1.5T MRI-guided trans-perineal laser ablation of locally recurrent prostate adenocarcinoma

E. Frederick McPhail, Lance A. Mynderse, Matthew R. Callstrom, Krzysztof R. Gorny, Roger J. McNichols, Thomas D. Atwell, Matthew T. Gettman, Kimberly K. Amrami, Akira Kawashima, David A. Woodrum

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Introduction: Biochemical recurrence of prostate cancer after definitive therapy with radical prostatectomy (RP) is known to occur between 25-30%. We present the first known case of 1.5T MRI guided ablation using laser interstitial thermal therapy (LITT) for locally recurrent prostate cancer following RP. Methods: The patient elected to undergo MRI-guided LITT of the biopsy proven cancer recurrence using an FDAapproved MRI compatible, 980nm, 15-watt laser system with MR thermometry. Under T2-weighted MR(1.5T Siemens) imaging, guidance and targeting of the lesions with trans-perineal placement of laser applicators. Multiple cycles of laser energy were used to ablate the tumor. A MRI-compatible urethral cooling catheter was placed to prevent urethral thermal damage. Results: Intra-procedural temperature mapping allowed continuous monitoring of the ablation zone and permitted ablation control until tumor coverage was achieved. Additionally, the protective cooling effects of the urethral cooling catheter could also be seen with the temperature mapping. Post-ablation gadolinium and T2 weighted MR imaging demonstrated an ablation defect encompassing the recurrent tumor with no residual hyper-enhancing nodules. Three month follow-up shows no residual or recurrent tumor seen on MR imaging. Conclusion: This represents the first known, successful, MRI-guided, LITT procedures at 1.5T for locally recurrent prostate adenocarcinoma following RP.

Original languageEnglish (US)
Title of host publicationPhotonic Therapeutics and Diagnostics VI
DOIs
StatePublished - Dec 1 2010
EventPhotonic Therapeutics and Diagnostics VI - San Francisco, CA, United States
Duration: Jan 23 2010Jan 25 2010

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume7548
ISSN (Print)1605-7422

Other

OtherPhotonic Therapeutics and Diagnostics VI
CountryUnited States
CitySan Francisco, CA
Period1/23/101/25/10

Keywords

  • MR-intervention
  • MRI
  • laser ablation
  • prostate cancer
  • prostate cancer recurrence

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging

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