Ultrasound Technique Treats Prostate Cancer with Minimal Side Effects (IMAGE)
Caption
Images in 75-year-old man with biopsy-confirmed Gleason score 7 (4+3) prostate cancer. (a) Pretreatment axial T2-weighted fast spin-echo MRI scan on day of treatment (repetition time msec/echo time msec, 4416/81) shows tumor in left posteromedial peripheral zone at midgland (arrow). Endorectal treatment probe with degassed water is seen in rectum. (b) Intraoperative MRI scan shows contoured rectal wall (red line), prostate margin (blue outline), and region of interest (yellow outline). Because urethra was included in planned treatment volume, a suprapubic catheter was placed for continuous bladder drainage during treatment. (c) Intraoperative MRI scan shows focused ultrasound beam path (blue) overlaid on treatment plan. Rectangles illustrate each sonication spot. (d) Thermal map image obtained during treatment with heat deposition color coded in red overlaid on sonication spot. (e) Axial gadopentetate dimeglumine-enhanced subtraction MRI scan (200/5.4) obtained immediately after treatment shows devascularized ablated volume (arrow). Note that devascularized area does not extend into transition zone anteriorly. (f) Corresponding axial T2-weighted fast spin-echo MRI scan (4140/97) at 5 months after ablation shows scarring at ablation site (arrow). (g) Axial gadopentetate dimeglumine-enhanced subtraction MRI scan (5.39/1.88) does not show any early enhancement on dynamic contrast-enhanced images at treatment area (arrow). All six cores from treatment area, including margins, were negative for cancer at biopsy.
Credit
Radiological Society of North America
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