Aytekin Oto MD, Presenter: Research Grant, Koninklijke Philips NV Consultant, Guerbet SA

Ambereen Yousuf MBBS, Abstract Co-Author: Nothing to Disclose

Shiyang Wang PhD, Abstract Co-Author: Grant, Koninklijke Philips NV

Tatjana Antic, Abstract Co-Author: Nothing to Disclose

Gregory Stanislaus Karczmar PhD, Abstract Co-Author: Nothing to Disclose

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

To assess the oncologic efficacy and safety of MRI-guided laser-induced interstitial thermal therapy of biopsy confirmed and MR-visible prostate cancer.

17 patients with biopsy proven low-to-intermediate 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 suspicious foci 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 recorded. Follow-up was performed with 3- month MRI examination and MR-guided biopsy and validated quality of life questionnaires to assess urinary and sexual function.

MRI guided laser ablation of prostate cancer was successfully performed in all 17 patients without significant peri-procedural complications. All patients were discharged home the same day. Average duration of the procedure was 3 hours 39 minutes and average duration of a single laser ablation was 1 minute 21 seconds. Total number of ablations per patient ranged from 2-7, with a median of 4. The treatment created an identifiable hypovascular defect in all cases. Post procedure complications were minor and included urinary symptoms, perineal bruising and erectile dysfunction, all of which self-resolved. MR-guided biopsy of the ablation zone performed at the 3-month time point showed no cancer in all patients. Validated quality of life urinary and sexual questionnaires obtained before and 3 months after the procedure did not reveal any significant differences (p≥0.05).

Very early results of MRI-guided focal laser ablation for treatment of clinically localized, low-to-intermediate risk prostate cancer appear promising. It may offer a minimally invasive procedure for selected patients that does not appreciably alter sexual or urinary function.

Interim results of our phase II trial show that MRI-guided focal laser ablation can be a safe and feasible option for treatment of low-to-intermediate risk prostate cancer.

Oto, A, Yousuf, A, Wang, S, Antic, T, Karczmar, G, Eggener, S, Interim Results of Phase II Clinical Trial for Evaluation of MRI-guided Laser Induced Interstitial Thermal Therapy (LITT) for Low-to-Intermediate Risk Prostate Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006233.html