High-Intensity Focused Ultrasound (HIFU) Focal Therapy for Localized Prostate Cancer with MRI-US Fusion Platform.

Autor:	Yee, Chi-Hang, Chiu, Peter Ka-Fung, Teoh, Jeremy Yuen-Chun, Ng, Chi-Fai, Chan, Chi-Kwok, Hou, See-Ming
Předmět:	HIGH-intensity focused ultrasound PROSTATE cancer PROSTATECTOMY GLEASON grading system TREATMENT failure DISEASE relapse TREATMENT effectiveness PROSTATE-specific antigen
Zdroj:	Advances in Urology; 12/14/2021, p1-7, 7p
Abstrakt:	Objective: The study aimed at investigating the outcome of prostate HIFU focal therapy using the MRI-US fusion platform for treatment localization and delivery.Methods: It is a prospectively designed case series of HIFU focal therapy for localized prostate cancer. The inclusion criteria include clinical tumor stage ≤T2, visible index lesion on multiparametric MRI less than 20 mm in diameter, absence of Gleason 5 pattern on prostate biopsy, and PSA ≤ 20 ng/ml. HIFU focal therapy was performed in the conventional manner in the beginning 50% of the series, whereas the subsequent cases were performed with MRI-US fusion platform. The primary outcome was treatment failure rate which is defined by the need of salvage therapy. Secondary outcomes included tumor recurrence in follow-up biopsy, PSA change, perioperative complications, and postoperative functional outcomes.Results: Twenty patients underwent HIFU focal ablation. HIFU on an MRI-US fusion platform had a trend of a longer total operative time than the conventional counterpart (124.2 min vs. 107.1 min, p=0.066). There was no difference in the mean ablation volume to lesion volume ratio between the two. The mean PSA percentage change from baseline to 6-month is more significant in the conventional group (63.3% vs. 44.6%, p=0.035). No suspicious lesion was seen at 6-month mpMRI in all 20 patients. Two patients, one from each group, eventually underwent radical treatment because of the presence of clinically significant prostate cancer in the form of out-of-field recurrences during follow-up biopsy. No significant difference was observed before and after HIFU concerning uroflowmetry, SF-12 score, and EPIC-26 score. It was observed that energy used per volume was positively correlated with PSA density of the patient (r = 0.6364, p=0.014).Conclusion: In conclusion, HIFU with conventional or MRI-US fusion platform provided similar oncological and functional outcomes. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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