MR imaging-controlled transurethral ultrasound therapy for conformal treatment of prostate tissue

Initial feasibility in humans

Rajiv Chopra, Alexandra Colquhoun, Mathieu Burtnyk, William A. N'djin, Ilya Kobelevskiy, Aaron Boyes, Kashif Siddiqui, Harry Foster, Linda Sugar, Masoom A. Haider, Michael Bronskill, Laurence Klotz

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Purpose: To evaluate the feasibility and safety of magnetic resonance (MR) imaging-controlled transurethral ultrasound therapy for prostate cancer in humans. Materials and Methods: This pilot study was approved by the institutional review board and was performed in eight men (mean age, 60 years; range, 49-70 years) with localized prostate cancer (Gleason score ≤7, prostate-specific antigen level ≤15 μg/L) immediately before radical prostatectomy. All patients provided written informed consent. This phase 0 feasibility and safety study is the first evaluation in humans. Transurethral ultrasound therapy was performed with the patient under spinal anesthesia by using a clinical 1.5-T MR unit. Patients then underwent radical prostatectomy, and the resected gland was sliced in the plane of treatment to compare the MR imaging measurements with the pattern of thermal damage. The overall procedure time and coagulation rate were measured. In addition, the spatial targeting accuracy was evaluated, as was the thermal history along the thermal damage boundaries in the gland. Results: The average procedure time was 3 hours, with 2 or fewer hours spent in the MR unit. The treatment was well tolerated by all patients, and a temperature uncertainty of less than 2°C was observed in the treatments. The mean temperature and thermal dose measured along the boundary of thermal coagulation were 52.3°C ± 2.1 and 3457 (cumulative equivalent minutes at 43°C) ± 5580, respectively. The mean treatment rate was 0.5 mL/min, and a spatial targeting accuracy of -1.0 mm ± 2.6 was achieved. Conclusion: MR imaging-controlled transurethral ultrasound therapy is feasible, safe, and well tolerated. This technology could be an attractive approach for whole-gland or focal therapy.

Original languageEnglish (US)
Pages (from-to)303-313
Number of pages11
JournalRadiology
Volume265
Issue number1
DOIs
StatePublished - Oct 2012

Fingerprint

Prostate
Magnetic Resonance Imaging
Hot Temperature
Therapeutics
Prostatectomy
Prostatic Neoplasms
Magnetic Resonance Spectroscopy
Safety
Temperature
Neoplasm Grading
Spinal Anesthesia
Research Ethics Committees
Feasibility Studies
Prostate-Specific Antigen
Informed Consent
Uncertainty
Technology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

MR imaging-controlled transurethral ultrasound therapy for conformal treatment of prostate tissue : Initial feasibility in humans. / Chopra, Rajiv; Colquhoun, Alexandra; Burtnyk, Mathieu; N'djin, William A.; Kobelevskiy, Ilya; Boyes, Aaron; Siddiqui, Kashif; Foster, Harry; Sugar, Linda; Haider, Masoom A.; Bronskill, Michael; Klotz, Laurence.

In: Radiology, Vol. 265, No. 1, 10.2012, p. 303-313.

Research output: Contribution to journalArticle

Chopra, R, Colquhoun, A, Burtnyk, M, N'djin, WA, Kobelevskiy, I, Boyes, A, Siddiqui, K, Foster, H, Sugar, L, Haider, MA, Bronskill, M & Klotz, L 2012, 'MR imaging-controlled transurethral ultrasound therapy for conformal treatment of prostate tissue: Initial feasibility in humans', Radiology, vol. 265, no. 1, pp. 303-313. https://doi.org/10.1148/radiol.12112263
Chopra, Rajiv ; Colquhoun, Alexandra ; Burtnyk, Mathieu ; N'djin, William A. ; Kobelevskiy, Ilya ; Boyes, Aaron ; Siddiqui, Kashif ; Foster, Harry ; Sugar, Linda ; Haider, Masoom A. ; Bronskill, Michael ; Klotz, Laurence. / MR imaging-controlled transurethral ultrasound therapy for conformal treatment of prostate tissue : Initial feasibility in humans. In: Radiology. 2012 ; Vol. 265, No. 1. pp. 303-313.
@article{bc4bb0ca6d3d413b9e027bf0036155d3,
title = "MR imaging-controlled transurethral ultrasound therapy for conformal treatment of prostate tissue: Initial feasibility in humans",
abstract = "Purpose: To evaluate the feasibility and safety of magnetic resonance (MR) imaging-controlled transurethral ultrasound therapy for prostate cancer in humans. Materials and Methods: This pilot study was approved by the institutional review board and was performed in eight men (mean age, 60 years; range, 49-70 years) with localized prostate cancer (Gleason score ≤7, prostate-specific antigen level ≤15 μg/L) immediately before radical prostatectomy. All patients provided written informed consent. This phase 0 feasibility and safety study is the first evaluation in humans. Transurethral ultrasound therapy was performed with the patient under spinal anesthesia by using a clinical 1.5-T MR unit. Patients then underwent radical prostatectomy, and the resected gland was sliced in the plane of treatment to compare the MR imaging measurements with the pattern of thermal damage. The overall procedure time and coagulation rate were measured. In addition, the spatial targeting accuracy was evaluated, as was the thermal history along the thermal damage boundaries in the gland. Results: The average procedure time was 3 hours, with 2 or fewer hours spent in the MR unit. The treatment was well tolerated by all patients, and a temperature uncertainty of less than 2°C was observed in the treatments. The mean temperature and thermal dose measured along the boundary of thermal coagulation were 52.3°C ± 2.1 and 3457 (cumulative equivalent minutes at 43°C) ± 5580, respectively. The mean treatment rate was 0.5 mL/min, and a spatial targeting accuracy of -1.0 mm ± 2.6 was achieved. Conclusion: MR imaging-controlled transurethral ultrasound therapy is feasible, safe, and well tolerated. This technology could be an attractive approach for whole-gland or focal therapy.",
author = "Rajiv Chopra and Alexandra Colquhoun and Mathieu Burtnyk and N'djin, {William A.} and Ilya Kobelevskiy and Aaron Boyes and Kashif Siddiqui and Harry Foster and Linda Sugar and Haider, {Masoom A.} and Michael Bronskill and Laurence Klotz",
year = "2012",
month = "10",
doi = "10.1148/radiol.12112263",
language = "English (US)",
volume = "265",
pages = "303--313",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "1",

}

TY - JOUR

T1 - MR imaging-controlled transurethral ultrasound therapy for conformal treatment of prostate tissue

T2 - Initial feasibility in humans

AU - Chopra, Rajiv

AU - Colquhoun, Alexandra

AU - Burtnyk, Mathieu

AU - N'djin, William A.

AU - Kobelevskiy, Ilya

AU - Boyes, Aaron

AU - Siddiqui, Kashif

AU - Foster, Harry

AU - Sugar, Linda

AU - Haider, Masoom A.

AU - Bronskill, Michael

AU - Klotz, Laurence

PY - 2012/10

Y1 - 2012/10

N2 - Purpose: To evaluate the feasibility and safety of magnetic resonance (MR) imaging-controlled transurethral ultrasound therapy for prostate cancer in humans. Materials and Methods: This pilot study was approved by the institutional review board and was performed in eight men (mean age, 60 years; range, 49-70 years) with localized prostate cancer (Gleason score ≤7, prostate-specific antigen level ≤15 μg/L) immediately before radical prostatectomy. All patients provided written informed consent. This phase 0 feasibility and safety study is the first evaluation in humans. Transurethral ultrasound therapy was performed with the patient under spinal anesthesia by using a clinical 1.5-T MR unit. Patients then underwent radical prostatectomy, and the resected gland was sliced in the plane of treatment to compare the MR imaging measurements with the pattern of thermal damage. The overall procedure time and coagulation rate were measured. In addition, the spatial targeting accuracy was evaluated, as was the thermal history along the thermal damage boundaries in the gland. Results: The average procedure time was 3 hours, with 2 or fewer hours spent in the MR unit. The treatment was well tolerated by all patients, and a temperature uncertainty of less than 2°C was observed in the treatments. The mean temperature and thermal dose measured along the boundary of thermal coagulation were 52.3°C ± 2.1 and 3457 (cumulative equivalent minutes at 43°C) ± 5580, respectively. The mean treatment rate was 0.5 mL/min, and a spatial targeting accuracy of -1.0 mm ± 2.6 was achieved. Conclusion: MR imaging-controlled transurethral ultrasound therapy is feasible, safe, and well tolerated. This technology could be an attractive approach for whole-gland or focal therapy.

AB - Purpose: To evaluate the feasibility and safety of magnetic resonance (MR) imaging-controlled transurethral ultrasound therapy for prostate cancer in humans. Materials and Methods: This pilot study was approved by the institutional review board and was performed in eight men (mean age, 60 years; range, 49-70 years) with localized prostate cancer (Gleason score ≤7, prostate-specific antigen level ≤15 μg/L) immediately before radical prostatectomy. All patients provided written informed consent. This phase 0 feasibility and safety study is the first evaluation in humans. Transurethral ultrasound therapy was performed with the patient under spinal anesthesia by using a clinical 1.5-T MR unit. Patients then underwent radical prostatectomy, and the resected gland was sliced in the plane of treatment to compare the MR imaging measurements with the pattern of thermal damage. The overall procedure time and coagulation rate were measured. In addition, the spatial targeting accuracy was evaluated, as was the thermal history along the thermal damage boundaries in the gland. Results: The average procedure time was 3 hours, with 2 or fewer hours spent in the MR unit. The treatment was well tolerated by all patients, and a temperature uncertainty of less than 2°C was observed in the treatments. The mean temperature and thermal dose measured along the boundary of thermal coagulation were 52.3°C ± 2.1 and 3457 (cumulative equivalent minutes at 43°C) ± 5580, respectively. The mean treatment rate was 0.5 mL/min, and a spatial targeting accuracy of -1.0 mm ± 2.6 was achieved. Conclusion: MR imaging-controlled transurethral ultrasound therapy is feasible, safe, and well tolerated. This technology could be an attractive approach for whole-gland or focal therapy.

UR - http://www.scopus.com/inward/record.url?scp=84866613971&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866613971&partnerID=8YFLogxK

U2 - 10.1148/radiol.12112263

DO - 10.1148/radiol.12112263

M3 - Article

VL - 265

SP - 303

EP - 313

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 1

ER -