Whole-Gland Prostate Cancer Cryoablation with Magnetic Resonance Imaging Guidance: One-Year Follow-Up

Kinsman, Kristin A.; White, Mariah L.; Mynderse, Lance A.; Kawashima, Akira; Rampton, Karen; Gorny, Krzysztof R.; Atwell, Thomas D.; Felmlee, Joel P.; Callstrom, Matthew R.; Woodrum, David A.

doi:10.1007/s00270-017-1799-6

Cited by 12 publications

(7 citation statements)

References 10 publications

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“…Kinsman et al also conducted a similar intervention on four patients with contraindications to standard therapies including one with recurrent PCa after RT. 31 All four patients in the series had undetectable PSA at 3–6 months post-CA and PSA remained undetectable at 12 months for all of the cases. 5 years follow-up data were available in two patients with PSA remaining undetectable.…”

Section: Introductionmentioning

confidence: 80%

Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review

et al. 2019

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Prostate cancer (PCa) is the most common malignant tumor in males. The benefits in terms of overall reduction in specific mortality due to the widespread use of Prostate Specific Antigen (PSA) screening and the advancements in the curative treatments (radical prostatectomy or radiotherapy) appear to have reached a plateau. There remains, however, the questions of overdiagnosis and overtreatment of such patients. Currently, the main challenge in the treatment of patients with clinically organ-confined PCa is to offer an oncologically efficient treatment with as little morbidity as possible. Amongst the arising novel curative techniques for PCa, cryoablation (CA) is the most established one, which is also included in the NICE and AUA guidelines. CA is commonly performed under ultrasound guidance with the inherent limitations associated with this technique. The recent advancements in MRI have significantly improved the accuracy of detecting and characterizing a clinically significant PCa. This, alongside the development of wide bore interventional MR scanners, has opened the pathway for in bore PCa treatment. Under MRI guidance, PCa CA can be used either as a standard whole gland treatment or as a tumor targeted one. With MR-fluoroscopy, needle guidance capability, multiplanar and real-time visualization of the iceball, MRI eliminates the inherent limitations of ultrasound guidance and can potentially lead to a lower rate of local complications. The aim of this review article is to provide an overview about PCa CA with a more specific insight on MR guided PCa CA; the limitations, challenges and applications of this novel technique will be discussed.

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Section: Introductionmentioning

confidence: 80%

Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review

et al. 2019

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“…Cryosurgery demonstrates high potential in oncology, in particular, to remove neoplasms and metastases of different localizations, such as liver, 37 breast, 55 lungs, 40 prostate, 56 kidney, 57 stomach, 58 and skin. 59 Considering the ability of THz technologies for tumor diagnosis along with currently developing THz instruments and methods for healthy and pathological tissues differentiation, 2 the combination of THz preoperative characterization of tissue with further TPS-controlled cryoablation could become an effective tool for oncology.…”

Section: Resultsmentioning

confidence: 99%

In situ terahertz monitoring of an ice ball formation during tissue cryosurgery: a feasibility test

et al. 2021

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Significance: Uncontrolled cryoablation of tissues is a strong reason limiting the wide application of cryosurgery and cryotherapy due to the certain risks of unpredicted damaging of healthy tissues. The existing guiding techniques are unable to be applied in situ or provide insufficient spatial resolution. Terahertz (THz) pulsed spectroscopy (TPS) based on sensitivity of THz time-domain signal to changes of tissue properties caused by freezing could form the basis of an instrument for observation of the ice ball formation.Aim: The ability of TPS for in situ monitoring of tissue freezing depth is studied experimentally.Approach: A THz pulsed spectrometer operated in reflection mode and equipped with a cooled sample holder and ex vivo samples of bovine visceral adipose tissue is applied. Signal spectrograms are used to analyze the changes of THz time-domain signals caused by the interface between frozen and unfrozen tissue parts.Results: Experimental observation of TPS signals reflected from freezing tissue demonstrates the feasibility of TPS to detect ice ball formation up to 657-μm depth.Conclusions: TPS could become the promising instrument for in situ control of cryoablation, enabling observation of the freezing front propagation, which could find applications in various fields of oncology, regenerative medicine, and THz biophotonics.

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“…Compared to ultrasound-guidance, MRI-guidance is more accurate as well as it makes biopsy-needles or cryoprobes positioning easier ( 7 - 10 ). In addition, it allows a real-time monitoring of the iceball.…”

Section: Discussionmentioning

confidence: 99%

“Prostate management” under MRI-guidance: 7 years of improvements

Tricard¹,

Garnon²,

Cazzato³

et al. 2020

Transl Cancer Res TCR

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Background The aim of this retrospective study is to represent our experience in percutaneous MRI-guided prostate procedures (biopsy and cryotherapy), and to discuss the improvement achieved in standardization of these procedures leading to a gain in feasibility and reproducibility of the technique used by urologists while handling MRI-environment. Methods From 2009 to 2018, 62 patients required MRI-guided prostate procedures in our institute. Throughout 9 years of experience, we have achieved an improvement of the technique used to protect the rectum and the urethra which increased accuracy and reproducibility. Procedures were performed by both urologists and radiologists under MRI guidance (Magnetom-Espree and Magnetom-Aera; Siemens, Erlangen, Germany) in a dedicated hybrid-room. Results Utilization of a patient stand and an acrylic needle-guided template created by Noras Company allowed standardization of the technique used and thus allowed an increase in accuracy. In order to protect the rectum, we inject patient’s own blood into the Denonvillier’s fascia which helps to dissect away the prostate from the rectum. In addition, the use of a thermocouple assistance probe placed in the urethral sphincter enabled urethral temperature monitoring during the entire procedure. The aim of temperature monitoring is to protect the urethra from possible thermal injuries. Conclusions Improvements achieved in our technique used in MRI guided prostate procedures may allow wide spread use of this technique in both radiological and urological fields and opens opportunities in the development of focal therapy of the prostate using MRI-guidance.

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Whole-Gland Prostate Cancer Cryoablation with Magnetic Resonance Imaging Guidance: One-Year Follow-Up

Cited by 12 publications

References 10 publications

Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review

Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review

In situ terahertz monitoring of an ice ball formation during tissue cryosurgery: a feasibility test

“Prostate management” under MRI-guidance: 7 years of improvements

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