A1 Journal article – refereed

Acute and subacute prostate MRI findings after MRI-guided transurethral ultrasound ablation of prostate cancer

List of Authors: Pietari Mäkelä, Mikael Anttinen, Visa Suomi, Aida Steiner, Jani Saunavaara, Teija Sainio, Antero Horte, Pekka Taimen, Peter Boström, Roberto Blanco Sequeiros

Publication year: 2020

Journal: Acta Radiologica

eISSN: 1600-0455

DOI: http://dx.doi.org/10.1177/0284185120976931



Magnetic resonance imaging (MRI)-guided transurethral ultrasound ablation (TULSA) is an emerging method for treatment of localized prostate cancer (PCa). TULSA-related subacute MRI findings have not been previously characterized.


To evaluate acute and subacute MRI findings after TULSA treatment in a treat-and-resect setting.

Material and Methods

Six men with newly diagnosed MRI-visible and biopsy-concordant clinically significant PCa were enrolled and completed the study. Eight lesions classified as PI-RADS 3–5 were focally ablated using TULSA. One- and three-week follow-up MRI scans were performed between TULSA and robot-assisted laparoscopic prostatectomy


TULSA-related hemorrhage was detected as a subtle T1 hyperintensity and more apparent T2 hypointensity in the MRI. Both prostate volume and non-perfused volume (NPV) markedly increased after TULSA at one week and three weeks after treatment, respectively. Lesion apparent diffusion coefficient values increased one week after treatment and decreased nearing the baseline values at the three-week MRI follow-up.


The optimal timing of MRI follow-up seems to be at the earliest at three weeks after treatment, when the post-procedural edema has decreased and the NPV has matured. Diffusion-weighted imaging has little or no added diagnostic value in the subacute setting.

Last updated on 2021-24-06 at 11:56