Real-Time MRI-Guided Focused Ultrasound for Focal Therapy of Locally Confined Low-Risk Prostate Cancer: Feasibility and Preliminary Outcomes

Ghai, Sangeet; Louis, Alyssa; Vliet, Meghan Van; Lindner, Uri; Haider, Masoom A.; Hlasny, Eugen; Spensieri, Paula; Kwast, Theodorus H. van der; McCluskey, Stuart A.; Kucharczyk, Walter; Trachtenberg, John

doi:10.2214/ajr.14.13098

Cited by 45 publications

(34 citation statements)

References 31 publications

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“…Magnetic Resonance Imaging (MRI)-guided Focused Ultrasound (MRgFUS) is a non-invasive, non-ionizing ablation modality, which is used to treat various tumors [3–5], neuropathic pain [6] and painful bone metastasis [7]. Additionally, multiple research studies have focused on the ability of FUS to disrupt nerve conduction and cause necrosis of nerves [8, 9], including MRgFUS renal sympathetic denervation [10], abltation of sciatic [11, 12] and intercostal [13] nerves.…”

Section: Introductionmentioning

confidence: 99%

MRI-guided focused ultrasound ablation of lumbar medial branch nerve: Feasibility and safety study in a swine model

Kaye

Monette

Srimathveeravalli

et al. 2016

International Journal of Hyperthermia

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Purpose About 10–40% of chronic low back pain cases involve facet joints, which are commonly treated with lumbar medial branch (MB) radiofrequency neurotomy. Magnetic Resonance Imaging-guided Focused Ultrasound (MRgFUS), a non-invasive, non-ionizing ablation modality used to treat tumors, neuropathic pain and painful bone metastasis, can also be used to disrupt nerve conduction. This work’s purpose was to study the feasibility and safety of direct MRgFUS ablation of the lumbar MB nerve in acute and subacute swine models. Materials and Methods In vivo MRgFUS ablation was performed in six swine (3 acute and 3 subacute) using a clinical MRgFUS system (ExAblate 2000®; InSightec Ltd., Haifa, Israel) and 3 T MRI scanner (SIGNA; GE Healthcare, Waukesha, WI, USA) combination. Behavioral assessment was performed, and imaging and histology were used to assess the treatment. Results and Conclusions Histological analysis of the in vivo studies confirmed thermal necrosis of the MB nerve could be achieved without damaging the spinal cord or adjacent nerve roots. MRgFUS did not cause changes in the animals’ behavior and ambulation.

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Section: Introductionmentioning

confidence: 99%

MRI-guided focused ultrasound ablation of lumbar medial branch nerve: Feasibility and safety study in a swine model

Kaye

Monette

Srimathveeravalli

et al. 2016

International Journal of Hyperthermia

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“…mpMRI performed better than PSA measurements in the detection of residual tumor after therapy. Similar data for real-time MRI-guided focused ultrasound has been reported demonstrating the feasibility and low morbidity of this technique in focal therapy of localized low-risk prostrate cancer [84]. Le Nobin and colleagues found that a 9 mm treatment margin around the MRI visible lesion is needed to consistently ensure treatment of entire histological tumor volume during focal therapy [85].…”

Section: Imaging In Focal Therapymentioning

confidence: 64%

Multimodal imaging in focal therapy planning and assessment in primary prostate cancer

Jadvar

2017

Clin Transl Imaging

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Purpose There is increasing interest in focal therapy (male lumpectomy) of localized low-intermediate risk prostate cancer. Focal therapy is typically associated with low morbidity and provides the possibility of retreatment. Imaging is pivotal in stratification of men with localized prostate cancer for active surveillance, focal therapy or radical intervention. This article provides a concise review of focal therapy and the evolving role of imaging in this clinical setting. Methods We performed a narrative and critical literature review by searching PubMed/Medline database from January 1997 to January 2017 for articles in the English language and the use of search keywords “focal therapy”, “prostate cancer”, and “imaging”. Results Most imaging studies are based on multiparametric magnetic resonance imaging. Transrectal ultrasound is inadequate independently but multiparametric ultrasound may provide new prospects. Positron emission tomography with radiotracers targeted to various underlying tumor biological features may provide unprecedented new opportunities. Multimodal Imaging appears most useful in localization of intraprostatic dominant index lesions amenable to focal therapy, in early assessment of therapeutic efficacy and potential need for additional focal treatments or transition to whole-gland therapy, and in predicting short-term and long-term outcomes. Conclusion Multimodal imaging is anticipated to play an increasing role in the focal therapy planning and assessment of low-intermediate risk prostate cancer and thereby moving this form of treatment option forward in the clinic.

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“…Magnetic resonance guidance has advantages over US, particularly superior depiction of anatomic detail . Magnetic resonance thermometry depicts the changes that occur within hydrogen atoms when they are subjected to heat. These changes can be recorded with phase shift imaging, chemical shift imaging, diffusion, spectroscopy, or even contrast agents added to the tissues …”

Section: Magnetic Resonance Versus Us Guidance For Hifumentioning

confidence: 99%

Histotripsy: The Next Generation of High‐Intensity Focused Ultrasound for Focal Prostate Cancer Therapy

Dubinsky

Khokhlova

et al. 2019

J of Ultrasound Medicine

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This article reviews the most current methods and technological aspects of highintensity focused ultrasound (HIFU), which is termed histotripsy. The rationale for focal therapy for prostate carcinoma rather than prostatectomy, which is being used extensively throughout Europe and Asia, is presented, and an argument for why HIFU is the modality of choice for primary therapy and recurrent disease is offered. The article presents a review of the technical advances including higher ultrasound beam energy than current thermal HIFU which allows for more accurate tissue targeting, less collateral tissue damage, and faster treatment times. Finally, the article presents a discussion about the advantage of ultrasound guidance for histotripsy in preference to magnetic resonance imaging guidance primarily based on cost, ease of application, and portability.

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Real-Time MRI-Guided Focused Ultrasound for Focal Therapy of Locally Confined Low-Risk Prostate Cancer: Feasibility and Preliminary Outcomes

Abstract: MRI-guided focused ultrasound is a feasible method of noninvasively ablating low-risk prostate cancers with low morbidity. Further investigation and follow-up are warranted in a larger patient series with appropriate statistical analysis of oncologic and functional outcome measures.

Cited by 45 publications

References 31 publications

MRI-guided focused ultrasound ablation of lumbar medial branch nerve: Feasibility and safety study in a swine model

MRI-guided focused ultrasound ablation of lumbar medial branch nerve: Feasibility and safety study in a swine model

Multimodal imaging in focal therapy planning and assessment in primary prostate cancer

Histotripsy: The Next Generation of High‐Intensity Focused Ultrasound for Focal Prostate Cancer Therapy

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