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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Main Authors: Mostafa Alabousi, Sangeet Ghai
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-01-01
Series:Frontiers in Oncology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2022.1069518/full
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author Mostafa Alabousi
Sangeet Ghai
author_facet Mostafa Alabousi
Sangeet Ghai
author_sort Mostafa Alabousi
collection DOAJ
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 doaj.art-934e9f0c93864813a6a32166c8b548212023-01-04T21:05:27ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-01-011210.3389/fonc.2022.10695181069518Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performanceMostafa AlabousiSangeet GhaiProstate 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.https://www.frontiersin.org/articles/10.3389/fonc.2022.1069518/fullprostate cancerMRIProstate MRIMRI-guided interventionFocal TherapyHIFU
spellingShingle Mostafa Alabousi
Sangeet Ghai
Magnetic resonance imaging-guided ultrasound ablation for prostate cancer – A contemporary review of performance
Frontiers in Oncology
prostate cancer
MRI
Prostate MRI
MRI-guided intervention
Focal Therapy
HIFU
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 prostate cancer
MRI
Prostate MRI
MRI-guided intervention
Focal Therapy
HIFU
url https://www.frontiersin.org/articles/10.3389/fonc.2022.1069518/full
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