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European Radiology

, Volume 22, Issue 8, pp 1829–1835 | Cite as

Percutaneous MR-guided cryoablation of prostate cancer: initial experience

  • Afshin GangiEmail author
  • Georgia Tsoumakidou
  • Omar Abdelli
  • Xavier Buy
  • Michel de Mathelin
  • Didier Jacqmin
  • Hervé Lang
Interventional

Abstract

Objective

We report our initial experience and the technical feasibility of transperineal prostate cryoablation under MR guidance.

Methods

Percutaneous MR-guided cryoablation was performed in 11 patients with prostatic adenocarcinoma contraindicated for surgery (mean age: 72 years, mean Gleason score: 6.45, mean prostate-specific antigen (PSA): 6.21 ng/ml, T1-2c/N0/M0, mean: prostate volume 36.44 ml). Free-hand probe positioning was performed under real-time MR imaging. Four to seven cryoprobes were inserted into the prostate, depending on gland volume. The ice ball was monitored using real-time and high-resolution BLADE multi-planar imaging. Patients were followed at 1, 3, 6, 9 and 12 months after the procedure with serum PSA level and post-ablation MRI.

Results

Prostate cryoablation was technically feasible in 10/11 patients. The ice ball was clearly and sharply visualised in all cases as a signal-void area. Mean ice-ball volume was 53.3 ml. Mean follow-up was 15 months (range: 1–25). Mean PSA nadir was 0.33 ng/ml (range: 0.02–0.94 ng/ml). Mean hospitalisation was 5 days (range: 3–13). Complications included a urethro-rectal fistula, urinary infection, transient dysuria and scrotal pain.

Conclusions

MR-guided prostate cryoablation is feasible and promising, with excellent monitoring of the ice ball. Future perspectives could include the use of MR guidance for focal prostate cancer cryotherapy.

Key Points

Magnetic resonance allows precise positioning of cryoprobes with real-time imaging.

High-resolution MRI allows excellent monitoring of the developing ice ball.

Cryoablation of prostate cancer under MR guidance is technically feasible.

Further work will refine the procedure and make it even safer.

Keywords

Prostate cancer Percutaneous thermal ablation MR guidance Cryoablation Rectal thermal protection 

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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Afshin Gangi
    • 1
    Email author
  • Georgia Tsoumakidou
    • 1
  • Omar Abdelli
    • 1
  • Xavier Buy
    • 1
  • Michel de Mathelin
    • 2
  • Didier Jacqmin
    • 3
  • Hervé Lang
    • 3
  1. 1.Department of Interventional RadiologyUniversity Hospital of StrasbourgStrasbourgFrance
  2. 2.LsiitUniversity of StrasbourgStrasbourgFrance
  3. 3.Department of UrologyUniversity Hospital of StrasbourgStrasbourgFrance

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