Irreversible electroporation for prostate cancer using PSMA PET-CT.

Area of Science:

• Oncology
• Radiology
• Urology

Background:

• Prostate cancer diagnosis and treatment require precise localization of tumors.
• Irreversible electroporation (IRE) is a focal therapy for localized prostate cancer.
• The role of PSMA PET-CT in guiding IRE needs further clinical validation.

Purpose of the Study:

• To evaluate the clinical utility of PSMA PET-CT for guiding IRE in prostate cancer patients.
• To assess the efficacy and safety of IRE focal therapy guided by PSMA PET-CT.

Main Methods:

• Seventeen men with localized prostate cancer underwent mpMRI and PSMA PET-CT.
• Transperineal MRI-ultrasound fusion-guided biopsy was performed.
• Patients received IRE focal therapy, with outcomes assessed via PSA levels and follow-up imaging/biopsies.

Main Results:

• The mean age was 66.1 years, with a median PSA of 7.5 ng/ml.
• Post-treatment, 64.7% of patients showed a PSA decline >50%.
• At 12 months, 88% of patients had negative biopsies post-IRE, with no recurrence in 13 out of 17 patients (excluding initial cases).

Conclusions:

• PSMA PET-CT is valuable for localizing prostate cancer to guide IRE.
• This imaging modality complements conventional mpMRI for complete lesion detection and treatment.
• PSMA PET-CT enhances the precision and completeness of IRE focal therapy.