title: Real-time magnetic resonance-guided high-intensity focused ultrasound focal therapy for localised prostate cancer: preliminary experience.
abstract: Five patients with unifocal, biopsy-proven prostate cancer (PCa) evident on multiparametric magnetic resonance imaging (MRI) were treated with magnetic resonance-guided focused ultrasound (MRgFUS) ablation before radical prostatectomy (RP). An endorectal probe featuring a phased-array focused ultrasound transducer was positioned for lesion ablation under MRI guidance. The tissue temperature and accumulation of thermal damage in the target zone was monitored during the procedure by MRI thermometry. Overlap between the ablation area and the devascularisation of the target lesion was evaluated by contrast-enhanced MRI performed immediately after treatment. The procedure was uneventful, and no adverse events were observed. RP was safely performed without significant surgical difficulties in relation to the previous MRgFUS treatment. The histopathology report showed extensive coagulative necrosis, with no residual tumour in the ablated area. Significant bilateral residual tumour, not evident on pretreatment MRI, was observed outside the treated area in two patients. MRgFUS ablation of focal localised PCa is feasible and, if confirmed in appropriate studies, could represent a valid option for the focal treatment of localised PCa.
authors.affiliation: Department of Radiology, University "La Sapienza," Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Napoli
authors.forename: Michele
authors.initials: M
authors.lastname: Anzidei
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.forename: Gaia
authors.initials: G
authors.lastname: Cartocci
authors.forename: Valeria
authors.initials: V
authors.lastname: Panebianco
authors.forename: Carlo
authors.initials: C
authors.lastname: De Dominicis
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
authors.forename: Federico
authors.initials: F
authors.lastname: Petrucci
authors.forename: Costantino
authors.initials: C
authors.lastname: Leonardo
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D014463:Ultrasonography