Twelve-month prostate volume reduction after MRI-guided transurethral ultrasound ablation of the prostate

Abstract

• MRI-guided transurethral ultrasound ablation (TULSA) achieved an 88% reduction of viable prostate tissue volume at 12 months, in excellent agreement with expectation from thermal dose calculations. • Non-perfused volume on immediate post-treatment contrast-enhanced MRI represents only 64% of the acute thermal ablation volume (ATAV), and reports only 60% (53% instead of 88% achieved) of the reduction in viable prostate tissue volume at 12 months. • MR-thermometry-based predictions of 12-month prostate volume reduction based on 240 cumulative equivalent minute thermal dose volume are in excellent agreement with reduction in viable prostate tissue volume measured on pre- and 12-month post-treatment T2w-MRI.

Development and clinical evaluation of a 3-step modified manipulation protocol for MRI-guided high-intensity focused ultrasound of uterine fibroids

“…The use of an endo-rectal coil is not a standard procedure at our center since it is expensive and sensitive to artifacts, but it was helpful in treating this large fibroid located in the recto-sigmoid region. The use of another endo-rectal device without a coil, but with a cooling system, has been previously described for MR-HIFU prostate treatment with the TULSA-PRO system [20]. However, this device is not inflatable and may therefore not provide enough pressure to move the fibroid anteriorly.…”

Magnetic resonance imaging‐guided transurethral ultrasound ablation in patients with localised prostate cancer: 3‐year outcomes of a prospective Phase I study

“…Treatment with TULSA Procedure MRI-guided TULSA of the prostate was delivered using the TULSA-PRO system (Profound Medical, Mississauga, ON, Canada) with the patient inside the bore of a 3-T MRI unit (Magnetom Trio, Siemens, Munich, Germany) as described previously [5,6]. The Urologist and Radiologist contoured the prostate from transverse MR images for treatment planning, monitored treatment delivery real time from live MRI temperature maps, and finally verified satisfactory treatment completion with gadolinium-enhanced post-treatment MR scan.…”

“…The first prospective evaluation of TULSA was a Phase I multicentre study of the safety and feasibility of near wholegland ablation in a primarily low-risk patient population [5,6]. Therein, the treatment plan was intentionally conservative, sparing a 3-mm rim of prostatic tissue from the capsule (equivalent to 10% of the prostate tissue volume remaining viable).…”

“…Therein, the treatment plan was intentionally conservative, sparing a 3-mm rim of prostatic tissue from the capsule (equivalent to 10% of the prostate tissue volume remaining viable). The 12-month primary safety endpoint (adverse event [AE] frequency and severity), secondary feasibility endpoint (ablation precision), and exploratory 12month quality-of-life (QoL) and efficacy endpoints have been reported [5], as well as the 12-month radiological prostate volume reduction [6].…”

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

“…Normal micturation function returned in all cases by 6 months . Bonekamp et al performed a review in 30 patients undergoing MR‐guided US ablation of the prostate and found that immediate posttreatment contrast MR imaging underrepresented the entire thermal ablation volume compared to that seen 12 months after the procedure. Burtnyk et al found 0.9‐mm accuracy and precision at necropsy in 8 patients undergoing transurethral prostate ablation using MR thermographic guidance.…”