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Review
. 2022 Nov;24(11):1433-1441.
doi: 10.1007/s11912-022-01291-3. Epub 2022 Jun 7.

Minimally Invasive Procedures in the Diagnosis and Treatment of Localized Prostate Cancer: an Interventional Radiologist's Perspective

Yaniv Avital  1   2 , Jurgen J Fütterer  3 , Alexei Cherniavsky  4 , Joyce G R Bomers  3
Affiliations
Review

Minimally Invasive Procedures in the Diagnosis and Treatment of Localized Prostate Cancer: an Interventional Radiologist's Perspective

Yaniv Avital et al. Curr Oncol Rep. 2022 Nov.

Abstract

Purpose of review: Minimal invasive procedures, including targeted biopsy (TB) and focal therapy (FT), are increasingly used in diagnosis and treatment of localized prostate cancer. Here, we review the current role of these procedures, from a perspective of an interventional radiologist.

Recent findings: TB is an established part of current guidelines for diagnosis of PCa. Several modalities of FT are gaining prevalence in recent years, as a tissue-preserving alternative for definitive treatment of localized PCa. FT is currently at early research stages, offered to selected patients in clinical trials settings. TB and FT are minimally invasive procedures used by multidisciplinary teams for diagnosis and treatment of localized PCa.

Keywords: Focal therapy; Interventional radiology; Localized prostate carcinoma; Multi-parametric MRI; Partial gland ablation; Targeted biopsy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
FT and partial gland ablative template. Focal therapy: Focused ablation of an image-visible index lesion. Partial gland ablation: destruction of all prostate tissue within an anatomical ablation zone, aiming to preserve at least one neurovascular bundle. Ablation templates include as follows: Quadrant ablation — a quadrant of the prostate tissue; Hemi-ablation — a lateralized hemisphere of the prostate or the anterior half of the prostate; Hockey stick ablation — prostate tissue within a lateralized hemisphere plus anterior contralateral region; Subtotal ablation — most of the prostate tissue with preservation of a posterior lateral region (unilaterally or bilaterally)
Fig. 2
Fig. 2
A 68-year-old male presenting with an elevated PSA level of 5 ng/mL was diagnosed with prostate cancer in the right peripheral zone in the midportion of his prostate, Gleason score of 3 + 4 = 7 (ISUP 2). a T2-weighted MR image of the lesion before treatment. b Contrast enhanced image directly at the end of the focal laser ablation procedure, showing lack of enhancement at the ablation bed. At 1-year follow-up after treatment, the patient’s PSA level dropped to 2.2 ng/mL and the following MRI images confirmed no evidence of residual or recurrent tumor at the treatment area: c Perfusion weighted color MR image, showing lack of perfusion in the treated area. d T2-weighted MR image, showing complete focal atrophy of the treated area
See this image and copyright information in PMC

References

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