MP46-07 PRELIMINARY RESULTS OF IN VIVO FOCAL TRANSPERINEAL LASER ABLATION TREATMENT OF THE PROSTATE: CORRELATION OF mpMRI AND CEUS IMAGING TO HISTOLOGY IN RADICAL PROSTATECTOMY SPECIMEN

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy (MP46)1 Sep 2021MP46-07 PRELIMINARY RESULTS OF IN VIVO FOCAL TRANSPERINEAL LASER ABLATION TREATMENT OF THE PROSTATE: CORRELATION OF mpMRI AND CEUS IMAGING TO HISTOLOGY IN RADICAL PROSTATECTOMY SPECIMEN Luigi van Riel, Rob van Kollenburg, Theo de Reijke, Dilara Savci-Heijink, Marc Engelbrecht, Harrie Beerlage, Ton van Leeuwen, Martijn de Bruin, and Jorg Oddens Luigi van RielLuigi van Riel More articles by this author , Rob van KollenburgRob van Kollenburg More articles by this author , Theo de ReijkeTheo de Reijke More articles by this author , Dilara Savci-HeijinkDilara Savci-Heijink More articles by this author , Marc EngelbrechtMarc Engelbrecht More articles by this author , Harrie BeerlageHarrie Beerlage More articles by this author , Ton van LeeuwenTon van Leeuwen More articles by this author , Martijn de BruinMartijn de Bruin More articles by this author , and Jorg OddensJorg Oddens More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002067.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal ablative techniques are an alternative for standard radical therapy of localized prostate cancer (PCa). Soractelite™ transperineal laser ablation (TPLA) using the Echolaser device, with four independent laser sources, is such a novel minimal invasive treatment. We conducted a study in patients planned for radical prostatectomy (RP) to determine the histological ablative efficacy in correlation with CEUS and mpMRI. The size of ablation zone on RP specimens was correlated to CEUS imaging and MRI following TPLA. Furthermore, safety and feasibility of TPLA using a (multi)fiber setup in men with localized PCa will be evaluated. METHODS: A prospective, multicenter and interventional phase I/II pilot study using Soractelite™ with an ablate-and-resect principle was designed that aims to include 15 patients. Patients underwent TPLA procedures, using a single fiber delivering 1800J at 3W under local anesthesia, with continuous ultrasound guidance approximately 4 weeks before RP. Imaging (grayscale US, CEUS and mpMRI) was performed prior to TPLA and RP. Whole-mount H&E-stained slides of RP specimens were digitized. The ablation zone was annotated on imaging and histology, and segmented into 3D models. RESULTS: Three outpatient clinic based TPLA procedures were performed successfully and discharged the same day. The ablation zone on T2-weighted, DCE and CEUS imaging and histology (figure 1) was clearly demarcated upon qualitative analysis and the 3D shape seems to be ellipsoid on MRI and CEUS. This closely matches the annotated ablation zone on histology. Currently, quantitative data, regarding 3D segmentation of T2-weighted, DCE, CEUS and histopathology, is being analyzed to be presented. CONCLUSIONS: TPLA is a feasible office-based minimal invasive focal treatment of PCa and it can be performed safely under local anesthesia, in these preliminary results. Multiple laser fiber configurations will be investigated with ongoing enrollment. The ablation zone is clearly demarcated on CEUS imaging and on MRI T2-weighted and DCE imaging. The histopathological defined 3D ablation zone closely matches the ablation zone seen on imaging. Source of Funding: This study was funded by STW and CfC © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e815-e816 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luigi van Riel More articles by this author Rob van Kollenburg More articles by this author Theo de Reijke More articles by this author Dilara Savci-Heijink More articles by this author Marc Engelbrecht More articles by this author Harrie Beerlage More articles by this author Ton van Leeuwen More articles by this author Martijn de Bruin More articles by this author Jorg Oddens More articles by this author Expand All Advertisement Loading ...