Image-Guided Adaptive Cryotherapy for Prostate Cancer Treatment.

Purpose: Focal cryoablation is an effective treatment for localized and recurrent prostate cancer, offering reduced risks of side effects. However, treatment success depends on physician experience, as intraprocedural adjustments are required due to needle deflection. To determine whether an image-guided adaptive treatment strategy could reduce the required years of experience, we developed Image-guided Adaptive Cryotherapy (ImAC).

Feasibility of MRI-Guided Transperineal Implantation of Microdevices for Drug Delivery and Response Assessment in Prostate Cancer.

Background: Prostate cancer (PCa) treatment often involves systemic therapies with varying mechanisms of action, affecting individuals differently. Implantable microdevices (IMDs) are designed to test multiple drugs within a patient's tumor, but the feasibility of MRI-guided placement in PCa has not been evaluated.

Purpose: To provide proof of concept for placing IMDs into lesions with MRI guidance to predict patient-specific responses to therapies.

Hospital-Level Variability in the Adoption of Image-Guided Focal Therapy for Localized Prostate and Kidney Cancer.

Background: Focal therapy, a minimally invasive procedure, offers targeted treatment for kidney and prostate cancer using image guidance. However, the current institutional landscape of its adoption in localized prostate and kidney cancer remains less understood. This analysis compares its usage between the 2 cancers to discern health system determinants affecting the adoption of these treatments.

A Phase II Prospective Blinded Trial of Magnetic Resonance Imaging and In-Bore Biopsy in Active Surveillance for Prostate Cancer.

Objective: To demonstrate the added benefit of multiparametric (mp)MRI risk stratification during active surveillance.

Methods: This prospective, single-arm, nonrandomized study included 82 men with low-risk prostate cancer (PCa). We compared two biopsy strategies in parallel.

MRI-Targeted, Systematic, or Combined Biopsy for Detecting Clinically Significant Prostate Cancer.

Purpose: The aim of this study was to assess MRI-targeted, systematic, or combined prostate biopsy for diagnosing prostate cancer to identify opportunities for diagnostic accuracy improvement.

Methods: This institutional review board-approved, retrospective study, performed at a large, quaternary hospital, included all men undergoing prostate multiparametric MRI (mpMRI) from January 1, 2015, to December 31, 2019, with prostate-specific antigen ≥ 4 ng/mL, biopsy target on mpMRI (Prostate Imaging Reporting and Data System [PI-RADS] 3-5 lesion), and combined targeted and systematic biopsy ≤6 months after MRI. Analysis included the highest grade lesion per patient.

Motorized template for MRI-guided focal cryoablation of prostate cancer.

MR-guided focal cryoablation of prostate cancer has often been selected as a minimally-invasive treatment option. Placing multiple cryo-needles accurately to form an ablation volume that adequately covers the target volume is crucial for better oncological/functional outcomes. This paper presents an MRI-compatible system combining a motorized tilting grid template with insertion depth sensing capabilities, enabling the physician to precisely place the cryo-needles into the desired location.

AI-Based Isotherm Prediction for Focal Cryoablation of Prostate Cancer.

Rationale And Objectives: Focal therapies have emerged as minimally invasive alternatives for patients with localized low-risk prostate cancer (PCa) and those with postradiation recurrence. Among the available focal treatment methods for PCa, cryoablation offers several technical advantages, including the visibility of the boundaries of frozen tissue on the intraprocedural images, access to anterior lesions, and the proven ability to treat postradiation recurrence. However, predicting the final volume of the frozen tissue is challenging as it depends on several patient-specific factors, such as proximity to heat sources and thermal properties of the prostatic tissue.

Tumor and Ablation Margin Visibility during Cryoablation of Musculoskeletal Tumors: Comparing Intraprocedural PET/CT Images with CT-Only Images.

Purpose: To compare tumor and ice-ball margin visibility on intraprocedural positron emission tomography (PET)/computed tomography (CT) and CT-only images and report technical success, local tumor progression, and adverse event rates for PET/CT-guided cryoablation procedures for musculoskeletal tumors.

Materials And Methods: This Health Insurance Portability and Accountability Act (HIPAA)-compliant and institutional review board-approved retrospective study evaluated 20 PET/CT-guided cryoablation procedures performed with palliative and/or curative intent to treat 15 musculoskeletal tumors in 15 patients from 2012 to 2021. Cryoablation was performed using general anesthesia and PET/CT guidance.

Contemporary patterns of local ablative therapies for prostate cancer at United States cancer centers: results from a national registry.

Purpose: To describe the national-level patterns of care for local ablative therapy among men with PCa and identify patient- and hospital-level factors associated with the receipt of these techniques.

Methods: We retrospectively interrogated the National Cancer Database (NCDB) for men with clinically localized PCa between 2010 and 2017. The main outcome was receipt of local tumor ablation with either cryo- or laser-ablation, and "other method of local tumor destruction including high-intensity focused ultrasound (HIFU)".

Image-Guided Ablation of Recurrent or Unresectable Intrahepatic Cholangiocarcinoma.

Purpose: To assess the safety and effectiveness of image-guided ablation of recurrent or unresectable intrahepatic cholangiocarcinoma (ICC).

Materials And Methods: In this retrospective study, 25 patients (14 women; age, 36-84 years) underwent 37 image-guided liver tumor ablation procedures to treat 47 ICCs (May 2004 to January 2022). At initial diagnosis, 20 patients had Stage 1 or 2 disease and 5 had Stage 3 or 4 disease.

Periprocedural factors associated with overall patient survival following percutaneous image-guided liver tumor cryoablation.

Purpose: To assess the impact of periprocedural factors, including adverse events, on overall patient survival following image-guided liver tumor cryoablation procedures.

Methods: In this retrospective single-institution study, 143 patients (73 male, 70 female, ages 29-88) underwent 169 image-guided liver tumor cryoablation procedures between October 1998 and August 2014. Patient, tumor and procedural variables were recorded.

In vivo evaluation of angulated needle-guide template for MRI-guided transperineal prostate biopsy.

Purpose: Magnetic resonance imaging (MRI)-guided transperineal prostate biopsy has been practiced since the early 2000s. The technique often suffers from targeting error due to deviation of the needle as a result of physical interaction between the needle and inhomogeneous tissues. Existing needle guide devices, such as a grid template, do not allow choosing an alternative insertion path to mitigate the deviation because of their limited degree-of-freedom (DoF).

F-18 FDG perfusion PET: intraprocedural assessment of the liver tumor ablation margin.

Purpose: To evaluate F-fluorodeoxyglucose (FDG) perfusion PET during FDG PET/CT-guided liver tumor microwave ablation procedures for assessing the ablation margin and correlating minimum margin measurements with local progression.

Methods: This IRB-approved, HIPAA-compliant study included 20 adult patients (11 M, 9 F; mean age 65) undergoing FDG PET/CT-guided liver microwave ablation to treat 31 FDG-avid tumors. Intraprocedural FDG perfusion PET was performed to assess the ablation margin.

Assessing ablation margins of FDG-avid liver tumors during PET/CT-guided thermal ablation procedures: a retrospective study.

Background: To retrospectively assess liver tumor ablation margins using intraprocedural PET/CT images from FDG PET/CT-guided microwave or cryoablation procedures and to correlate minimum margin measurements with local progression outcomes.

Methods: Fifty-six patients (ages 36 to 85, median 62; 32 females) with 77 FDG-avid liver tumors underwent 60 FDG PET/CT guided, percutaneous microwave, or cryoablation procedures. Single breath-hold PET/CT images were used for intraprocedural assessment of the tumor ablation margin: liver tumors remained visible on PET immediately following ablation; microwave ablation zones were visible using contrast-enhanced CT; cryoablation zones (ice balls) were visible using unenhanced CT.

Percutaneous CT- and MRI-guided Cryoablation of cT1 Renal Cell Carcinoma: Intermediate- to Long-term Outcomes in 307 Patients.

Background Percutaneous ablation for cT1 renal cell carcinoma (RCC) remains underused, partially because of heterogeneous and limited long-term outcomes data assessing recent cryoablation methods. Purpose To report intermediate- to long-term outcomes of image-guided percutaneous cryoablation of cT1 RCC and to compare outcomes for CT versus MRI guidance. Materials and Methods This HIPAA-compliant retrospective single-institution study assessed patients who underwent percutaneous cryoablation for solitary pathology-proven cT1 RCC between August 2000 and July 2017.

Simulated accuracy assessment of small footprint body-mounted probe alignment device for MRI-guided cryotherapy of abdominal lesions.

Purpose: Magnetic resonance imaging (MRI)-guided percutaneous cryotherapy of abdominal lesions, an established procedure, uses MRI to guide and monitor the cryoablation of lesions. Methods to precisely guide cryotherapy probes with a minimum amount of trial-and-error are yet to be established. To aid physicians in attaining precise probe alignment without trial-and-error, a body-mounted motorized cryotherapy-probe alignment device (BMCPAD) with motion compensation was clinically tested in this study.

CT Texture Analysis and Machine Learning Improve Post-ablation Prognostication in Patients with Adrenal Metastases: A Proof of Concept.

Introduction: To assess the performance of pre-ablation computed tomography texture features of adrenal metastases to predict post-treatment local progression and survival in patients who underwent ablation using machine learning as a prediction tool.

Materials And Methods: This is a pilot retrospective study of patients with adrenal metastases undergoing ablation. Clinical variables were collected.

Open Source Platform for Transperineal In-Bore MRI-Guided Targeted Prostate Biopsy.

Objective: Accurate biopsy sampling of the suspected lesions is critical for the diagnosis and clinical management of prostate cancer. Transperineal in-bore MRI-guided prostate biopsy (tpMRgBx) is a targeted biopsy technique that was shown to be safe, efficient, and accurate. Our goal was to develop an open source software platform to support evaluation, refinement, and translation of this biopsy approach.

Automatic Needle Segmentation and Localization in MRI With 3-D Convolutional Neural Networks: Application to MRI-Targeted Prostate Biopsy.

Image guidance improves tissue sampling during biopsy by allowing the physician to visualize the tip and trajectory of the biopsy needle relative to the target in MRI, CT, ultrasound, or other relevant imagery. This paper reports a system for fast automatic needle tip and trajectory localization and visualization in MRI that has been developed and tested in the context of an active clinical research program in prostate biopsy. To the best of our knowledge, this is the first reported system for this clinical application and also the first reported system that leverages deep neural networks for segmentation and localization of needles in MRI across biomedical applications.

Evaluation of robot-assisted MRI-guided prostate biopsy: needle path analysis during clinical trials.

While the interaction between a needle and the surrounding tissue is known to cause a significant targeting error in prostate biopsy leading to false-negative results, few studies have demonstrated how it impacts in the actual procedure. We performed a pilot study on robot-assisted MRI-guided prostate biopsy with an emphasis on the in-depth analysis of the needle-tissue interaction in vivo. The data were acquired during in-bore transperineal prostate biopsies in patients using a 4 degrees-of-freedom (DoF) MRI-compatible robot.