title: Percutaneous MR-guided cryoablation of prostate cancer: initial experience.
abstract: OBJECTIVE
  We report our initial experience and the technical feasibility of transperineal prostate cryoablation under MR guidance.
  
  
  METHODS
  Percutaneous MR-guided cryoablation was performed in 11 patients with prostatic adenocarcinoma contraindicated for surgery (mean age: 72 years, mean Gleason score: 6.45, mean prostate-specific antigen (PSA): 6.21 ng/ml, T1-2c/N0/M0, mean: prostate volume 36.44 ml). Free-hand probe positioning was performed under real-time MR imaging. Four to seven cryoprobes were inserted into the prostate, depending on gland volume. The ice ball was monitored using real-time and high-resolution BLADE multi-planar imaging. Patients were followed at 1, 3, 6, 9 and 12 months after the procedure with serum PSA level and post-ablation MRI.
  
  
  RESULTS
  Prostate cryoablation was technically feasible in 10/11 patients. The ice ball was clearly and sharply visualised in all cases as a signal-void area. Mean ice-ball volume was 53.3 ml. Mean follow-up was 15 months (range: 1-25). Mean PSA nadir was 0.33 ng/ml (range: 0.02-0.94 ng/ml). Mean hospitalisation was 5 days (range: 3-13). Complications included a urethro-rectal fistula, urinary infection, transient dysuria and scrotal pain.
  
  
  CONCLUSIONS
  MR-guided prostate cryoablation is feasible and promising, with excellent monitoring of the ice ball. Future perspectives could include the use of MR guidance for focal prostate cancer cryotherapy.
  
  
  CONCLUSIONS
  • Magnetic resonance allows precise positioning of cryoprobes with real-time imaging. • High-resolution MRI allows excellent monitoring of the developing ice ball. • Cryoablation of prostate cancer under MR guidance is technically feasible. • Further work will refine the procedure and make it even safer.
authors: Department of Interventional Radiology, University Hospital of Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg, France. gangi@unistra.fr
authors: Afshin
authors: A
authors: Gangi
authors: Georgia
authors: G
authors: Tsoumakidou
authors: Omar
authors: O
authors: Abdelli
authors: Xavier
authors: X
authors: Buy
authors: Michel
authors: M
authors: de Mathelin
authors: Didier
authors: D
authors: Jacqmin
authors: Hervé
authors: H
authors: Lang
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000368:Aged; D001706:Biopsy; D003452:Cryosurgery / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011471:Prostatic Neoplasms / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen