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Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance

Prostate cancer (PCa) is one of the most common malignancies in men, but patient outcomes are varied depending on extent of disease. Radical, whole-gland therapies, such as prostatectomy or radiotherapy, are definitive treatments for PCa, but they are associated with significant morbidity, including...

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Autores principales: Alabousi, Mostafa, Ghai, Sangeet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846805/
https://www.ncbi.nlm.nih.gov/pubmed/36686753
http://dx.doi.org/10.3389/fonc.2022.1069518
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author Alabousi, Mostafa
Ghai, Sangeet
author_facet Alabousi, Mostafa
Ghai, Sangeet
author_sort Alabousi, Mostafa
collection PubMed
description Prostate cancer (PCa) is one of the most common malignancies in men, but patient outcomes are varied depending on extent of disease. Radical, whole-gland therapies, such as prostatectomy or radiotherapy, are definitive treatments for PCa, but they are associated with significant morbidity, including erectile dysfunction and urinary incontinence. Focal therapies for PCa, whereby the part of gland harboring disease is selectively treated, spares the normal surrounding structures, and minimizes the morbidity associated with whole gland treatment. The use of magnetic resonance imaging (MRI) guidance provides advantages over ultrasound guidance, such as better localization and targeting of clinically significant PCa (csPCa), as well as MRI thermometry which optimizes tissue ablation temperatures. This review will discuss two MRI-guided high-intensity focused ultrasound (HIFU) techniques – transrectal MR-guided focused ultrasound (MRgFUS) and TULSA (transurethral ultrasound ablation) ablation for localized PCa. Overall, recent major trials for MRgFUS and TULSA have shown promising oncological and functional results in the treatment of low- to intermediate-risk PCa. Recent Phase II MRgFUS trials have shown better oncologic outcomes than the published results for focal ultrasound guided HIFU and may justify the additional costs associated with MRI guidance. While initial studies on TULSA have focused on subtotal gland ablation, recent trials assessing oncological outcomes for focal treatment of angular sectors have shown promise.
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spelling pubmed-98468052023-01-19 Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance Alabousi, Mostafa Ghai, Sangeet Front Oncol Oncology Prostate cancer (PCa) is one of the most common malignancies in men, but patient outcomes are varied depending on extent of disease. Radical, whole-gland therapies, such as prostatectomy or radiotherapy, are definitive treatments for PCa, but they are associated with significant morbidity, including erectile dysfunction and urinary incontinence. Focal therapies for PCa, whereby the part of gland harboring disease is selectively treated, spares the normal surrounding structures, and minimizes the morbidity associated with whole gland treatment. The use of magnetic resonance imaging (MRI) guidance provides advantages over ultrasound guidance, such as better localization and targeting of clinically significant PCa (csPCa), as well as MRI thermometry which optimizes tissue ablation temperatures. This review will discuss two MRI-guided high-intensity focused ultrasound (HIFU) techniques – transrectal MR-guided focused ultrasound (MRgFUS) and TULSA (transurethral ultrasound ablation) ablation for localized PCa. Overall, recent major trials for MRgFUS and TULSA have shown promising oncological and functional results in the treatment of low- to intermediate-risk PCa. Recent Phase II MRgFUS trials have shown better oncologic outcomes than the published results for focal ultrasound guided HIFU and may justify the additional costs associated with MRI guidance. While initial studies on TULSA have focused on subtotal gland ablation, recent trials assessing oncological outcomes for focal treatment of angular sectors have shown promise. Frontiers Media S.A. 2023-01-04 /pmc/articles/PMC9846805/ /pubmed/36686753 http://dx.doi.org/10.3389/fonc.2022.1069518 Text en Copyright © 2023 Alabousi and Ghai https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Alabousi, Mostafa
Ghai, Sangeet
Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance
title Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance
title_full Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance
title_fullStr Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance
title_full_unstemmed Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance
title_short Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance
title_sort magnetic resonance imaging-guided ultrasound ablation for prostate cancer – a contemporary review of performance
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846805/
https://www.ncbi.nlm.nih.gov/pubmed/36686753
http://dx.doi.org/10.3389/fonc.2022.1069518
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