Aytekin Oto MD, Presenter: Consultant, General Electric Company Research grant, Koninklijke Philips Electronics NV Research grant, Bayer AG Research grant, Visualase Inc Research grant, General Electric Company

Roger McNichols PhD, Abstract Co-Author: Employee, BioTex, Inc

Ila Sethi MBBS, DMRD, Abstract Co-Author: Nothing to Disclose

Joseph H Yacoub MD, Abstract Co-Author: Nothing to Disclose

Ashok Gowda PhD, Abstract Co-Author: Stockholder, BioTex, Inc Stockholder, Visualase, Inc

Scott Eggener, Abstract Co-Author: Research grant, Visualase, Inc Speakers Bureau, Johnson & Johnson

To assess the feasibility and safety of MRI guided targeted laser therapy for localized prostate cancer

8 patients with biopsy proven low risk prostate cancer underwent MRI guided laser ablation of the cancer using Visualase laser ablation device. All patients had a pre-procedure endorectal MRI which showed a suspicious focus concomitant with the positive sextant on TRUS guided biopsy. The area of interest was targeted transperineally using 1.5 T Philips MRI scanner and Visualase ablation device. Ablation was monitored by real time MR thermometry using Visualase MRI thermometry software. Perioperative, early and late complications and adverse events were solicited and recorded. Follow-up was performed with 3 months and 6 months MRI examinations. Validated quality of life questionnaires were used to assess the effect on voiding symptoms and erectile function.

MRI guided laser ablation of the prostate cancer was technically feasible to perform. Average duration of the procedure was 2.9 hours and average duration of laser ablation was 1.6 minutes. The treatment created an identifiable hypovascular defect in all cases. However, localization and targeting of the suspicious focus using MR guidance was suboptimal in 3 cases. All patients were discharged home free from catheter the same day. There were no perioperative, early or late complications other than self resolving dermal abrasion (n=1) and focal numbness of glans penis (n=1). Validated quality of life questionnaires obtained at 3 and 6 months confirmed stable voiding and erectile function compared to baseline.

MRI guided focal laser ablation of low risk prostate cancer is feasible and targeted lesion can be safely ablated. Improvements in lesion targeting may be helpful to increase the efficiency of the procedure.

MRI guided focal laser ablation can be a safe and feasible option for treatment of low risk prostate cancer. Further trials are required to demonstrate the effectiveness of this treatment concept.

Oto, A, McNichols, R, Sethi, I, Yacoub, J, Gowda, A, Eggener, S, Real-time Magnetic Resonance Imaging-guided Focal Laser Ablation in Patients with Low Risk Prostate Cancer: Phase I Trial.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11009056.html