To investigate the feasibility and safety of MRI-guided focal laser ablation (FLA) in localized, International Society of Urological Pathology (ISUP) grade 1-3, prostate cancer (PCa) using an integrated system.
Ten consecutive males (mean age: 66±7 years) with low-to-intermediate risk PCa were prospectively included (April 2022-May 2023) and treated with MRI-guided FLA using an integrated system for laser energy control and MR thermometry monitoring. Primary endpoints were technical success, procedure-related adverse events (AEs) following SIR (Society of Interventional Radiology) classification, and 12-months local tumor progression-free survival (LTPFS), defined as no evident residual/ recurrent disease on follow-up imaging or histopathology at the treatment site. Secondary endpoints included MRI-derived percentual volumetric tumor coverage, prostate-specific antigen (PSA), sexual and urinary function response measured by the International Prostate Symptom Score index and Sexual Health Inventory for Men (SHIM) questionnaires.
Technical success was achieved in 10/10 (100%) patients (ISUP grade 1 (n=1), 2 (n=8) and 3 (n=1)). Three AEs were observed: urinary tract infection (n=2; SIR grade B) and acute urinary retention (n=1; SIR grade D). Cumulative 12-month LTPFS was 80% (8/10 patients). Median tumor coverage was 100% (IQR: 95-100%). Compared to baseline, the mean PSA level decreased, but did not reach statistical significance (6.6 vs. 4.4 ng/mL; p=0.06), and mean urinary (8.6 vs. 7.3; p=0.60) and sexual function (11.3 vs. 10.5; p=1.00) scores were non-significantly altered at 12 months follow-up.
MRI-guided FLA in patients with low-to-intermediate risk PCa using an integrated system was feasible and safe and indicates promising short-term oncological and functional outcomes.
Journal of vascular and interventional radiology : JVIR. 2025 Jan 28 [Epub ahead of print]
Yvonne Wimper, Lauren P W Te Molder, J P Michiel Sedelaar, Joyce G R Bomers, Christiaan G Overduin, Jurgen J Fütterer
Department of Medical Imaging, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands. Electronic address: ., Department of Medical Imaging, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands., Department of Urology, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.