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Open Access 01-05-2017 | Original Article

MRI-guided focal laser ablation for prostate cancer followed by radical prostatectomy: correlation of treatment effects with imaging

Authors: Joyce G. R. Bomers, Erik B. Cornel, Jurgen J. Fütterer, Sjoerd F. M. Jenniskens, H. Ewout Schaafsma, Jelle O. Barentsz, J. P. Michiel Sedelaar, Christina A. Hulsbergen-van de Kaa, J. Alfred Witjes

Published in: World Journal of Urology | Issue 5/2017

Abstract

Purpose

To correlate treatment effects of MRI-guided focal laser ablation in patients with prostate cancer with imaging using prostatectomy as standard of reference.

Methods

This phase I study was approved by the Institutional Review Board. Three weeks prior to prostatectomy, five patients with histopathologically proven, low/intermediate grade prostate cancer underwent transrectal MRI-guided focal laser ablation. Per patient, only one ablation was performed to investigate the effect of ablation on the tissue rather than the effectiveness of ablation. Ablation was continuously monitored with real-time MR temperature mapping, and damage-estimation maps were computed. A post-ablation high-resolution T1-weighted contrast-enhanced sequence was acquired. Ablation volumes were contoured and measured on histopathology specimens (with a shrinkage factor of 1.15), T1-weighted contrast-enhanced images, and damage-estimation maps, and were compared.

Results

A significant volume correlation was seen between the ablation zone on T1-weighted contrast-enhanced images and the whole-mount histopathology section (r = 0.94, p = 0.018). The damage-estimation maps and histopathology specimen showed a correlation of r = 0.33 (p = 0.583). On histopathology, the homogeneous necrotic area was surrounded by a reactive transition zone (1–5 mm) zone, showing neovascularisation, and an increased mitotic index, indicating increased tumor activity.

Conclusions

The actual ablation zone was better indicated by T1-weighted contrast-enhanced than by damage-estimation maps. Histopathology results highlight the importance of complete tumor ablation with a safety margin.

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Title: MRI-guided focal laser ablation for prostate cancer followed by radical prostatectomy: correlation of treatment effects with imaging
Authors: Joyce G. R. Bomers
Erik B. Cornel
Jurgen J. Fütterer
Sjoerd F. M. Jenniskens
H. Ewout Schaafsma
Jelle O. Barentsz
J. P. Michiel Sedelaar
Christina A. Hulsbergen-van de Kaa
J. Alfred Witjes
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 5/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-016-1924-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MRI-guided focal laser ablation for prostate cancer followed by radical prostatectomy: correlation of treatment effects with imaging

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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