Three-dimensional transrectal ultrasound guided cryoablation for localized prostate cancer in nonsurgical candidates: A feasibility study and report of early results

Purpose: A 3-dimensional (D) transrectal ultrasound imaging system was incorporated into the cryoablation routine for prostate cancer to assess its feasibility and use. The objective was to improve visibility for probe placement and for intraoperative monitoring. Materials and Methods: A commercially available transrectal ultrasound unit was coupled with a custom designed software system to construct 3-dimensional prostate images. A total of 52 patients with clinically localized prostate cancer, in whom radiotherapy had failed (45) or who were otherwise judged to be nonsurgical candidates (7) were treated with cryoablation, using 3-D transrectal ultrasound for intraoperative guidance. Results: In all cases the intraoperative 3-D transrectal ultrasound images provided a unique coronal view of the prostate, revealing useful information and facilitating more precise probe placement and treatment monitoring. Early postoperative histological and biochemical results and complication rates compare well with other contemporary series. Conclusions: Although the precise role of cryoablation in the management of prostate cancer remains unclear and long-term results are pending, incorporation of a 3-D transrectal ultrasound imaging system into the cryoablation routine proved to be feasible and appeared to be a worthwhile effort to facilitate the procedure, and deserves further evaluation.