MP70-15 PRECISE PROSTATE CRYOTHERAPY GUIDED BY MAGNETIC RESONANCE IMAGING AND 99MTC-PSMA SPECT/CT

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (MP70)1 Apr 2020MP70-15 PRECISE PROSTATE CRYOTHERAPY GUIDED BY MAGNETIC RESONANCE IMAGING AND 99MTC-PSMA SPECT/CT Guo-Wen Lin* Guo-Wen Lin*Guo-Wen Lin* More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000950.015AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cryotherapy can effectively control tumor lesions, relieve symptoms and improve patients' quality of life by killing tumor cells at low temperature. The 99mTc-PSMA SPECT/CT examination has high specificity, sensitivity and cost performance for prostate cancer. This study explored the value of precision magnetic resonance imaging and 99mTc-PSMA SPECT/CT guided precision prostate cryotherapy in early localized prostate cancer. METHODS: We retrospectively collected data from 20 patients with localized prostate cancer who underwent prostate cryotherapy from October 2017 to October 2018. Preoperative pelvic magnetic resonance imaging (MR) and 99mTc-PSMA SPECT/CT were performed to assess the location of lesions and its size. Argon-helium cryoablation technique was used. The intraoperative ultrasound guided the 1.47mm diameter probe into the prostate through the perineum. The argon gas formed the needle tip into a spherical ice hockey with a diameter of 2cm and the ice hockey cooled to -140∼-170°C, after 10-15 minutes, the argon gas was turned off, and then the helium gas was started to rapidly raise the local temperature to 20∼40°C for 3 minutes, and two cycles were performed to completely damage the diseased tissue. Postoperative follow-up was used to assess changes in PSA and imaging. RESULTS: Evaluation of lesions using images, combined with intraoperative ultrasound real-time images. All patients accurately located the lesion location and size, and ice hockey range prostate tissue should be included as much as possible, and at least 1 needle complete including tumor lesions. PSA was reviewed 1 month after cryotherapy, suggesting that the median value was 10.3 ng/mL (45.5% reduction). Three months later, 18 patients underwent MR and/or 99mTc-PSMA SPECT/CT, showing the lesion disappeared completely for 4 cases, 14 patients' local lesions were clearly controlled. Common postoperative adverse reactions included short-term dysuria (6/20, 30%), lower abdominal distension (4/20, 20%), hematuria (1/20, 5%), and local necrosis of the urethra (1/20, 5%). CONCLUSIONS: Prostatic cryotherapy is effective for patients with a life expectancy of <10 years or an early stage of surgery that is not suitable for surgery. The examination of MR and/or 99mTc-PSMA SPECT/CT can guide the precise positioning and treatment of prostate cryopreservation, and has great clinical value. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1060-e1061 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Guo-Wen Lin* More articles by this author Expand All Advertisement PDF downloadLoading ...