ISSN 1305-3825 | E-ISSN 1305-3612
Interventional Radiology - Original Article
Irreversible electroporation for the treatment of localized prostate cancer: a summary of imaging findings and treatment feedback
1 Department of Urology, AMC University Hospital, Amsterdam, The Netherlands  
2 Department of Biomedical Engineering and Physics, AMC University Hospital, Amsterdam, The Netherlands  
3 Department of Radiology, AMC University Hospital, Amsterdam, The Netherlands  
4 Signal Processing Systems, Eindhoven University of Technology, The Netherlands  
Diagn Interv Radiol 2017; 23: 365-370
DOI: 10.5152/dir.2017.16608
Abstract

Purpose: Imaging plays a crucial role in ablative therapies for prostate cancer (PCa). Irreversible electroporation (IRE) is a new treatment modality used for focal treatment of PCa. We aimed to demonstrate what imaging modalities can be used by descriptively reporting contrast-enhanced ultrasonography (CEUS), multiparametric magnetic resonance imaging (mpMRI), and grey-scale transrectal ultrasound (TRUS) results. Furthermore, we aimed to correlate quantitatively the ablation zone seen on mpMRI and CEUS with treatment planning to provide therapy feedback.

 

Methods: Imaging data was obtained from two prospective multicenter trials on IRE for localized low- to intermediate-risk PCa. The ablation zone volume (AZV) seen on mpMRI and CEUS was 3D reconstructed to correlate with the planned AZV.

 

Results: Descriptive examples are provided using mpMRI, TRUS, and CEUS for treatment planning and follow-up after IRE. The mean AZV on T2-weighted imaging 4 weeks following IRE was 12.9 cm3 (standard deviation [SD]=7.0), 5.3 times larger than the planned AZV. Linear regression showed a positive correlation (r=0.76, P = 0.002). For CEUS the mean AZV was 20.7 cm3 (SD=8.7), 8.5 times larger than the planned AZV with a strong positive correlation (r=0.93, P = 0.001). Prostate volume is reduced over time (mean= -27.5%, SD=11.9%) due to ablation zone fibrosis and deformation, illustrated by 3D reconstruction.

 

Conclusion: The role of imaging in conjunction with IRE is of crucial importance to guide clinicians throughout the treatment protocol. CEUS and mpMRI may provide essential treatment feedback by visualizing the ablation zone dimensions and volume.

 

You may cite this article as:  Scheltema  MJ, Postema AW, de Bruin DM, et al. Irreversible electroporation for the treatment of localized prostate cancer: a summary of imaging findings and treatment feedback. Diagn Interv Radiol 2017; 23:365–370.

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