Journal of vascular and interventional radiology : JVIR · 2025
MR-Guided Transrectal Focal Laser Ablation for Localized Low- and Intermediate-Risk Prostate Cancer: Initial Outcomes Using an Integrated Laser Ablation System.
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Wimper Yvonne, Te Molder Lauren P W, Sedelaar J P Michiel, Bomers Joyce G R, Overduin Christiaan G, Fütterer Jurgen J
Аннотация
PURPOSE: To investigate the feasibility and safety of magnetic resonance (MR) imaging-guided focal laser ablation (FLA) in localized, International Society of Urological Pathology (ISUP) Grade 1-3, prostate cancer (PCa) using an integrated system.
MATERIALS AND METHODS: Ten consecutive males (mean age, 66 years [SD ± 7]) with low-to-intermediate-risk PCa were prospectively included (April 2022-May 2023) and treated with MR imaging-guided FLA using an integrated system for laser energy control and MR thermometry monitoring. Primary end points were technical success, procedure-related adverse events (AEs) following Society of Interventional Radiology (SIR) classification, and 12-month local tumor progression-free survival, defined as no evident residual/recurrent disease on follow-up imaging or histopathology at the treatment site. Secondary end points included MR imaging-derived volumetric tumor coverage percentage, prostate-specific antigen (PSA) levels, and sexual and urinary function response measured by the Sexual Health Inventory for Men (SHIM) and International Prostate Symptom Score (IPSS) index questionnaires, respectively.
RESULTS: Technical success was achieved in all 10 (100%) patients (ISUP Grade 1, n = 1; Grade 2, n = 8; and Grade 3, n = 1). Three AEs were observed: urinary tract infection (n = 2; SIR Grade 2) and acute urinary retention (n = 1; SIR Grade 3). Cumulative 12-month local tumor progression-free survival was 80% (8/10 patients). Median tumor coverage was 100% (IQR, 95%-100%). Compared with baseline, the mean PSA level decreased, but did not reach statistical significance (6.6 vs 4.4 ng/mL; P = .06), and mean urinary (8.6 vs 7.3; P = 0.60) and sexual function (11.3 vs 10.5; P = 1.00) scores were nonsignificantly altered at 12-month follow-up.
CONCLUSIONS: MR imaging-guided FLA in patients with low-to-intermediate-risk PCa using an integrated system was feasible and safe and resulted in promising short-term oncologic and functional outcomes.
MATERIALS AND METHODS: Ten consecutive males (mean age, 66 years [SD ± 7]) with low-to-intermediate-risk PCa were prospectively included (April 2022-May 2023) and treated with MR imaging-guided FLA using an integrated system for laser energy control and MR thermometry monitoring. Primary end points were technical success, procedure-related adverse events (AEs) following Society of Interventional Radiology (SIR) classification, and 12-month local tumor progression-free survival, defined as no evident residual/recurrent disease on follow-up imaging or histopathology at the treatment site. Secondary end points included MR imaging-derived volumetric tumor coverage percentage, prostate-specific antigen (PSA) levels, and sexual and urinary function response measured by the Sexual Health Inventory for Men (SHIM) and International Prostate Symptom Score (IPSS) index questionnaires, respectively.
RESULTS: Technical success was achieved in all 10 (100%) patients (ISUP Grade 1, n = 1; Grade 2, n = 8; and Grade 3, n = 1). Three AEs were observed: urinary tract infection (n = 2; SIR Grade 2) and acute urinary retention (n = 1; SIR Grade 3). Cumulative 12-month local tumor progression-free survival was 80% (8/10 patients). Median tumor coverage was 100% (IQR, 95%-100%). Compared with baseline, the mean PSA level decreased, but did not reach statistical significance (6.6 vs 4.4 ng/mL; P = .06), and mean urinary (8.6 vs 7.3; P = 0.60) and sexual function (11.3 vs 10.5; P = 1.00) scores were nonsignificantly altered at 12-month follow-up.
CONCLUSIONS: MR imaging-guided FLA in patients with low-to-intermediate-risk PCa using an integrated system was feasible and safe and resulted in promising short-term oncologic and functional outcomes.