MRI-guided Transurethral Ultrasound Therapy of the Prostate Gland Using Real-time Thermal Mapping: Initial Studies

被引:51
作者
Siddiqui, Kashif [1 ,2 ]
Chopra, Rajiv [2 ,5 ]
Vedula, Siddharth [2 ]
Sugar, Linda [3 ]
Haider, Masoom [4 ]
Boyes, Aaron [2 ]
Musquera, Mireia [1 ]
Bronskill, Michael [2 ,5 ]
Klotz, Laurence [1 ]
机构
[1] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Urol, Toronto, ON M4N 3M5, Canada
[2] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Imaging Res, Toronto, ON M4N 3M5, Canada
[3] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Pathol, Toronto, ON M4N 3M5, Canada
[4] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Radiol, Toronto, ON M4N 3M5, Canada
[5] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Biophys, Toronto, ON M4N 3M5, Canada
关键词
INTENSITY FOCUSED ULTRASOUND; CANINE PROSTATE; TEMPERATURE FEEDBACK; FREQUENCY-SHIFT; CANCER; ABLATION; THERMOMETRY; RATIONALE;
D O I
10.1016/j.urology.2010.04.046
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE To confirm the correlation between planning and thermal injury of the prostate as determined by magnetic resonance imaging (MRI) and histology in canine and humans treated with transurethral ultrasound. MATERIAL AND METHODS Canine studies: 2 sets of in vivo studies were performed under general anesthesia in 1.5 T clinical MRI. Nine dogs were treated using single transducer; 8 dogs were treated using urethral applicator with multiple transducers. Rectal cooling was maintained. After initial imaging, a target boundary was selected and high-intensity ultrasound energy delivered. The spatial temperature distribution was measured continuously every 5 seconds with MR thermometry using the proton-resonant frequency shift method. The goal was to achieve 55 degrees C at the target boundary. After treatment, the prostate was harvested and fixed with adjoining tissue, including rectum. Temperature maps, anatomical images, and histologic sections were registered to each other and compared. Human studies: To date, 5 patients with localized prostate cancer have been treated immediately before radical prostatectomy. Approximately 30% of the gland volume was targeted. RESULTS A continuous pattern of thermal coagulation was successfully achieved within the target region, with an average spatial precision of 1-2 mm. Radical prostatectomy was routine, with an uncomplicated postoperative course in all patients. The correlation between anatomical, thermal, and histologic images was <= 3 mm. Treatment time was <30 minutes. No thermal damage to rectal tissue was observed. CONCLUSIONS Thermal ablation within the prescribed target of the prostate has been successfully demonstrated in canine studies. The treatment is also feasible in humans. UROLOGY 76: 1506-1511, 2010. (C) 2010 Elsevier Inc.
引用
收藏
页码:1506 / 1511
页数:6
相关论文
共 29 条
[1]   Prostate tissue analysis immediately following magnetic resonance imaging guided transurethral ultrasound thermal therapy [J].
Boyes, Aaron ;
Tang, Kee ;
Yaffe, Martin ;
Sugar, Linda ;
Chopra, Rajiv ;
Bronskill, Michael .
JOURNAL OF UROLOGY, 2007, 178 (03) :1080-1085
[2]   Quantitative analysis of 3-D conformal MRI-guided transurethral ultrasound therapy of the prostate: Theoretical simulations [J].
Burtnyk, Mathieu ;
Chopra, Rajiv ;
Bronskill, Michael J. .
INTERNATIONAL JOURNAL OF HYPERTHERMIA, 2009, 25 (02) :116-131
[3]   Prostate cancer: MR imaging and thermometry during microwave thermal ablation-initial experience [J].
Chen, JC ;
Moriarty, JA ;
Derbyshire, JA ;
Peters, RD ;
Trachtenberg, J ;
Bell, SD ;
Doyle, J ;
Arrelano, R ;
Wright, GA ;
Henkelman, RM ;
Hinks, RS ;
Lok, SY ;
Toi, A ;
Kucharczyk, W .
RADIOLOGY, 2000, 214 (01) :290-297
[4]   Analysis of factors important for transurethral ultrasound prostate heating using MR temperature feedback [J].
Chopra, R ;
Wachsmuth, J ;
Burtnyk, M ;
Haider, MA ;
Bronskill, MJ .
PHYSICS IN MEDICINE AND BIOLOGY, 2006, 51 (04) :827-844
[5]   Method for MRI-guided conformal thermal therapy of prostate with planar transurethral ultrasound heating applicators [J].
Chopra, R ;
Burtnyk, M ;
Haider, MA ;
Bronskill, MJ .
PHYSICS IN MEDICINE AND BIOLOGY, 2005, 50 (21) :4957-4975
[6]   MRI-compatible transurethral ultrasound system for the treatment of localized prostate cancer using rotational control [J].
Chopra, Rajiv ;
Baker, Nicole ;
Choy, Vanessa ;
Boyes, Aaron ;
Tang, Kee ;
Bradwell, David ;
Bronskill, Michael J. .
MEDICAL PHYSICS, 2008, 35 (04) :1346-1357
[7]   Analysis of the spatial and temporal accuracy of heating in the prostate gland using transurethral ultrasound therapy and active MR temperature feedback [J].
Chopra, Rajiv ;
Tang, Kee ;
Burtnyk, Mathieu ;
Boyes, Aaron ;
Sugar, Linda ;
Appu, Sree ;
Klotz, Laurence ;
Bronskill, Michael .
PHYSICS IN MEDICINE AND BIOLOGY, 2009, 54 (09) :2615-2633
[8]   MR thermometry for monitoring tumor ablation [J].
de Senneville, Baudouin Denis ;
Mougenot, Charles ;
Quesson, Bruno ;
Dragonu, Iulius ;
Grenier, Nicolas ;
Moonen, Chrit T. W. .
EUROPEAN RADIOLOGY, 2007, 17 (09) :2401-2410
[9]  
Eggener SE, 2007, J UROLOGY, V178, P2260, DOI 10.1016/j.juro.2007.08.072
[10]  
FOSTER RS, 1993, EUR UROL, V23, P330