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Related Experiment Video

Updated: May 8, 2025

Focal Laser Ablation of Prostate Cancer: An Office Procedure
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Focal Laser Ablation of Prostate Cancer: An Office Procedure

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MRI-directed Micro-US-guided Transperineal Focal Laser Ablation for Localized Prostate Cancer: A 1-year Follow-up

Franҫois Cornud1, Katelijne de Bie1, Luigi van Riel1

  • 1From the Departments of Radiology (F.C., A.L.) and Urology (M.G.), Clinique de l'Alma, 166 Rue de l'Université, 75007 Paris, France; Department of Urology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands (K.d.B., L.v.R.); and Department of Pathology, i-Path Institut de Pathologie des Hauts-de-France, Amiens, France (P.C.).

Radiology
|December 24, 2024
PubMed
Summary

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MRI-guided micro-ultrasound focal laser ablation (FLA) shows promise for localized prostate cancer. Multifiber FLA demonstrated feasibility and safety, with an 18% recurrence rate at 12 months.

Area of Science:

  • Urology
  • Oncology
  • Medical Imaging

Background:

  • MRI-guided focal laser ablation (FLA) is an emerging treatment for localized prostate cancer (PCa).
  • Micro-ultrasound (micro-US) guided FLA offers potential for outpatient procedures, but clinical data is limited.

Purpose of the Study:

  • To assess the safety, feasibility, and 12-month outcomes of MRI-guided micro-US transperineal FLA for localized PCa.
  • To evaluate micro-US accuracy in visualizing lesions identified by MRI (PI-RADS 3 or higher).

Main Methods:

  • Prospective observational study of 55 men with localized PCa and PI-RADS 3+ lesions treated with transperineal FLA.
  • Single- or multifiber FLA used, guided by MRI-delineated image fusion.
  • 12-month follow-up included recurrence rates, complications, and functional scores (erectile and urinary).

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Last Updated: May 8, 2025

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Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
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Main Results:

  • 53 of 58 lesions (91%) were visualized by micro-US.
  • Multifiber FLA yielded larger ablation volumes (15 mL) compared to single-fiber (4.5 mL).
  • At 12 months, 17 of 35 treated tumors (49%) showed recurrence (18% with multifiber FLA). Erectile function decreased, while urinary function remained stable. One rectoprostatic fistula occurred.

Conclusions:

  • Multifiber micro-US-guided FLA is a safe and feasible outpatient treatment for localized prostate cancer.
  • The technique shows promising oncologic control, with a 18% recurrence rate at 1 year using multifiber applicators.
  • Further research is warranted to optimize treatment protocols and long-term outcomes.