Single setting 3D MRI-US guided frozen section and focal cryoablation of the index lesion: proof of principle and initial series
Abstract
In this video we first report reliability of frozen section for the diagnosis of prostate cancer combined with a real time 3D focal cryoablation of the index lesion.
NaviGo system provided a real time 3D monitoring of the index lesion, while focal cryoablation is performed using the Endocare CryoCS. V-probes are used to tailor the ice ball size to the treatment area. Systematic prostate biopsy is performed to confirm absence of cancer outside the index lesion. Complications, functional and early oncologic outcomes are reported.
This initial report includes 3 patients with a clinical suspicious of prostate cancer based on PSA and a single MRI lesion with a PIRADS score 4 or 5. All patients denied consent to any radical treatment.
Prostate cancer diagnosis was histologically confirmed in all 3 patients by frozen sections. Postoperative course was uneventful and all patients were discharged on first postoperative day.
Mean PSA values decreased from 12.51 (baseline) to 1.72 ng/mL at 3-mo evaluation. Three-mo postoperative MRI images showed complete ablation of the index lesion in all patients.
Urinary continence and erectile function were preserved in all patients.
Achieving diagnosis and focal treatment of prostate cancer index lesion in a single session is a further step towards a minimally invasive and patient tailored approach.