate cancer prior to biopsy. BJU Int. 2017;120(6):774–781. doi: 10.1111/bju.13814
  57. Muthigi A, George AK, Sidana A, et al. Missing the Mark: Prostate Cancer Upgrading by Systematic Biopsy over Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Biopsy. J Urol. 2017;197(2):327–334. doi: 10.1016/j.juro.2016.08.097
  58. Cash H, Günzel K, Maxeiner A, et al. Prostate cancer detection on transrectal ultrasonography-guided random biopsy despite negative real-time magnetic resonance imaging/ultrasonography fusion-guided targeted biopsy: reasons for targeted biopsy failure. BJU Int. 2016;118(1):35–43. doi: 10.1111/bju.13327
  59. Bryk DJ, Llukani E, Taneja SS, et al. The Role of Ipsilateral and Contralateral Transrectal Ultrasound-guided Systematic Prostate Biopsy in Men With Unilateral Magnetic Resonance Imaging Lesion Undergoing Magnetic Resonance Imaging-ultrasound Fusion-targeted Prostate Biopsy. Urology. 2017;102:178–182. doi: 10.1016/j.urology.2016.11.017
  60. Porpiglia F, De Luca S, Passera R, et al. Multiparametric Magnetic Resonance/Ultrasound Fusion Prostate Biopsy: Number and Spatial Distribution of Cores for Better Index Tumor Detection and Characterization. J Urol. 2017;198(1):58–64. doi: 10.1016/j.juro.2017.01.036
  61. Fütterer JJ, Briganti A, De Visschere P, et al. Can Clinically Significant Prostate Cancer Be Detected with Multiparametric Magnetic Resonance Imaging? A Systematic Review of the Literature. Eur Urol. 2015;68(6):1045–1053. doi: 10.1016/j.eururo.2015.01.013
  62. Thompson JE, Moses D, Shnier R, et al. Multiparametric magnetic resonance imaging guided diagnostic biopsy detects significant prostate cancer and could reduce unnecessary biopsies and over detection: a prospective study. J Urol. 2014;192(1):67–74. doi: 10.1016/j.juro.2014.01.014
  63. Delongchamps NB, Portalez D, Bruguière E, et al. Are Magnetic Resonance Imaging-Transrectal Ultrasound Guided Targeted Biopsies Noninferior to Transrectal Ultrasound Guided Systematic Biopsies for the Detection of Prostate Cancer. J Urol. 2016;196(4):1069–1075. doi: 10.1016/j.juro.2016.04.003
  64. Filson CP, Natarajan S, Margolis DJ, et al. Prostate cancer detection with magnetic resonance-ultrasound fusion biopsy: The role of systematic and targeted biopsies. Cancer. 2016;122(6):884–892. doi: 10.1002/cncr.29874
  65. Rosenkrantz AB, Verma S, Choyke P, et al. Prostate Magnetic Resonance Imaging and Magnetic Resonance Imaging Targeted Biopsy in Patients with a Prior Negative Biopsy: A Consensus Statement by AUA and SAR. J Urol. 2016;196(6):1613–1618. doi: 10.1016/j.juro.2016.06.079
  66. Simmons LAM, Kanthabalan A, Arya M, et al. The PICTURE study: diagnostic accuracy of multiparametric MRI in men requiring a repeat prostate biopsy. Br J Cancer. 2017;116(9):1159–1165. doi: 10.1038/bjc.2017.57
  67. Hansen NL, Kesch C, Barrett T, et al. Multicentre evaluation of targeted and systematic biopsies using magnetic resonance and ultrasound image-fusion guided transperineal prostate biopsy in patients with a previous negative biopsy. BJU Int. 2017;120(5):631–638. doi: 10.1111/bju.13711
  68. Radtke JP, Kuru TH, Bonekamp D, et al. Further reduction of disqualification rates by additional MRI-targeted biopsy with transperineal saturation biopsy compared with standard 12-core systematic biopsies for the selection of prostate cancer patients for active surveillance. Prostate Cancer Prostatic Dis. 2016;19(3):283–291. doi: 10.1038/pcan.2016.16
  69. Henderson DR, de Souza NM, Thomas K, et al. Nine-year Follow-up for a Study of Diffusion-weighted Magnetic Resonance Imaging in a Prospective Prostate Cancer Active Surveillance Cohort. Eur Urol. 2016;69(6):1028–1033. doi: 10.1016/j.eururo.2015.10.010
  70. Frye TP, George AK, Kilchevsky A, et al. Magnetic Resonance Imaging-Transrectal Ultrasound Guided Fusion Biopsy to Detect Progression in Patients with Existing Lesions on Active Surveillance for Low and Intermediate Risk Prostate Cancer. J Urol. 2017;197(3 Pt 1):640–646. doi: 10.1016/j.juro.2016.08.109
  71. Recabal P, Assel M, Sjoberg DD, et al. The Efficacy of Multiparametric Magnetic Resonance Imaging and Magnetic Resonance Imaging Targeted Biopsy in Risk Classification for Patients with Prostate Cancer on Active Surveillance. J Urol. 2016;196(2):374–381. doi: 10.1016/j.juro.2016.02.084
  72. Tran GN, Leapman MS, Nguyen HG, et al. Magnetic Resonance Imaging-Ultrasound Fusion Biopsy During Prostate Cancer Active Surveillance. Eur Urol. 2017;72(2):275–281. doi: 10.1016/j.eururo.2016.08.023

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
2. Fig. 1

Жүктеу (470KB)
3. Fig. 2

Жүктеу (171KB)
4. Fig. 3

Жүктеу (272KB)
5. Fig. 4

Жүктеу (236KB)

© Eco-Vector, 2024

Creative Commons License
Бұл мақала лицензия бойынша қол жетімді Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Осы сайт cookie-файлдарды пайдаланады

Біздің сайтты пайдалануды жалғастыра отырып, сіз сайттың дұрыс жұмыс істеуін қамтамасыз ететін cookie файлдарын өңдеуге келісім бересіз.< / br>< / br>cookie файлдары туралы< / a>