PURPOSE: Magnetic resonance imaging-guided transurethral ultrasound ablation uses directional thermal ultrasound under magnetic resonance imaging thermometry feedback control for prostatic ablation. We report 12-month outcomes from a prospective multicenter trial (TACT). MATERIALS AND METHODS: A total of 115 men with favorable to intermediate risk prostate cancer across 13 centers were treated with whole gland ablation sparing the urethra and apical sphincter. The co-primary 12-month endpoints were safety and efficacy. RESULTS: In all, 72 (63%) had grade group 2 and 77 (67%) had NCCN® intermediate risk disease. Median treatment delivery time was 51 minutes with 98% (IQR 95-99) thermal coverage of target volume and spatial ablation precision of ±1.4 mm on magnetic resonance imaging thermometry. Grade 3 adverse events occurred in 9 (8%) men. The primary endpoint (U.S. Food and Drug Administration mandated) of prostate specific antigen reduction ≥75% was achieved in 110 of 115 (96%) with median prostate specific antigen reduction of 95% and nadir of 0.34 ng/ml. Median prostate volume decreased from 37 to 3 cc. Among 68 men with pretreatment grade group 2 disease, 52 (79%) were free of grade group 2 disease on 12-month biopsy. Of 111 men with 12-month biopsy data, 72 (65%) had no evidence of cancer. Erections (International Index of Erectile Function question 2 score 2 or greater) were maintained/regained in 69 of 92 (75%). Multivariate predictors of persistent grade group 2 at 12 months included intraprostatic calcifications at screening, suboptimal magnetic resonance imaging thermal coverage of target volume and a PI-RADS™ 3 or greater lesion at 12-month magnetic resonance imaging (p <0.05). CONCLUSIONS: The TACT study of magnetic resonance imaging-guided transurethral ultrasound whole gland ablation in men with localized prostate cancer demonstrated effective tissue ablation and prostate specific antigen reduction with low rates of toxicity and residual disease.
PURPOSE: Magnetic resonance imaging-guided transurethral ultrasound ablation uses directional thermal ultrasound under magnetic resonance imaging thermometry feedback control for prostatic ablation. We report 12-month outcomes from a prospective multicenter trial (TACT). MATERIALS AND METHODS: A total of 115 men with favorable to intermediate risk prostate cancer across 13 centers were treated with whole gland ablation sparing the urethra and apical sphincter. The co-primary 12-month endpoints were safety and efficacy. RESULTS: In all, 72 (63%) had grade group 2 and 77 (67%) had NCCN® intermediate risk disease. Median treatment delivery time was 51 minutes with 98% (IQR 95-99) thermal coverage of target volume and spatial ablation precision of ±1.4 mm on magnetic resonance imaging thermometry. Grade 3 adverse events occurred in 9 (8%) men. The primary endpoint (U.S. Food and Drug Administration mandated) of prostate specific antigen reduction ≥75% was achieved in 110 of 115 (96%) with median prostate specific antigen reduction of 95% and nadir of 0.34 ng/ml. Median prostate volume decreased from 37 to 3 cc. Among 68 men with pretreatment grade group 2 disease, 52 (79%) were free of grade group 2 disease on 12-month biopsy. Of 111 men with 12-month biopsy data, 72 (65%) had no evidence of cancer. Erections (International Index of Erectile Function question 2 score 2 or greater) were maintained/regained in 69 of 92 (75%). Multivariate predictors of persistent grade group 2 at 12 months included intraprostatic calcifications at screening, suboptimal magnetic resonance imaging thermal coverage of target volume and a PI-RADS™ 3 or greater lesion at 12-month magnetic resonance imaging (p <0.05). CONCLUSIONS: The TACT study of magnetic resonance imaging-guided transurethral ultrasound whole gland ablation in men with localized prostate cancer demonstrated effective tissue ablation and prostate specific antigen reduction with low rates of toxicity and residual disease.
Entities:
Keywords:
image guided; magnetic resonance imaging; minimally invasive surgical procedures; prostatic neoplasms; radiotherapy; transurethral resection of prostate
Authors: Anne Sailer; Pejman Ghanouni; George R Schade; Alessandro Napoli; Joan Vidal-Jove; Steven S Raman; Mishal Mendiratta-Lala; Sangeet Ghai; Andre Abreu; Karthik M Sundaram; Antonio Westphalen; Sandeep Arora Journal: Radiographics Date: 2022-10 Impact factor: 6.312
Authors: Behfar Ehdaie; Clare M Tempany; Ford Holland; Daniel D Sjoberg; Adam S Kibel; Quoc-Dien Trinh; Jeremy C Durack; Oguz Akin; Andrew J Vickers; Peter T Scardino; Dan Sperling; Jeffrey Y C Wong; Bertram Yuh; David A Woodrum; Lance A Mynderse; Steven S Raman; Allan J Pantuck; Marc H Schiffman; Timothy D McClure; Geoffrey A Sonn; Pejman Ghanouni Journal: Lancet Oncol Date: 2022-06-14 Impact factor: 54.433
Authors: Xinrui Zhang; Lisa Landgraf; Nikolaos Bailis; Michael Unger; Thies H Jochimsen; Andreas Melzer Journal: J Nucl Med Date: 2021-06-04 Impact factor: 10.057
Authors: Gencay Hatiboglu; Valentin Popeneciu; David Bonekamp; Mathieu Burtnyk; Robert Staruch; Florian Distler; Jan Philipp Radtke; Johann Motsch; Heinz Peter Schlemmer; Sascha Pahernik; Joanne Nyarangi-Dix Journal: Front Oncol Date: 2021-10-27 Impact factor: 6.244
Authors: Fabian Tollens; Niklas Westhoff; Jost von Hardenberg; Sven Clausen; Michael Ehmann; Frank G Zöllner; Anne Adlung; Dominik F Bauer; Stefan O Schoenberg; Dominik Nörenberg Journal: Radiologe Date: 2021-07-12 Impact factor: 0.635
Authors: Mikael Anttinen; Pietari Mäkelä; Antti Viitala; Pertti Nurminen; Visa Suomi; Teija Sainio; Jani Saunavaara; Pekka Taimen; Roberto Blanco Sequeiros; Peter J Boström Journal: Eur Urol Open Sci Date: 2020-11-25