Abdominal Radiology

, Volume 41, Issue 5, pp 877–888 | Cite as

Targeted prostate biopsy and MR-guided therapy for prostate cancer

  • David A. Woodrum
  • Akira Kawashima
  • Krzysztof R. Gorny
  • Lance A. Mynderse
Invited Article

Abstract

Prostate cancer is the most commonly diagnosed noncutaneous cancer and second-leading cause of death in men. Many patients with clinically organ-confined prostate cancer undergo definitive treatment of the whole gland including radical prostatectomy, radiation therapy, and cryosurgery. Active surveillance is a growing alternative option for patients with documented low-volume, low-grade prostate cancer. With recent advances in software and hardware of MRI, multiparametric MRI of the prostate has been shown to improve the accuracy in detecting and characterizing clinically significant prostate cancer. Targeted biopsy is increasingly utilized to improve the yield of MR-detected, clinically significant prostate cancer and to decrease in detection of indolent prostate cancer. MR-guided targeted biopsy techniques include cognitive MR fusion TRUS biopsy, in-bore transrectal targeted biopsy using robotic transrectal device, and in-bore direct MR-guided transperineal biopsy with a software-based transperineal grid template. In addition, advances in MR compatible thermal ablation technology allow accurate focal or regional delivery of optimal thermal energy to the biopsy-proved, MRI-detected tumor, utilizing cryoablation, laser ablation, high-intensity focused ultrasound ablation under MR guidance and real-time or near simultaneous monitoring of the ablation zone. Herein we present a contemporary review of MR-guided targeted biopsy techniques of MR-detected lesions as well as MR-guided focal or regional thermal ablative therapies for localized naïve and recurrent cancerous foci of the prostate.

Keywords

MRI MRI-targeted biopsy Native prostate cancer Recurrent prostate cancer Laser ablation Cryoablation Focused ultrasound ablation 

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • David A. Woodrum
    • 1
  • Akira Kawashima
    • 1
  • Krzysztof R. Gorny
    • 1
  • Lance A. Mynderse
    • 2
  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Department of UrologyMayo ClinicRochesterUSA

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