V14-06 CETRUS; CONTRAST-ENHANCED TRANS-RECTAL ULTRASOUND TO MONITOR POST-TREATMENT RECURRENCE AFTER FOCAL HIFU OF PROSTATE

Abstract

You have accessJournal of UrologyProstate Cancer (V14)1 Apr 2020V14-06 CETRUS; CONTRAST-ENHANCED TRANS-RECTAL ULTRASOUND TO MONITOR POST-TREATMENT RECURRENCE AFTER FOCAL HIFU OF PROSTATE Aliasger Shakir*, Atsuko Fujihara, Tsuyoshi Iwata, Alessandro Tafuri, Cacciamani Giovanni, Suzanne Palmer, Inderbir Gill, and Andre Luis Abreu Aliasger Shakir*Aliasger Shakir* More articles by this author , Atsuko FujiharaAtsuko Fujihara More articles by this author , Tsuyoshi IwataTsuyoshi Iwata More articles by this author , Alessandro TafuriAlessandro Tafuri More articles by this author , Cacciamani GiovanniCacciamani Giovanni More articles by this author , Suzanne PalmerSuzanne Palmer More articles by this author , Inderbir GillInderbir Gill More articles by this author , and Andre Luis AbreuAndre Luis Abreu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000982.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess the role of contrast enhanced trans-rectal ultrasound (CeTRUS) in the follow-up evaluation of patients who underwent focal High Intensity Focused Ultrasound (HIFU) for prostate cancer (PCa). METHODS: From our IRB-approved database (HS-17-00749), we identified 22 patients who underwent focal hemi-gland HIFU ablation of the prostate and had follow-up CeTRUS, mutiparametric MRI (mpMRI) and prostate biopsy (PBx) between 6 months to 1 year after HIFU. Salvage or whole-gland HIFU patients were excluded. CeTRUS was performed following a 2.5cc intravenous bolus of ultrasound contrast agent (LUMASON). Two-minute cine images of the regions of interest were recorded. CeTRUS findings were compared with mpMRI and the results of PBx. CeTRUS images were evaluated qualitatively. A PIRADS v2 score of 3 or higher was considered positive. Clinically significant PCa (csPCa) is defined as ISUP Grade Group (GG) ≥ 2 and non-csPCa is defined as ISUP Grade Group (GG) < 2. RESULTS: At baseline, median age and PSA was 65 year old and 5.1ng/ml. Six (26%) patients had low-risk, 13 (57%) had intermediate-risk and 3 (13%) had high-risk PCa. Post HIFU, median PSA nadir, and reduction in PSA were 1.0 ng/mL and 72%, respectively. On follow-up PBx with a median follow of 16M, 12 (55%) patients had cancer, 6 (27%) patients had csPCa, 3 (14%) patients had in-field recurrences, 9 (40%) patients had out-field recurrences, and 10 (45%) patients had a negative biopsy. Among them, three (14%) patients had in-field csPCa, 3 (14%) had out-field csPCa, 0 (0%) had in-field ncsPCa, and 6 (27%) had out-field ncsPCa. In the 3 patients with in-field csPCa (Table), MRI detected 2 (66%) lesions and CeTRUS detected 2 (66%) lesions. However, the patients with lesions detected by MRI and CeTRUS were not the same. One patient had a lesion detected by both MRI and CeTRUS, one patient had a lesion detected by MRI only and one patient had a lesion detected by CeTRUS only. Overall, among the 3 patients with in-field csPCa, 3 (100%) had lesions detected by either imaging modality. CONCLUSIONS: CeTRUS enhancement pattern showed high correlation with in-field csPCa on follow up PBx. CeTRUS and MRI were able to identify more csPCa compared to MRI alone. The addition of CeTRUS to MRI can be helpful in the follow up after focal HIFU and aid detection, and localization of csPCa. Source of Funding: This study was funded in part by the R01 grant CA205058-01 from the National Institutes of Health/ National Cancer Institute (M.C.S, I.S.G. and A.L.A.). © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1307-e1308 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aliasger Shakir* More articles by this author Atsuko Fujihara More articles by this author Tsuyoshi Iwata More articles by this author Alessandro Tafuri More articles by this author Cacciamani Giovanni More articles by this author Suzanne Palmer More articles by this author Inderbir Gill More articles by this author Andre Luis Abreu More articles by this author Expand All Advertisement PDF downloadLoading ...