464 FOCAL LASER ABLATION FOR PROSTATE CANCER FOLLOWED BY RADICAL PROSTATECTOMY –VALIDATION OF FOCAL THERAPY AND IMAGING ACCURACY (2010)

You have accessJournal of UrologyProstate Cancer: Localized II1 Apr 2010464 FOCAL LASER ABLATION FOR PROSTATE CANCER FOLLOWED BY RADICAL PROSTATECTOMY –VALIDATION OF FOCAL THERAPY AND IMAGING ACCURACY Uri Lindner, Nathan Lawrentschuk, Robert A. Weersink, Sean R.H. Davidson, Orit Raz, Eugen Hlasny, Deanna L. Langer, Mark R. Gertner, Theodorus Van der Kwast, Massom A. Haider, and John Trachtenberg Uri LindnerUri Lindner Kiryat Ono, Israel More articles by this author , Nathan LawrentschukNathan Lawrentschuk Toronto, Canada More articles by this author , Robert A. WeersinkRobert A. Weersink Toronto, Canada More articles by this author , Sean R.H. DavidsonSean R.H. Davidson Toronto, Canada More articles by this author , Orit RazOrit Raz Toronto, Canada More articles by this author , Eugen HlasnyEugen Hlasny Toronto, Canada More articles by this author , Deanna L. LangerDeanna L. Langer Toronto, Canada More articles by this author , Mark R. GertnerMark R. Gertner Toronto, Canada More articles by this author , Theodorus Van der KwastTheodorus Van der Kwast Toronto, Canada More articles by this author , Massom A. HaiderMassom A. Haider Toronto, Canada More articles by this author , and John TrachtenbergJohn Trachtenberg Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.537AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the effects of focal laser ablation (FLA) on prostate cancer (PC) tissue, and to assess the accuracy of magnetic resonance imaging (MRI) in determining the ablated lesion volume by comparing to histology. METHODS Four patients with biopsy proven PC underwent FLA followed by radical prostatectomy (RP) one week later. MRI was done prior to FLA and immediately before RP. Meticulous step-sectioned, whole-mount histopathologic examination of the RP specimens was performed. Areas of necrosis were demarcated using standard hematoxylin and eosin (H&E) and immunohistochemical stains for cytokeratin 8, to assess treatment effect and for purpose of correlation against imaging findings. RESULTS The ablated areas were characterized by homogeneous coagulation necrosis, entirely lacking cytokeratin 8 expression. The median index tumor volume for ablation as calculated by MRI was 0.46cc (range 0.16-0.9cc); the median total ablated volume based on MRI was 2.7cc (range 2.5-4.5cc). The ablated area was 7.6 times the tumor volume (range 3-28x).The MRI calculated ablated volume was 1.4 times the histopathologically-calculated volume derived from H&E (range 1-1.6x,r=0.79) and 1.1 times that derived from vital staining (range 0.95-1.2x,r=0.89). The correlation between MRI findings of viable tissue between the ablation zone and the prostatic capsule and histopathology was very high (r=0.95). CONCLUSIONS FLA creates confluent ablation with no evidence of viable cells in treated regions. Post-ablation MRI is able to determine the ablation volume and the presence of viable tissue adjacent to the ablated zone. Laser energy appears suited for focal therapy for PC and should be evaluated further in well-designed clinical trials. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e183 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Uri Lindner Kiryat Ono, Israel More articles by this author Nathan Lawrentschuk Toronto, Canada More articles by this author Robert A. Weersink Toronto, Canada More articles by this author Sean R.H. Davidson Toronto, Canada More articles by this author Orit Raz Toronto, Canada More articles by this author Eugen Hlasny Toronto, Canada More articles by this author Deanna L. Langer Toronto, Canada More articles by this author Mark R. Gertner Toronto, Canada More articles by this author Theodorus Van der Kwast Toronto, Canada More articles by this author Massom A. Haider Toronto, Canada More articles by this author John Trachtenberg Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...