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European Radiology
Published in: European Radiology 1/2021

01-01-2021 | Prostate Cancer | Urogenital

T2*-weighted MRI as a non-contrast-enhanced method for assessment of focal laser ablation zone extent in prostate cancer thermotherapy

Authors: Chongpeng Sun, Shiyang Wang, Aritrick Chatterjee, Milica Medved, Scott Eggener, Gregory S. Karczmar, Aytekin Oto

Published in: European Radiology | Issue 1/2021

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Abstract

Objectives

To evaluate utility of T2*-weighted (T2*W) MRI as a tool for intra-operative identification of ablation zone extent during focal laser ablation (FLA) of prostate cancer (PCa), as compared to the current standard of contrast-enhanced T1-weighted (T1W) MRI.

Methods

Fourteen patients with biopsy-confirmed low- to intermediate-risk localized PCa received MRI-guided (1.5 T) FLA thermotherapy. Following FLA, axial multiple-TE T2*W images, diffusion-weighted images (DWI), and T2-weighted (T2W) images were acquired. Pre- and post-contrast T1W images were also acquired to assess ablation zone (n = 14) extent, as reference standard. Apparent diffusion coefficient (ADC) maps and subtracted contrast-enhanced T1W (sceT1W) images were calculated. Ablation zone regions of interest (ROIs) were outlined manually on all ablated slices. The contrast-to-noise ratio (CBR) of the ablation site ROI relative to the untreated contralateral prostate tissue was calculated on T2*W images and ADC maps and compared to that in sceT1W images.

Results

CBRs in ablation ROIs on T2*W images (TE = 32, 63 ms) did not differ (p = 0.33, 0.25) from those in sceT1W images. Bland–Altman plots of ROI size and CBR in ablation sites showed good agreement between T2*W (TE = 32, 63 ms) and sceT1W images, with ROI sizes on T2*W (TE = 63 ms) strongly correlated (r = 0.64, p = 0.013) and within 15% of those in sceT1W images.

Conclusions

In detected ablation zone ROI size and CBR, non-contrast-enhanced T2*W MRI is comparable to contrast-enhanced T1W MRI, presenting as a potential method for intra-procedural monitoring of FLA for PCa.

Key Points

• T2*-weighted MR images with long TE visualize post-procedure focal laser ablation zone comparably to the contrast-enhanced T1-weighted MRI.
• T2*-weighted MRI could be used as a plausible method for repeated intra-operative monitoring of thermal ablation zone in prostate cancer, avoiding potential toxicity due to heating of contrast agent.
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Metadata
Title
T2*-weighted MRI as a non-contrast-enhanced method for assessment of focal laser ablation zone extent in prostate cancer thermotherapy
Authors
Chongpeng Sun
Shiyang Wang
Aritrick Chatterjee
Milica Medved
Scott Eggener
Gregory S. Karczmar
Aytekin Oto
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07127-7

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