V14-08 NOVEL AUTOMATED 3D SURGICAL PLANNING TOOL AND MRI/ULTRASOUND FUSION TECHNOLOGY TO PERFORM NANOPARTICLE ABLATION AND CRYOABLATION OF THE PROSTATE FOR FOCAL THERAPY

Abstract

You have accessJournal of UrologyProstate Oncology II & Testis Oncology & Misc. Oncology (V14)1 Sep 2021V14-08 NOVEL AUTOMATED 3D SURGICAL PLANNING TOOL AND MRI/ULTRASOUND FUSION TECHNOLOGY TO PERFORM NANOPARTICLE ABLATION AND CRYOABLATION OF THE PROSTATE FOR FOCAL THERAPY Joshua Jue, Samuel Coons, Gilion Hautvast, Scott Thompson, Jack Geraats, Lee Richstone, Michael Schwartz, and Ardeshir Rastinehad Joshua JueJoshua Jue More articles by this author , Samuel CoonsSamuel Coons More articles by this author , Gilion HautvastGilion Hautvast More articles by this author , Scott ThompsonScott Thompson More articles by this author , Jack GeraatsJack Geraats More articles by this author , Lee RichstoneLee Richstone More articles by this author , Michael SchwartzMichael Schwartz More articles by this author , and Ardeshir RastinehadArdeshir Rastinehad More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002111.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although MRI/Ultrasound fusion has been primarily used to assist in the diagnosis of prostate cancer, the next logical step forward would be using the technology to focally treat localized prostate cancer. We present one case of nanoparticle directed ablation and two cases of cryoablation to focally treat prostate tumors. METHODS: Three patients underwent MRI/Ultrasound fusion transperineal prostate biopsies to confirm low to intermediate risk prostate cancer prior to treatment. The MRI lesions correlated with the biopsy proven disease, and no prostate cancer was present on systematic biopsies using the modified Barzel template. Pelvic MRI segmentation was performed with DynaCAD 5.0 workstation. The MRI lesion including a 6-10 mm margin, prostate, bladder, urethra, urethral sphincter, rectum, and pubic bone were segmented. MRI/Ultrasound fusion was performed with the novel Philips UroNav 4.0 system. Lesions were treated with focal nanoparticle ablation or focal cryoablation. RESULTS: A 69-year-old male with a 10mm lesion in the right mid gland posterior medial peripheral zone was positive for Gleason GG3 cancer and was treated with focal nanoparticle ablation. The UroNav 4.0 system reported 100% ablation of the segmented tumor and 94% of the 6-10 mm margin at the end of the case. A 68-year-old male with a 13mm lesion in the left anterior fibromuscular stroma apex positive for Gleason GG2 cancer and a 71-year-old male with a 16mm lesion in the right peripheral zone posterior lateral positive for Gleason GG1 cancer, were treated with focal cryoablation. The UroNav 4.0 system reported 100% ablation of the segmented tumor and 82% of the 6-10mm margin at the end of the case for the left anterior fibromuscular stroma apex lesion. CONCLUSIONS: Visualization of the prostate tumor(s), surrounding critical structures, and pelvis in 3 dimensions, along with the anticipated ablation zone, is one of the challenges of pelvic surgery and percutaneous ablation. The DynaCAD 5.0 Urology system can create anauto-segmented 3D rendering of critical structures and the tumor(s), as well as visualization and quantification of the anticipated ablation coverage, to facilitate preoperative planning of needle placement. Ultimately, this MRI/Ultrasound fusion technology combined with 3D mapping holds significant potential and will be utilized for new applications in the future. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1167-e1168 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Jue More articles by this author Samuel Coons More articles by this author Gilion Hautvast More articles by this author Scott Thompson More articles by this author Jack Geraats More articles by this author Lee Richstone More articles by this author Michael Schwartz More articles by this author Ardeshir Rastinehad More articles by this author Expand All Advertisement Loading ...