Transperineal radiofrequency interstitial tumor ablation of the prostate: Correlation of magnetic resonance imaging with histopathologic examination

Djavan, Bob; Zlotta, Alexandre R.; Susani, Martin; Heinz, Gertraud; Shariat, Shahrokh F.; Silverman, David; Schulman, Claude; Marberger, Michael

doi:10.1016/s0090-4295(97)00540-2

Cited by 83 publications

(39 citation statements)

References 13 publications

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“…The RFA of prostate cancer is also considered as a promising complement for surgery (3). In previous studies, the effectiveness and value of RFA in localized prostate cancer has been investigated (3,14). Although the results of initial studies were encouraging, various limitations still exist regarding this procedure.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation

Cao

Hu²,

Hu³

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to evaluate and compare the effectiveness of different imaging methods during follow-up of prostatic radiofrequency ablation. Prostatic radiofrequency ablation (RFA) was performed in 20 healthy beagle dogs. Various imaging examinations were used to monitor the results of RFA, including conventional ultrasound (US), contrast enhanced ultrasound (CEUS) and enhanced magnetic resonance (MR). Imaging exams were performed at five phases: Immediately following RFA, one week later, one month later, three months later and six months later. The morphology for each imaging test and histological results were recorded and compared in each phase. Based on the actual results from autopsy, the accuracy of those imaging exams was evaluated. The canine prostate gland demonstrated typical coagulative necrosis immediately following RFA. The lesion would develop into stable cyst if no other complications occurred within the six-month follow-up. Regarding the RFA lesion volume measurement and the reflection of pathological changes, conventional US was not able to accurately measure the volume of RFA lesion and missed many more details concerning the RFA-treated area than CEUS and MR during the three months. The results from CEUS exhibited comparable accuracy to those from enhanced MR at each phase. However, there were no significant differences in the results from US, CEUS and MR at six months, which may contribute to the complete formation of lesion cyst. In the early phase, conventional US was not sufficient for evaluating the efficacy of RFA. Enhanced US and MR provided clear images and accurate information. However, CEUS has the advantage of being more economical, using more convenient equipment and faster scanning, thus identifying it as the more feasible choice. Furthermore, no notable advantages were observed among any image examinations in the long-term follow-up. IntroductionThe worldwide incidence of prostate cancer has been rising in recent years and prostate cancer has become a major threat for aged male populations. Each year, ~914,000 new cases are diagnosed, and 258,000 cases lead to mortality (1). At present, radical prostatectomy is the standard treatment for localized prostate cancer; however, this surgical procedure may have a notable negative impact on patients, such as incontinence or erectile dysfunction (2). Radiofrequency ablation (RFA) is gaining popularity as a method of treating prostate diseases, as it is an interventional therapy that causes less trauma, quicker recovery and fewer complications (3).In order to obtain results from RFA, the use of a real-time prostatic imaging monitor is necessary. At present, conventional transrectal ultrasound (US) is typically used for guiding prostate RFA, allowing the procedure to be visualized in real time. However, the indication of RFA is vague and the accuracy of imaging results is not reliable (3,4). In addition to conventional US, contrast enhanced US (CEUS) and enhanced magnetic resonance (MR) have also been considered ...

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Section: Discussionmentioning

confidence: 99%

Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation

Cao

Hu²,

Hu³

et al. 2017

Experimental and Therapeutic Medicine

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“…After ablation, MR contrast media provide moderate to intense enhancement of the rim surrounding the thermally ablated tissue. In a prostate cancer study, RFA ablated lesions appear hypoenhanced after gadolinium injection [42] . Similarly, Goldberg and Dupuy observed a lack of contrast enhancement after gadolinium injection in ablated liver metastasis [43] .…”

Section: Tissue Ablationmentioning

confidence: 99%

Value of MR contrast media in image-guided body interventions

Saeed¹

2012

WJR

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In the past �ew years, there have been multiple advances in magnetic resonance (MR) instrumentation, in vivo devices, real-time imaging sequences and interventional procedures with new therapies. More recently, interventionists have started to use minimally invasive image-guided procedures and local therapies, which reduce the pain �rom conventional surgery and increase drug e��ectiveness, respectively. Local therapy also reduces the systemic dose and eliminates the toxic side e��ects o� some drugs to other organs. The success o� MR-guided procedures depends on visualization o� the targets in 3D and precise deployment o� ablation catheters, local therapies and devices. MR contrast media provide a wealth o� tissue contrast and allows 3D and 4D image acquisitions. A�ter the development o� �ast imaging sequences, the clinical applications o� MR contrast media have been substantially expanded to include pre-during-and post-interventions. �rior to intervention, MR contrast media have the potential to localize and delineate pathologic tissues o� vital organs, such as the brain, heart, breast, kidney, prostate, liver and uterus. They also o��er other options such as labeling therapeutic agents or cells. During intervention, these agents have the capability to map blood vessels and enhance the contrast between the endovascular guidewire/catheters/devices, blood and tissues as well as direct therapies to the target. Furthermore, labeling therapeutic agents or cells aids in visualizing their delivery sites and tracking their tissue distribution. A�ter intervention, MR contrast media have been used �or assessing the efficacy of ablation and therapies. It should be noted that most image-guided procedures are under preclinical research and development. It can be concluded that MR contrast media have great value in preclinical and some clinical interventional procedures. Future applications o� MR contrast media in image-guided procedures depend on their sa�ety, tolerability, tissue speci�icity and e��ectiveness in demonstrating success o� the interventions and therapies.

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“…14 Radiofrequency interstitial tumor ablation has been used to treat primary or metastatic liver neoplasms in patients unsuitable for surgery, with encouraging results, [15][16][17][18] and has recently been proposed for use the treatment of prostate cancer. [7][8][9][10] The histopathological effects of RITA treatments have received little attention so far, however. Some authors 8 have reported finding sharply defined margins of necrosis, although they also found two cases with a patchy pattern of necrosis, with an inadequate cooling phase.…”

Section: Histopathological Findings After Rfmentioning

confidence: 99%

“…[7][8][9][10] The histopathological effects of RITA treatments have received little attention so far, however. Some authors 8 have reported finding sharply defined margins of necrosis, although they also found two cases with a patchy pattern of necrosis, with an inadequate cooling phase. The question of whether RITA-induced tissue lesions are truly necrotic in nature also remains to be clarified.…”

Section: Histopathological Findings After Rfmentioning

confidence: 99%

“…4 In urology, treatment based on the delivery of low-level RF energy at a high temperature, has been claimed to be a good alternative to classic surgery in the treatment of benign prostatic hyperplasia [4][5][6] and carcinoma. [7][8][9][10] The aim of our pilot study was to evaluate the histopathology of thermal lesions induced by RF energy delivered interstitially (radiofrequency interstitial tumor ablation, RITA) in prostate cancer patients scheduled for radical prostatectomy, and to comment on the feasibility and the safety of this method.…”

Section: Introductionmentioning

confidence: 99%

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Histopathological findings after radiofrequency (RITA) treatment for prostate cancer

Patriarca

Bergamaschi

Gazzano

et al. 2006

Prostate Cancer Prostatic Dis

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Radiofrequency interstitial tumor ablation (RITA) is a thermal ablation method that uses needles and low radiofrequency (RF) energy. The aim of our study was to evaluate the histopathology of thermal lesions induced by RF energy delivered interstitially in prostate cancer patients who subsequently underwent prostatectomy, and to determine the feasibility, effectiveness and safety of this new method in a pilot study.

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Transperineal radiofrequency interstitial tumor ablation of the prostate: Correlation of magnetic resonance imaging with histopathologic examination

Cited by 83 publications

References 13 publications

Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation

Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation

Value of MR contrast media in image-guided body interventions

Histopathological findings after radiofrequency (RITA) treatment for prostate cancer

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