MP37-01 HYPOTHERMIC PELVIC COOLING MEASURED BY REAL TIME MRI IMAGING PRIOR TO ROBOT ASSISTED RADICAL PROSTATECTOMY (RARP); FEASIBILITY AND IMPLICATIONS (2014)

You have accessJournal of UrologyTechnology & Instruments: Robotics - Benign & Malignant Disease1 Apr 2014MP37-01 HYPOTHERMIC PELVIC COOLING MEASURED BY REAL TIME MRI IMAGING PRIOR TO ROBOT ASSISTED RADICAL PROSTATECTOMY (RARP); FEASIBILITY AND IMPLICATIONS Douglas Skarecky, Hon Yu, Blanca Morales, Min-Ying (Lydia) Su, and Thomas Ahlering Douglas SkareckyDouglas Skarecky More articles by this author , Hon YuHon Yu More articles by this author , Blanca MoralesBlanca Morales More articles by this author , Min-Ying (Lydia) SuMin-Ying (Lydia) Su More articles by this author , and Thomas AhleringThomas Ahlering More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1238AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This study is an innovative application of Thermal MRI imaging as a feasibility method for maximization of improved clinical outcomes of Hypothermic Endorectal Balloon (ECB) in radical prostatectomy (RP). The effective depth and spread of hypothermic cooling was quantitatively mapped by thermo MRI to assess the dispersion and drop in temperature in pelvic tissue and to potentially reduce inflammatory cascade in potency neurovascular bundles (NVB) in men. METHODS Three subjects, prior to undergoing RARP, were cooled via an ECB, rendered MRI compatible by removing metal components for patient safety (HS2012-8392). Prior to cooling hypothermia, anatomic MR images identified the pelvic structures, and measured simultaneously at 3T scanner using 29, 3-mm thick axial slices matched to that of anatomical T2w but with 46-cm FOV and in 256x256 image matrix; the sequence is based on Philips' multishot EPI (echo planar imaging) with TR/TE=48/16 (ms), flip-angle at 20-degree and NSA=2 ('number of average'); the sequence was performed repeatedly during the cooling experiment with 76-sec temporal resolution while the phase data were collected using an integrated MR-HIFU workstation (Sonalleve, Philips) for processing temperature changes in real time. After the anatomical scans, pelvic cooling was instituted with an RPX cooling console (Phillips Healtcare) located outside the MRI coil with 30' of cooling tubing to reach the subject, and the thermometry scan was repeated every 6 s for one hour. RESULTS Figure 1 ABC demonstrates that pelvic cooling measured in real time is feasible. A temperature drop of 20-25 degrees was achieved after an initial time delay of 10-15' for the ECB to cool. Figure 1 middle and bottom compare the anatomic image of the prostate and NVB and demonstrate cooling at this interface of 10-15 degrees, and that cooling extends into the prostate itself ∼ 5 degrees, and disperses into the pelvic region as well. CONCLUSIONS Using a cooling balloon modified for MRI compatibility, we have demonstrated an effective method to measure the impact of a novel ECB balloon on NVB and surrounding structures and potentially useful to visualize the effectiveness of hypothermic saturation in other urologic tissue regions as well. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e392 Advertisement Copyright & Permissions© 2014Metrics Author Information Douglas Skarecky More articles by this author Hon Yu More articles by this author Blanca Morales More articles by this author Min-Ying (Lydia) Su More articles by this author Thomas Ahlering More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...