The simplified preoperative planning of multiprobe prostate cryoablation limits its efficiency. In order to improve it, the thermal history prediction software is being developed. However, the problem of high risks at the prostate-urethra boundary has not been solved yet. The urethral warming system is used to protect the urethral canal from freezing. On the one hand it is used to reduce the risk of damage to the urethra; on the other hand it increases the risk of insufficient ablation of the tumor. This paper presents a step towards the possibility of carrying out the precision prostate cryoablation in this region. For the experimental part, three cases of arrangement of one and two argon cryoprobes and a heating catheter have been considered. Freezing zone shape and dimensions, and temperature at control points depending on time have been obtained. Experimental results have clearly shown the effect of the heating catheter, the second cryoprobe, and the initial temperature of the biotissue phantom on the freezing zone. After, the thermal aspects of treatment simulation have been developed and verified. A series of calculations have been carried out with the goal to get the information about optimizing the prostate cryoablation on the prostate-urethra boundary. The arrangement of cryoprobes has been proposed for three different variants for prostate cryoablation (sectors of 90, 180° and 360°). The area of prostate tissues near the urethra that cannot be cooled below the necrosis temperature is shown. This information is expected to be useful for improving the quality of cryosurgery planning algorithms (e.g. for tumor treatment).
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http://dx.doi.org/10.1016/j.cryobiol.2022.10.002 | DOI Listing |
J Endourol
January 2025
Urological Research Network, Miami Lakes, Florida, USA.
Focal therapy (FT) is an emerging option for intermediate-risk prostate cancer (IR-PCa). Transperineal MRI fusion laser ablation of PCa (TPFLA) is a novel FT technique with limited data reported. We conducted a phase I clinical trial evaluating the safety, feasibility, and 1-year oncologic results for patients with IR-PCa treated with TPFLA in an office setting.
View Article and Find Full Text PDFTransl Cancer Res
November 2024
Section of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA.
Background And Objective: The role of focal therapy in the treatment of localized prostate cancer is evolving. However, despite accumulating evidence, current guidelines and regulatory bodies refrain from endorsing focal therapy outside of clinical trials. Our goal was the to review the focal therapy realm for ongoing clinical trials and high impact recently published trials.
View Article and Find Full Text PDFJ Comput Assist Tomogr
December 2024
From the Department of Radiology, NYU Grossman School of Medicine.
Background: Minimally invasive focal therapy of low- to intermediate-risk prostate cancer is becoming more common and has demonstrated lower morbidity compared to other treatments. Multiparametric prostate magnetic resonance imaging (mpMRI) has the potential to be an effective posttreatment evaluation method for residual/recurrent neoplasm.
Objective: This study aimed to evaluate the ability of mpMRI to detect residual/recurrent neoplasm after focal therapy treatment of prostate cancer using a 3-point Likert scale.
BJU Int
November 2024
Department of Urology, Mayo Clinic, Phoenix, AZ, USA.
Objective: To define the natural history, patterns of recurrence and treatment modalities for local prostate cancer (PCa) recurrence following radical prostatectomy (RP) and radiation therapy (RT), and to investigate factors that could predict metastasis-free survival (MFS) in this unique patient population.
Methods: We queried a prospectively maintained PCa registry to identify men developing in-field recurrence (IFR) following RP and RT from 2008 to 2021 at a single institution. IFR was defined as biopsy-proven recurrent PCa or the presence of persistent positron emission tomography-avid lesions in the prior radiation field without evidence of metastasis.
Urol Oncol
November 2024
Division of Biostatistics and Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH.
Purpose: To evaluate the oncological and genitourinary outcomes of various forms of prostate ablation for localized prostate cancer.
Methods: A prospectively managed database included men with localized prostate cancer who underwent prostate ablation during January 2018-August 2023. Patients received either whole or partial-gland ablation using 1 of 3 energy modalities: cryotherapy, High Intensity Focused Ultrasound (HIFU), or Irreversible electroporation (IRE).
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