Percutaneous MR-guided whole-gland prostate cancer cryoablation: safety considerations and oncologic results in 30 consecutive patients

Marini, Pierre De; Cazzato, Roberto Luigi; Garnon, Julien; Tricard, Thibault; Koch, Guillaume; Tsoumakidou, Georgia; Ramamurthy, Nitin; Lang, Hervé; Gangi, Afshin

doi:10.1259/bjr.20180965

Cited by 11 publications

(11 citation statements)

References 34 publications

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“…The results of this study have been recently expanded by De Marini et al who investigated the safety and the oncologic results at mid-/long-term in a population of 30 consecutive patients (18 primary treatments; 12 salvage treatments) including the first 11 patients previously reported. 49 In this larger experience, the overall local progression-free survival (LPFS) in the whole population was 92.0%, 75.7% and 69.4% at 1-, 3- and 5 year follow-up, respectively. When stratified by treatment type, 1-, 3- and 5 year LPFS was 88.9%, 75.2%, and 67.7% in the primary treatment group and 100%, 75.0% and 75.0% in the salvage treatment group, respectively.…”

Section: Introductionmentioning

confidence: 81%

Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review

et al. 2019

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Prostate cancer (PCa) is the most common malignant tumor in males. The benefits in terms of overall reduction in specific mortality due to the widespread use of Prostate Specific Antigen (PSA) screening and the advancements in the curative treatments (radical prostatectomy or radiotherapy) appear to have reached a plateau. There remains, however, the questions of overdiagnosis and overtreatment of such patients. Currently, the main challenge in the treatment of patients with clinically organ-confined PCa is to offer an oncologically efficient treatment with as little morbidity as possible. Amongst the arising novel curative techniques for PCa, cryoablation (CA) is the most established one, which is also included in the NICE and AUA guidelines. CA is commonly performed under ultrasound guidance with the inherent limitations associated with this technique. The recent advancements in MRI have significantly improved the accuracy of detecting and characterizing a clinically significant PCa. This, alongside the development of wide bore interventional MR scanners, has opened the pathway for in bore PCa treatment. Under MRI guidance, PCa CA can be used either as a standard whole gland treatment or as a tumor targeted one. With MR-fluoroscopy, needle guidance capability, multiplanar and real-time visualization of the iceball, MRI eliminates the inherent limitations of ultrasound guidance and can potentially lead to a lower rate of local complications. The aim of this review article is to provide an overview about PCa CA with a more specific insight on MR guided PCa CA; the limitations, challenges and applications of this novel technique will be discussed.

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Section: Introductionmentioning

confidence: 81%

Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review

et al. 2019

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“…Under the MR imaging system, cryoprobes can be placed in solid tumors and lesions ablated by using real-time monitoring 147 . Like other noninvasive imaging modalities, MRI can be used to guide cryoablation in many tumor types, such as prostate cancer 148 , hepatic cancer 149 , and breast cancer 150 . One study took advantage of MRI sensitivity to water by adding saline to displace rectal wall from prostate during MRI-guided cryoablation of prostate cancer, which produced clear margin around the rectal wall, preventing intrusion of ice ball formation into the rectum 125 .…”

Section: Image-guided Cryoablation Cancer Therapymentioning

confidence: 99%

Recent progress in cryoablation cancer therapy and nanoparticles mediated cryoablation

Kwak¹,

B²,

Lewandowski³

et al. 2022

Theranostics

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With rapid advances in modern imaging, minimally invasive ablative procedures have emerged as popular alternatives to surgical removal of tumors. Tumor ablation modalities currently offered in clinical practice include microwave ablation, radiofrequency ablation, cryoablation, high-intensity focused ultrasound, and irreversible electroporation. Cryoablation, a non-heat-based method of ablation, is increasingly being used for treating various solid tumors. Accumulated comparative data of cryoablation versus heat-based ablation techniques (e.g., radiofrequency and microwave ablation) shows superior tumor response and quicker recovery time. Evolving research has demonstrated that nanocarriers may serves as excellent catalysts for the cryoablation therapy, imaging guidance, and the co-delivery of therapeutics for minimally invasive, precise, and complete treatment of cancer with immune modulation. This review article focuses on the current status of cryoablation in clinical practice, considers opportunities for enhancing therapeutic outcomes from cryoablation, and discusses new research in the field, including theranostic nanoparticles-mediated cryotherapy and combinational cryo-based immunotherapies.

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“…Together with multiplanar and high-resolution MR imaging, it offers precise tumor localization, multiplanar needle guidance, and precise monitoring of the ice ball. 11 However, the need for a calibration curve with the associated MR parameters is a limiting factor, as patient-specific parameters may be required. Furthermore, motion artifacts (breathing artifacts) can influence the accuracy of thermometry, since the recording time of a UTE sequence is about 1 min.…”

Section: Introductionmentioning

confidence: 99%

“…Magnetic resonance thermometry thus shows great potential for monitoring cryoablation in clinical application without the need of positioning additional temperature probes in the organ. Together with multiplanar and high‐resolution MR imaging, it offers precise tumor localization, multiplanar needle guidance, and precise monitoring of the ice ball 11 . However, the need for a calibration curve with the associated MR parameters is a limiting factor, as patient‐specific parameters may be required.…”

Section: Introductionmentioning

confidence: 99%

“…However, the need for a calibration curve with the associated MR parameters is a limiting factor, as patient‐specific parameters may be required. Furthermore, motion artifacts (breathing artifacts) can influence the accuracy of thermometry, since the recording time of a UTE sequence is about 1 min 11 . At the beginning of cryoablation, the temperature in the immediate vicinity of the cryoprobe drops exponentially, so that particularly adjacent high‐risk soft tissue must be monitored in shorter intervals.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the thermal sensitivity of porcine liver in CT‐guided cryoablation: an initial study

et al. 2020

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Purpose: To evaluate computed tomography (CT)-based thermometry in cryoablation, the thermal sensitivity of an ex-vivo porcine liver was determined in an initial study design. Methods: The CT-guided cryoablation was performed in three porcine liver samples over a period of 10 min. Fiber optic temperature probes were positioned parallel to the shaft of the cryoprobe in an axial slice orientation. During ablation, temperature measurements were performed simultaneously with CT imaging at 5 s intervals. On the CT images, the average CT number was calculated for a region of interest of 3 9 3 pixels just below the tip of each temperature probe. A linear regression analysis was performed using eleven data sets to determine the dependence of the CT number on the temperature. Results: With decreasing temperature, an increasing hypodense area around the tip of the cryoprobe was observed on the CT images and decreasing values of the CT number were determined. Starting at a temperature of À 40°C a linear relation between the CT number and the temperature was determined and a thermal sensitivity of 0.95 HU/°C (R 2 = 0.73) was obtained. The thermal sensitivity was used to calculate color-coded temperature maps. The calculated temperature distribution corresponds quantitatively to the increasing hypodense area. Conclusions: A noninvasive CT-based temperature determination during cryoablation in a normal ex vivo porcine liver is feasible. A thermal sensitivity of 0.95 HU/°C was determined by linear regression analysis. A color-coded map of the temperature distribution was presented.

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Percutaneous MR-guided whole-gland prostate cancer cryoablation: safety considerations and oncologic results in 30 consecutive patients

Cited by 11 publications

References 34 publications

Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review

Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review

Recent progress in cryoablation cancer therapy and nanoparticles mediated cryoablation

Evaluation of the thermal sensitivity of porcine liver in CT‐guided cryoablation: an initial study

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