Prostate Cancer Ablation with Transrectal High-Intensity Focused Ultrasound: Assessment of Tissue Destruction with Contrast-enhanced US

Rouvière, Olivier; Glas, L.; Girouin, N.; Mège‐Lechevallier, Florence; Gelet, A.; Dantony, Emmanuelle; Rabilloud, Muriel; Chapelon, Jean‐Yves; Lyonnet, D.

doi:10.1148/radiol.11101489

Cited by 42 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For instance, DCE-US was found to map tissue devascularisation as well as DCE-MRI after interstitial laser therapy [61, 62]. DCE-US has, therefore, been used for interstitial laser therapy [63] and high-intensity focused US treatment to visualize viable and devascularized regions [64, 65]. Apart from the classifier’s aid for tumour localization and monitoring, the ability of such classifier to discriminate low-risk and high-risk disease would especially improve the application of focal therapy and active surveillance strategies.…”

Section: Discussionmentioning

confidence: 99%

Multiparametric dynamic contrast-enhanced ultrasound imaging of prostate cancer

et al. 2016

View full text Add to dashboard Cite

ObjectivesThe aim of this study is to improve the accuracy of dynamic contrast-enhanced ultrasound (DCE-US) for prostate cancer (PCa) localization by means of a multiparametric approach.Materials and MethodsThirteen different parameters related to either perfusion or dispersion were extracted pixel-by-pixel from 45 DCE-US recordings in 19 patients referred for radical prostatectomy. Multiparametric maps were retrospectively produced using a Gaussian mixture model algorithm. These were subsequently evaluated on their pixel-wise performance in classifying 43 benign and 42 malignant histopathologically confirmed regions of interest, using a prostate-based leave-one-out procedure.ResultsThe combination of the spatiotemporal correlation (r), mean transit time (μ), curve skewness (κ), and peak time (PT) yielded an accuracy of 81% ± 11%, which was higher than the best performing single parameters: r (73%), μ (72%), and wash-in time (72%). The negative predictive value increased to 83% ± 16% from 70%, 69% and 67%, respectively. Pixel inclusion based on the confidence level boosted these measures to 90% with half of the pixels excluded, but without disregarding any prostate or region.ConclusionsOur results suggest multiparametric DCE-US analysis might be a useful diagnostic tool for PCa, possibly supporting future targeting of biopsies or therapy. Application in other types of cancer can also be foreseen.Key points• DCE-US can be used to extract both perfusion and dispersion-related parameters.• Multiparametric DCE-US performs better in detecting PCa than single-parametric DCE-US.• Multiparametric DCE-US might become a useful tool for PCa localization.

show abstract

Section: Discussionmentioning

confidence: 99%

Multiparametric dynamic contrast-enhanced ultrasound imaging of prostate cancer

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The ability of contrast enhanced imaging, either ultrasound or MRI to visualize necrotic tissue permits initial assessment of FT 41 . Several studies 3,8,9 converge by defining oncologic success of FT as negative biopsy at the treated area.…”

Section: Discussionmentioning

confidence: 99%

3D Registration of mpMRI for Assessment of Prostate Cancer Focal Therapy

et al. 2017

View full text Add to dashboard Cite

Purpose To assess a novel method of 3D co-registration of prostate MRI exams performed before and after prostate cancer focal therapy. Material and method We developed a software platform for automatic 3D deformable coregistration of prostate MRI at different time points and applied this method to ten patients who underwent focal ablative therapy. MRI exams were performed preoperatively, as well as one week and six months posttreatment. Rigid registration served as reference for assessing coregistration accuracy and precision. Results Segmentation of preoperative and postoperative prostate revealed a significant post-operative volume decrease of the gland that averaged 6.49 cc (p=0.017). Applying deformable transformation based upon Mutual Information (MI) from 120 pairs of MRI slices, we refined by 2.9 mm (max 6.25mm) the alignment of the ablation zone (AZ), segmented from contrastenhanced images on the one-week post-operative exam, to the 6-month postoperative T2-weighted images. This represented a 500% improvement over the rigid approach (p=0.001), corrected by volume. The dissimilarity by Dice index of the mapped AZ using deformable transformation vs. rigid control was significantly (p=0.04) higher at the ablation site compared to the whole gland. Conclusion Our findings illustrate our method's ability to correct for deformation at the ablation site. The preliminary analysis suggests that deformable transformation computed from MI of preoperative and follow-up MRI is accurate in co-registration of MRI exams performed before and after focal therapy. The ability to localize the previously ablated tissue in 3D space may improve targeting for image-guided follow-up biopsy within focal therapy protocols.

show abstract

“…CEUS can also be used to monitor HIFU irradiation and to evaluate lesions after HIFU ablation [17]. Because changes of the acoustic attenuation coefficient and the backscatter coefficient that occur after HIFU irradiation in tissues are not significant compared with the surrounding normal tissue, the boundaries of HIFU ablation lesions are often not clearly displayed on B-mode images [18, 19]. In this study, an HIFU acoustic energy dose at the sub-threshold ablation temperature was used, and the tissue temperature was not raised above 60° C. No significant ultrasound imaging changes were observed after tissue injury, and xenografts before and after irradiation showed low to very low echo in the B-mode US images.…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasound evaluation of pancreatic cancer xenografts in nude mice after irradiation with sub-threshold focused ultrasound for tumor ablation

Gao¹,

Wu²,

Wang³

et al. 2017

Oncotarget

View full text Add to dashboard Cite

We evaluated the efficacy of contrast-enhanced ultrasound for assessing tumors after irradiation with sub-threshold focused ultrasound (FUS) ablation in pancreatic cancer xenografts in nude mice. Thirty tumor-bearing nude mice were divided into three groups: Group A received sham irradiation, Group B received a moderate-acoustic energy dose (sub-threshold), and Group C received a high-acoustic energy dose. In Group B, B-mode ultrasound (US), color Doppler US, and dynamic contrast-enhanced ultrasound (DCE-US) studies were conducted before and after irradiation. After irradiation, tumor growth was inhibited in Group B, and the tumors shrank in Group C. In Group A, the tumor sizes were unchanged. In Group B, contrast-enhanced ultrasound (CEUS) images showed a rapid rush of contrast agent into and out of tumors before irradiation. After irradiation, CEUS revealed contrast agent perfusion only at the tumor periphery and irregular, un-perfused volumes of contrast agent within the tumors. DCE-US perfusion parameters, including peak intensity (PI) and area under the curve (AUC), had decreased 24 hours after irradiation. PI and AUC were increased 48 hours and 2weeks after irradiation. Time to peak (TP) and sharpness were increased 24 hours after irradiation. TP decreased at 48 hours and 2 weeks after irradiation. CEUS is thus an effective method for early evaluation after irradiation with sub-threshold FUS.

show abstract

Prostate Cancer Ablation with Transrectal High-Intensity Focused Ultrasound: Assessment of Tissue Destruction with Contrast-enhanced US

Abstract: Contrast-enhanced US is a promising tool for distinguishing between ablated (devascularized) and viable (enhancing) tissue immediately after HIFU treatment.

Cited by 42 publications

References 24 publications

Multiparametric dynamic contrast-enhanced ultrasound imaging of prostate cancer

Multiparametric dynamic contrast-enhanced ultrasound imaging of prostate cancer

3D Registration of mpMRI for Assessment of Prostate Cancer Focal Therapy

Contrast-enhanced ultrasound evaluation of pancreatic cancer xenografts in nude mice after irradiation with sub-threshold focused ultrasound for tumor ablation

Contact Info

Product

Resources

About