MR Imaging-guided Focal Cryoablation in Patients with Recurrent Prostate Cancer
MR Imaging-guided Focal Cryoablation in Patients with Recurrent Prostate Cancer
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DOI：
10.1148/radiol.13121291
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发表时间：
2013-08-01
期刊：
影响因子：
19.7
通讯作者：
Futterer, Jurgen J.
中科院分区：
文献类型：
--
作者：
Bomers, Joyce G. R.;Yakar, Derya;Futterer, Jurgen J.
目的：评估磁共振（MR）成像引导下局部冷冻消融治疗局部复发前列腺癌患者放疗后的可行性。材料与方法：这是一项前瞻性研究，所有患者均知情同意。连续10例组织病理学证实的前列腺癌放疗后复发，没有远处转移的证据，而在全身麻醉下在1.5 T MR单元进行治疗。插入尿道加温器。在实时MR成像下经会阴插入冷冻针。然后，插入直肠加温器。在MR成像引导下连续监测冰球生长。进行了两次冻融循环。随访包括3个月、6个月和12个月时拜访泌尿科医生、测量前列腺特异性抗原水平和多参数MR成像。结果：所有患者均成功治疗。在1例患者中，无法插入尿道加温器，手术被取消。两个月后，该程序成功重复。另1例患者出现尿潴留。所有患者的随访数据均可用。两名患者在6个月后发现局部复发或残留肿瘤，另一名患者在12个月后发现。结论：MRI引导下局部冷冻治疗前列腺癌放疗后复发是安全可行的。初步结果是有希望的，但是，需要更长的随访时间，必须研究更多的患者。(c)RSNA，2013年
Purpose: To assess the feasibility of magnetic resonance (MR) imaging-guided focal cryoablation in patients with locally recurrent prostate cancer after radiation therapy.Materials and Methods: This was a prospective study, and informed consent was obtained from all patients. Ten consecutive patients with histopathologically proved recurrent prostate cancer after radiation therapy, without evidence of distant metastases, were treated while under general anesthesia in a 1.5-T MR unit. A urethral warmer was inserted. Cryoneedles were transperineally inserted under real-time MR imaging. Then, a rectal warmer was inserted. Ice ball growth was continuously monitored under MR imaging guidance. Two freeze-thaw cycles were performed. Follow-up consisted of a visit to the urologist, measurement of prostate-specific antigen level, and multiparametric MR imaging at 3, 6, and 12 months. Potential complications were recorded.Results: All patients were successfully treated. In one patient, the urethral warmer could not be inserted and the procedure was cancelled. Two months later, the procedure was successfully repeated. Another patient had urinary retention. Follow-up data were available for all patients. A local recurrence or remnant tumor was found in two patients after 6 months and in another patient after 12 months. These three patients underwent successful retreatment with MR imaging-guided focal cryoablation.Conclusion: MR imaging-guided focal cryoablation of recurrent prostate cancer after radiation therapy is feasible and safe. Initial results are promising; however, longer follow-up is needed and more patients must be studied. (c) RSNA, 2013