To evaluate the safety and effectiveness of MRI-guided cryoablation of prostate cancer metastatic lymph nodes(LN).
Fifty-two patients with prostate cancer who underwent MRI guided lymph node (LN) ablation from September 2013 to June 2022 were retrospectively reviewed. Of these, 6 patients were excluded because adequate ablation margins (3-5mm) could not be achieved secondary to adjacent structures. The remaining 46 patients (mean age, 70±7 years) underwent 55 MRI-guided cryoablation procedures of metastatic LN (25 in pelvic side wall, 20 within pelvic region and 10 in the abdomen) with procedural intent of complete ablation. Locoregional tumor control (i.e. technical success in the target LN) was evaluated on initial follow-up PET scans at mean of 4±2 months. Pre- and post-ablation prostate specific antigen (PSA) levels were recorded. Imaging follow-up continued until a median of 27.5 months (3-108 months).
Ninety-five percent (52/55) of treated LN demonstrated no considerable activity on PET scans at initial follow-up at 4±2 months. PSA decreased to undetectable level of <0.1ng/mL after cryoablation in 14/46 patients (30.4%) with corresponding lack of activity in 13/46 (28.2%) patients on continued PET imaging follow-up. Only 6/55 (10.9%) patients had transient adverse events which all resolved with no long term sequalae.
MRI-guided percutaneous cryoablation of metastatic LN is a safe and technically effective technique for treating metastatic prostate cancer in LN.
Journal of vascular and interventional radiology : JVIR. 2024 Jun 22 [Epub ahead of print]
Aliza Mushtaq, Lance Mynderse, Scott Thompson, Daniel Adamo, Derek Lomas, Christopher Favazza, Aiming Lu, Eugene Kwon, David Woodrum
Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia, USA, 30322. Electronic address: ., Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA, 55905 and Department of Urology, Mayo Clinic, Rochester, Minnesota, USA, 55905. Electronic address: ., Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA, 55905. Electronic address: ., Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA, 55905. Electronic address: ., Department of Urology, Mayo Clinic, Rochester, Minnesota, USA, 55905. Electronic address: ., Department of Medical Physics, Mayo Clinic, Rochester, Minnesota, USA, 55905. Electronic address: ., Department of Medical Physics, Mayo Clinic, Rochester, Minnesota, USA, 55905. Electronic address: ., Department of Urology, Mayo Clinic, Rochester, Minnesota, USA, 55905. Electronic address: ., Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA, 55905. Electronic address: .