Percutaneous MR-guided cryoablation of prostate cancer: initial experience

Gangi, Afshin; Tsoumakidou, Georgia; Abdelli, Omar; Buy, Xavier; Mathelin, Michel de; Jacqmin, Didier; Lang, Hervé

doi:10.1007/s00330-012-2411-8

Cited by 77 publications

(55 citation statements)

References 30 publications

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“…Gangi et al reported on 11 patients who underwent MRI-guided cryoablation of the entire prostate. With technical success in 10/11 patients, only one major complication with a spontaneously healing rectourethral fistula occurred [71]. Bomers et al reported similar data regarding focal MRI-guided cryoablation in the case of relapse after radiation therapy of prostate cancer.…”

Section: Prostatementioning

confidence: 77%

Current Technique and Application of Percutaneous Cryotherapy

Mahnken

König

Figiel

2018

Fortschr Röntgenstr

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ABSTR AC TPurpose Local ablative therapies have become an established treatment option in interventional oncology. Radiofrequency ablation (RFA) and microwave ablation (MWA) are a standard of care in the treatment of hepatocellular carcinoma (HCC). Currently, there is an increasing interest in cryotherapy, one of the oldest ablation techniques. It has some unique characteristics with regard to technology and mechanism of action.Materials and Methods A systematic literature search using the terms cryotherapy, cryosurgery and cryoablation was performed. Selected studies are presented dealing with the mechanism of action, cryobiology and clinical use of percutaneous, image-guided cryoablation. Recent developments and perspectives are presented.Results Cryotherapy is increasingly used and has been included in guidelines for selected tumor entities such as renal cell carcinoma. Cryo-immunotherapy and combination treatments are future areas of interest.Conclusion Cryoabalation may be used in many indications.Its major advantages are its unique visualization and the anesthesiologic effects of cold. While there are only a few prospectively randomized trials, the existing data on the use of cryoablation is promising. Its use appears to be justified in selected tumors, oligometastatic patients and for palliative indications.

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Section: Prostatementioning

confidence: 77%

Current Technique and Application of Percutaneous Cryotherapy

Mahnken

König

Figiel

2018

Fortschr Röntgenstr

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“…This is currently, possible performing cryosurgery under MRI guidance instead of transrectal ultrasound guidance. To date, only limited data about MRI-guided cryosurgery study of the prostate are available [14]. During the Laser Ablation Treatment, a laser fiber is positioned in the tumor under imaging guidance (ultrasound or MRI) destroying the tissue by the raising of the temperature than 60°C.…”

Section: Discussionmentioning

confidence: 99%

Focal therapy for localized unifocal and multifocal prostate cancer: A prospective development study using real time MR guided focused ultrasound

Napoli¹,

Caliolo²,

Boni³

et al. 2017

AIP Conference Proceedings

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Comparison between high-intensity focused ultrasound devices for the treatment of patients with localized prostate cancer AIP Conference Proceedings 1821, 030002 (2017) Abstract. To assess safety and feasibility of non-invasive high intensity 3T MR guided focused ultrasound (MRgFUS) treatment of localized prostate cancer in an exploratory designed study. Men aged 45-80 years were eligible for this prospective study if they had low-risk localized prostate cancer (prostate specific antigen [PSA] ≤10 ng/mL, Gleason score ≤ 3 + 3), with no previous androgen deprivation or treatment for prostate cancer, and who could safely undergo multiparametric MRI (Discovery 750, GE; Gd-Bopta, Bracco) and have a spinal anesthetic. Patients underwent focal therapy using real time MR guided high intensity focused ultrasound (MRgFUS), delivered to all known cancer lesions, with a margin of normal tissue. Primary endpoints were adverse events (serious and otherwise) and urinary symptoms and erectile function assessed using patient questionnaires. 8 men were recruited between June 2011 and June 2012. After treatment, one man was admitted to hospital for acute urinary retention. Another patient had self-resolving, mild, intermittent dysuria (median duration 5.0 days). Urinary tract infection was not reported. Urinary debris occurred in 6 men (75%), with a median duration of 12 days. Median overall International Index of Erectile Function-15 (IIEF-15) scores were similar at baseline and at 6 to 12 months (p=0.060), as were median IIEF-15 scores for intercourse satisfaction (p=0.433), sexual desire (p=0.622), and overall satisfaction (p=0.256). There was an improvement in lower urinary tract symptoms, assessed by International Prostate Symptom Score (IPSS), between baseline and 6 to 12 months (p=0.026). All 8 men with no baseline urinary incontinence were leak-free and pad-free by 9 months. No histological evidence of cancer was identified in 7 of 8 men biopsied at 6 months (87,5%); overall, the entire population (8 patients) was free of clinically significant cancer and had no evidence of disease on multi-parametric MRI at 6 to 12 months. MR guided Focused Ultrasound focal therapy of individual prostate cancer lesions, whether multifocal or unifocal, leads to a low rate of genitourinary side-effects and an encouraging rate of early absence of clinically significant prostate cancer.

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“…-20°C buz küresinin içerisin-dedir. Bu, buz küresinden daha küçük bir alanın nekroza gittiğini göstermiştir [52,53].…”

Section: Eği̇ti̇ci̇ Noktaunclassified