PURPOSE: To correlate laser ablation-induced changes in the prostate as depicted at endorectal magnetic resonance (MR) imaging with results at histologic examination. MATERIALS AND METHODS: In eight patients with prostate carcinoma, visually guided laser ablation was performed during lymphadenectomy. Radical prostate resection was performed 4-9 days (mean, 6.9 days) after ablation in seven patients and at 70 days in one patient. The study protocol consisted of (a) endorectal T2-weighted fast spin-echo imaging, (b) dynamic T1-weighted spoiled gradient-echo imaging prior to and after injection of contrast material, and (c) gadolinium-enhanced T1-weighted spin-echo imaging. Imaging findings were correlated with macroscopic and histologic findings. RESULTS: Histologic examination revealed periurethral necrosis with a marginal zone that consisted of partially necrotic tissue, dilated vessels, and hemorrhagic areas. Considerable interindividual difference was observed in the extent of morphologic alterations (area, 0-18.0 cm3). Gadolinium-enhanced images were best suited for assessment of laser ablation-induced changes. The correlation between the volume of altered tissue measured on MR images and in macroscopic specimens was excellent (r2 = .96). CONCLUSION: MR imaging helped monitor changes induced with laser ablation (which differed greatly among individuals). MR monitoring may thus be useful in patients with obstructive benign prostatic hyperplasia after laser ablation.
PURPOSE: To correlate laser ablation-induced changes in the prostate as depicted at endorectal magnetic resonance (MR) imaging with results at histologic examination. MATERIALS AND METHODS: In eight patients with prostate carcinoma, visually guided laser ablation was performed during lymphadenectomy. Radical prostate resection was performed 4-9 days (mean, 6.9 days) after ablation in seven patients and at 70 days in one patient. The study protocol consisted of (a) endorectal T2-weighted fast spin-echo imaging, (b) dynamic T1-weighted spoiled gradient-echo imaging prior to and after injection of contrast material, and (c) gadolinium-enhanced T1-weighted spin-echo imaging. Imaging findings were correlated with macroscopic and histologic findings. RESULTS: Histologic examination revealed periurethral necrosis with a marginal zone that consisted of partially necrotic tissue, dilated vessels, and hemorrhagic areas. Considerable interindividual difference was observed in the extent of morphologic alterations (area, 0-18.0 cm3). Gadolinium-enhanced images were best suited for assessment of laser ablation-induced changes. The correlation between the volume of altered tissue measured on MR images and in macroscopic specimens was excellent (r2 = .96). CONCLUSION: MR imaging helped monitor changes induced with laser ablation (which differed greatly among individuals). MR monitoring may thus be useful in patients with obstructive benign prostatic hyperplasia after laser ablation.
Authors: R Del Vescovo; F Pisanti; V Russo; S Battisti; R L Cazzato; F D'Agostino; F Giurazza; C C Quattrocchi; E Faiella; R Setola; R Giulianelli; R F Grasso; B Beomonte Zobel Journal: Radiol Med Date: 2012-09-17 Impact factor: 3.469