Samuel J Galgano1,2, Virginia B Planz3, Sandeep Arora3, Soroush Rais-Bahrami4,5,6. 1. Department of Radiology, University of Alabama at Birmingham, 619 19th St S, JT N325, Birmingham, AL, 35249, USA. samuelgalgano@uabmc.edu. 2. O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA. samuelgalgano@uabmc.edu. 3. Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA. 4. Department of Radiology, University of Alabama at Birmingham, 619 19th St S, JT N325, Birmingham, AL, 35249, USA. 5. O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA. 6. Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
PURPOSE OF REVIEW: The goal of this paper was to review the novel treatment modality of high-intensity transurethral directional ultrasound for prostate cancer. RECENT FINDINGS: Prostate cancer is a heterogeneous disease with some patients electing for active surveillance and focal therapies instead of definitive treatment with radical prostatectomy or radiation therapy. Prostate MRI has become a cornerstone of prostate cancer diagnosis, targeted biopsy, and treatment planning. Transurethral high-intensity directional ultrasound allows for MRI-guided ablation of the prostate gland with the ability to contour boundaries and spare critical structures, such as the neurovascular bundle and urinary sphincter. Although results are still emerging, this may offer patients a new option for focal therapy with a favorable side-effect profile. High-intensity transurethral directional ultrasound is an emerging treatment modality for both whole-gland and focal ablation with promising early results. Further research is needed to establish safety, tolerability, and long-term oncologic outcomes.
PURPOSE OF REVIEW: The goal of this paper was to review the novel treatment modality of high-intensity transurethral directional ultrasound for prostate cancer. RECENT FINDINGS:Prostate cancer is a heterogeneous disease with some patients electing for active surveillance and focal therapies instead of definitive treatment with radical prostatectomy or radiation therapy. Prostate MRI has become a cornerstone of prostate cancer diagnosis, targeted biopsy, and treatment planning. Transurethral high-intensity directional ultrasound allows for MRI-guided ablation of the prostate gland with the ability to contour boundaries and spare critical structures, such as the neurovascular bundle and urinary sphincter. Although results are still emerging, this may offer patients a new option for focal therapy with a favorable side-effect profile. High-intensity transurethral directional ultrasound is an emerging treatment modality for both whole-gland and focal ablation with promising early results. Further research is needed to establish safety, tolerability, and long-term oncologic outcomes.
Entities:
Keywords:
Ablation; Focal therapy; High-intensity ultrasound; Prostate cancer
Authors: Jonathan I Epstein; Lars Egevad; Mahul B Amin; Brett Delahunt; John R Srigley; Peter A Humphrey Journal: Am J Surg Pathol Date: 2016-02 Impact factor: 6.394