Irreversible electroporation for prostate cancer: another promising focal therapy

Radical treatment for prostate cancer is associated with significant morbidity. Percutaneous image-guided irreversible electroporation is a non-thermal ablative technique that has emerged as a valuable option. This study describes the case of a patient with prostate cancer who was successfully treated using irreversible electroporation. We report the case of a 72-year-old male patient who presented with elevated PSA (4.0ng/mL) during routine testing. Multiparametric magnetic resonance imaging of the prostate revealed a 0.8 cm lesion in the posterolateral aspect of the right midgland with marked hypointensity on ADC (ACR PI-RADS 4). The transperineal prostate revealed acinar adenocarcinoma (Gleason Score 3+3=6; International Society of Urological Pathology=1). Serum PSA levels reduced to 1.04ng/mL 32 days after the procedure and remained within normal limits (1.26ng/mL) after 349 days. Follow-up imaging performed 90 days later with prostate-specific membrane antigen PET/MRI showed size reduction, retraction, and diffuse hypointensity in the peripheral zone of the right prostate lobe, with no increase in prostate-specific membrane antigen uptake. Magnetic resonance imaging found no suspicious lesions 367 days after irreversible electroporation. At the final clinical follow-up at 390 days, the patient was asymptomatic. Our findings illustrate the potential of irreversible electroporation as a possible alternative treatment for prostate cancer.