Evolving imaging methods of prostate cancer and the emergence of magnetic resonance imaging guided ablation techniques

: Anttinen Mikael, Sequeiros Roberto Blanco, Boström Peter J, Taimen Pekka

Publisher: Frontiers Media SA

: 2022

: Frontiers in Oncology

: FRONTIERS IN ONCOLOGY

: FRONT ONCOL

: 1043688

: 12

: 11

: 2234-943X

DOI: https://doi.org/10.3389/fonc.2022.1043688

: https://www.frontiersin.org/articles/10.3389/fonc.2022.1043688/full

: https://research.utu.fi/converis/portal/detail/Publication/177939304

Established therapies for prostate cancer (PCa), surgery and radiotherapy, treat the entire gland regardless of the location of the cancerous lesion within the prostate. Although effective, these methods include a significant risk of worsening genitourinary outcomes. Targeted image-guided cancer therapy has gained acceptance through improved PCa detection, localization, and characterization by magnetic resonance imaging (MRI). Minimally-invasive ablative techniques aim to achieve comparable oncological outcomes to radical treatment while preserving genitourinary function. Transurethral ultrasound ablation (TULSA) and next-generation transrectal high-intensity focused ultrasound (HIFU) utilize MRI guidance to thermally ablate prostate tissue under real-time MRI monitoring and active temperature feedback control. Previous trials performed by our group and others, including a large multicenter study in men with localized favorable-risk disease, have demonstrated that TULSA provides effective prostate ablation with a favorable safety profile and low impact on quality of life. Recently, MRI-guided HIFU focal therapy was also shown as a safe and effective treatment of intermediate-risk PCa. Here we review the current literature on ablative techniques in the treatment of localized PCa with a focus on TULSA and HIFU methods.

fonc-12-1043688.pdf