Localized Intermediate-Risk Prostate Cancer: MRI-Guided Focused Ultrasound Ablation
Posted: Monday, May 3, 2021
Based on the early results of a phase II clinical trial, MRI-guided, high-intensity, targeted ultrasonography may prove an effective way to treat patients with intermediate-risk prostate cancer. In addition, according to Nathan Perlis, MD, MSc, FRCSC, Princess Margaret Cancer Centre, University of Toronto, and colleagues, the novel technique was associated with minimal side effects. These findings were published in the journal Radiology.
“By combining the high-intensity focused ultrasound device with MRI, we can target our treatment to the exact location, because we’re able to pinpoint precisely where the tumor is,” commented study coauthor Sangeet Ghai, MD, of the University Health Network, Toronto, in a Radiological Society of North America press release. “The results so far have been very good, and patients preserved their erectile and urinary function.”
In this prospective study, conducted between February 2016 and July 2019, 44 men with unifocal clinically significant prostate cancer visible at MRI took part. A total of 36 had grade group 2 tumors, and 8 had grade group 3 tumors; the median age of patients was 67 years. All were successfully treated with transrectal MRI-guided focused ultrasonography.
At 5-month biopsy—the primary study endpoint—41 of the 44 men (93%) were free of clinically significant prostate cancer at the treatment site. No major adverse effects related to treatment were reported. In fact, the median IPSS (International Prostate Symptom Score) and IIEF-15 (International Index of Erectile Function-15) scores were similar at baseline and at 5 months. However, compared with smaller ablations, larger ablations (≥ 15 cm3) tended to be linked to a decline in IIEF-15 scores at 6 weeks (adjusted P < .01) and at 5 months (adjusted P = .07).
Disclosure: For full disclosures of the study authors, visit pubs.rsna.org.