Related Experiment Video
Updated: Aug 2, 2025
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
MR-Guided Transurethral Ultrasound Ablation of Prostate Cancer: Initial Experience of Monitoring Tumor Response by
Lena Meyer1, Andreas Bohlscheid2, Oscar Lemmer3
1University of Bonn, Bonn, Germany.
Introduction:
Diffusion-weighted imaging (DWI) as part of multiparametric magnetic resonance imaging (mpMRI) is an important sequence for the detection of prostate cancer (PCa). The objective of this retrospective analysis was to evaluate changes in apparent diffusion coefficient (ADC) measurements in biopsy-proven PCa undergoing TULSA-PRO (MR-guided transurethral ultrasound ablation of the prostate) at 3.0 T after 1, 3, and 6-12 months posttreatment.
Methods:
Nineteen patients underwent follow-up examinations after 1, 3, and 6-12 months including mpMRI at 3.0 T and urological-clinical examinations with quantitative analysis of ADCs.
Results:
In PCa, a significant increase of ADC values after 6-12 months was measured after TULSA-PRO treatment by 29.1% (pre-TULSA: 0.79 ± 0.16 × 10-3 mm2/s, 6-12 months: 1.02 ± 0.35 × 10-3 mm2/s), while the corresponding value in the reference tissue decreased by 48.5% (pre-TULSA: 1.20 ± 0.15 × 10-3 mm2/s, 6-12 months: 0.91 ± 0.29 × 10-3 mm2/s). The mean ADC values in the early follow-up groups at 1 and 3 months did not change significantly.
Conclusion:
DWI with ADC as part of mpMRI can serve as a biomarker to dynamically monitor the follow-up after TULSA after 6-12 months. For early posttreatment progression, it is not suitable due to too many confounding variables.
Insights
Diffusion-weighted imaging (DWI) using apparent diffusion coefficient (ADC) measurements can monitor prostate cancer (PCa) treatment with TULSA-PRO after 6-12 months. Early follow-up (1-3 months) is not reliable for assessing treatment response due to confounding variables.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Diffusion-weighted imaging (DWI) is crucial in multiparametric MRI (mpMRI) for prostate cancer (PCa) detection.
- TULSA-PRO (MR-guided transurethral ultrasound ablation) is a treatment for PCa.
- Understanding post-treatment changes in prostate tissue is vital for patient management.
Purpose of the Study:
- To evaluate changes in apparent diffusion coefficient (ADC) values in PCa patients post-TULSA-PRO treatment.
- To assess the utility of ADC measurements at 1, 3, and 6-12 months after TULSA-PRO.
- To determine if DWI can serve as a biomarker for monitoring TULSA-PRO treatment outcomes.
Main Methods:
- Retrospective analysis of 19 patients with biopsy-proven PCa treated with TULSA-PRO.
- Follow-up mpMRI at 3.0 T and urological-clinical examinations at 1, 3, and 6-12 months post-treatment.
- Quantitative analysis of ADC values in PCa lesions and reference tissue.
Main Results:
- Significant ADC increase in PCa by 29.1% at 6-12 months post-TULSA-PRO (0.79 to 1.02 × 10-3 mm2/s).
- Significant ADC decrease in reference tissue by 48.5% at 6-12 months post-TULSA-PRO (1.20 to 0.91 × 10-3 mm2/s).
- No significant changes in mean ADC values were observed at 1 and 3 months post-treatment.
Conclusions:
- DWI with ADC measurements can be a valuable biomarker for monitoring TULSA-PRO treatment in PCa at 6-12 months.
- Early post-treatment monitoring (1-3 months) using ADC is not suitable due to confounding variables.
- ADC changes reflect treatment-induced tissue modifications, aiding in long-term outcome assessment.
