title: MRI and contrast-enhanced ultrasound imaging for evaluation of focal irreversible electroporation treatment: results from a phase I-II study in patients undergoing IRE followed by radical prostatectomy.
abstract: OBJECTIVE
  Irreversible electroporation (IRE) is an ablative therapy with a low side-effect profile in prostate cancer. The objective was: 1) To compare the volumetric IRE ablation zone on grey-scale transrectal ultrasound (TRUS), contrast-enhanced ultrasound (CEUS) and multiparametric MRI (mpMRI) with histopathology findings; 2) To determine a reliable imaging modality to visualize the IRE ablation effects accurately.
  
  
  METHODS
  A prospective phase I-II study was performed in 16 patients scheduled for radical prostatectomy (RP). IRE of the prostate was performed 4 weeks before RP. Prior to, and 4 weeks after the IRE treatment, imaging was performed by TRUS, CEUS, and mpMRI. 3D-analysis of the ablation volumes on imaging and on H&E-stained whole-mount sections was performed. The volumes were compared and the correlation was calculated.
  
  
  RESULTS
  Evaluation of the imaging demonstrated that with T2-weighted MRI, dynamic contrast enhanced (DCE) MRI, and CEUS, effects of IRE are visible. T2MRI and CEUS closely match the volumes on histopathology (Pearson correlation r = 0.88 resp. 0.80). However, IRE is not visible with TRUS.
  
  
  CONCLUSIONS
  mpMRI and CEUS are appropriate for assessing IRE effects and are the most feasible imaging modalities to visualize IRE ablation zone. The imaging is concordant with results of histopathological examination.
  
  
  CONCLUSIONS
  • mpMRI and contrast-enhanced ultrasound are appropriate imaging modalities for assessing IRE effects • mpMRI and CEUS are the most feasible imaging modalities to visualize IRE ablation zone • The imaging is concordant with results of histopathological examination after IRE • Grey-scale US is insufficient for assessing IRE ablations.
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands. w.vandenbos@amc.uva.nl.|Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. w.vandenbos@amc.uva.nl.
authors.forename: Willemien
authors.initials: W
authors.lastname: van den Bos
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.|Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: D M
authors.initials: DM
authors.lastname: de Bruin
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: van Randen
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: M R W
authors.initials: MR
authors.lastname: Engelbrecht
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: A W
authors.initials: AW
authors.lastname: Postema
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: B G
authors.initials: BG
authors.lastname: Muller
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, 1 Sismanogliou Street, 151 26, Marousi, Greece.
authors.forename: I M
authors.initials: IM
authors.lastname: Varkarakis
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio General Hospital, 1 Sismanogliou Street, 151 26, Marousi, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Skolarikos
authors.affiliation: Department of Pathology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: C D
authors.initials: CD
authors.lastname: Savci-Heijink
authors.affiliation: Department of Pathology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: R R
authors.initials: RR
authors.lastname: Jurhill
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: Zondervan
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Laguna Pes
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.|Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Wijkstra
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: T M
authors.initials: TM
authors.lastname: de Reijke
authors.affiliation: Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: J J M C H
authors.initials: JJ
authors.lastname: de la Rosette
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D018274:Electroporation / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery / Q000628:therapy*; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Focal therapy; IRE; Imaging; Irreversible electroporation; Prostate cancer