Transurethral Microwave Thermotherapy

Nordenstam, Gunnar; Aspelin, Peter; Edsborg, Nick; Hallin, Anders; Berlin, Tomas

doi:10.1177/02841851960373p219

Cited by 3 publications

References 10 publications

(13 reference statements)

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Prostate thermal therapy: technologies and treatment strategies

Diederich

Nau

2000

SPIE Proceedings

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Benign prostatic hyperplasia is a frequent benign disease that often requires surgical intervention. Prostate cancer affects 250,000 men annually, with surgery and radiation therapy the common form of treatment. Numerous biological and clinical investigations have demonstrated that HT in the 41 -45 °C range can significantly enhance clinical responses to radiation therapy, and has potential for enhancing other therapies such as chemotherapy, immunotherapy, and gene therapy. Furthermore, high temperature hyperthermia (greater than 50 °C) alone is being used for selective tissue destruction as an alternative to conventional invasive surgery. Thermal techniques are being utilized to complement existing courses of treatment or provide minimally invasive alternative to surgery with less complications, and morbidity for each of these diseases. This article reviews a selection of heating technology and strategies specific to prostate thermal therapy, which are either in clinical use or currently under development. Transurethral, transrectal, and interstitial systems are discussed for RF current, laser, microwave, ultrasound, and thermal conduction heating technology.

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Prostate thermal therapy: technologies and treatment strategies

Diederich

Nau

2000

SPIE Proceedings

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Transurethral ultrasound applicators with directional heating patterns for prostate thermal therapy:In vivoevaluation using magnetic resonance thermometry

et al. 2004

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A catheter-based transurethral ultrasound applicator with angularly directional heating patterns has been designed for prostate thermal therapy and evaluated in canine prostate in vivo using MRI to monitor and assess performance. The ultrasound transducer array (3.5 mm diameter tubular transducers, 180 degrees active sectors, approximately 7.5 MHz) was integrated to a flexible delivery catheter (4 mm OD), and encapsulated within an expandable balloon (35 mm x 10 mm OD, 80 ml min(-1) ambient water) for coupling and cooling of the prostatic urethra. These devices were used to thermally coagulate targeted portions of the canine prostate (n = 2) while using MR thermal imaging (MRTI) to monitor the therapy. MRI was also used for target definition, positioning of the applicator, and evaluation of target viability post-therapy. MRTI was based upon the complex phase-difference mapping technique using an interleaved gradient echo-planar imaging sequence with lipid suppression. MRTI derived temperature distributions, thermal dose exposures, T1-contrast enhanced MR images, and histology of sectioned prostates were used to define destroyed tissue zones and characterize the three-dimensional heating patterns. The ultrasound applicators produced approximately 180 degrees directed zones of thermal coagulation within targeted tissue which extended 15-20 mm radially to the outer boundary of the prostate within 15 min. Transducer activation lengths of 17 mm and 24 mm produced contiguous zones of coagulation extending axially approximately 18 mm and approximately 25 mm from base to apex, respectively. Peak temperatures around 90 degrees C were measured, with approximately 50 degrees C-52 degrees C corresponding to outer boundary t43 = 240 min at approximately 15 min treatment time. These devices are MRI compatible, and when coupled with multiplanar MRTI provide a means for selectively controlling the length and sector angle of therapeutic thermal treatment in the prostate.

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