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Prostate Cancer Focal Therapy

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https://www.readbyqxmd.com/read/29678358/impact-of-68-ga-psma-pet-on-the-management-of-patients-with-prostate-cancer-a-systematic-review-and-meta-analysis
#1
REVIEW
Sangwon Han, Sungmin Woo, Yeon Joo Kim, Chong Hyun Suh
CONTEXT: 68 Gallium prostate-specific membrane antigen positron emission tomography (68 Ga-PSMA PET) is an emerging imaging modality for assessment of prostate cancer. Recent studies show promising results regarding its ability to detect recurrent or metastatic prostate cancer superior to that of conventional imaging modalities. However, the impact of 68 Ga-PSMA PET on management of patients with prostate cancer has not been well established. OBJECTIVE: To perform a systematic review and meta-analysis to evaluate the impact of 68 Ga-PSMA PET on management of patients with prostate cancer...
April 17, 2018: European Urology
https://www.readbyqxmd.com/read/29664243/new-technologies-and-techniques-for-prostate-cancer-focal-therapy-a-review-of-the-current-literature
#2
Estefanía Linares-Espinós, Arie Carneiro, Juan I Martínez-Salamanca, Fernando Bianco, Adalberto Castro-Alfaro, Xavier Cathelineau, Massimo Valerio, Rafael Sanchez-Salas
BACKGROUND: The aim of this study was to review the oncological and functional outcomes of new and established primary focal treatments (FT) for localized prostate cancer (PCa). METHODS: We performed a systematic search of published studies on FT for localized PCa using electronic databases (Medline and Embase). These studies included reports on hemiablation, focal ablation and target-ablation. We excluded salvage focal therapy studies and limited the search to those with a minimum of 12 months of follow-up...
April 16, 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/29661587/medium-term-follow-up-of-vascular-targeted-photodynamic-therapy-of-localized-prostate-cancer-using-tookad-soluble-wst-11-phase-ii-trials
#3
A Noweski, A Roosen, S Lebdai, E Barret, M Emberton, F Benzaghou, M Apfelbeck, B Gaillac, C Gratzke, C Stief, A R Azzouzi
BACKGROUND AND OBJECTIVE: To assess the medium-term tumor control in patients with localized prostate cancer (PCa) treated with vascular-targeted photodynamic (VTP) therapy with TOOKAD Soluble WST11 (VTP) and to assess the medium-term tolerability of the treatment. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: During the clinical phase II studies, 68 patients were treated with VTP under optimal treatment conditions (WST11 at 4mg/kg, light energy at 200J/cm, and a light density index ≥1) and have been included in a 3...
April 13, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29660918/contrast-enhanced-ultrasound-ceus-with-mri-image-fusion-for-monitoring-focal-therapy-of-prostate-cancer-with-high-intensity-focused-ultrasound-hifu-1
#4
M Apfelbeck, D-A Clevert, J Ricke, C Stief, B Schlenker
INTRODUCTION: Reduced acceptance of radical prostatectomy in patients with low risk or intermediate risk prostate cancer has significantly changed treatment strategies in prostate cancer (PCa) during the last years. Focal therapy of the prostate with high intensity focused ultrasound (HIFU) is an organ-preserving treatment for prostate cancer with less impairment of health-related quality of life. Follow-up after HIFU therapy by imaging modalities remains a major problem as eg. MRI performs poorly...
April 7, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29659383/prostate-specific-membrane-antigen-negative-metastases-a-potential-pitfall-in-prostate-specific-membrane-antigen-pet
#5
Benjamin Noto, Katharina Auf der Springe, Sebastian Huss, Thomas Allkemper, Lars Stegger
Ga-PSMA-11 PET/CT was performed in a 74-year-old man because of biochemical recurrence of prostate cancer following radiation therapy of the prostate gland 24 months earlier. Besides focal nuclide accumulation in the prostate gland suggestive of local recurrence, PET scan revealed no further pathologic uptake. However, CT showed multiple pulmonic nodules suggestive of metastases. Thoracotomy and pathologic examination revealed the nodules to be prostate cancer metastasis. Furthermore, immunohistochemical staining with PSMA antibodies demonstrated a virtual lack of PSMA expression...
April 13, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29625754/re-focal-therapy-in-primary-localised-prostate-cancer-the-european-association-of-urology-position-in-2018
#6
Arie Carneiro, Rafael Sanchez-Salas
No abstract text is available yet for this article.
April 3, 2018: European Urology
https://www.readbyqxmd.com/read/29594551/pair-matched-patient-reported-quality-of-life-and-early-oncological-control-following-focal-irreversible-electroporation-versus-robot-assisted-radical-prostatectomy
#7
Matthijs J Scheltema, John I Chang, Maret Böhm, Willemien van den Bos, Alexandar Blazevski, Ilan Gielchinsky, Anton M F Kalsbeek, Pim J van Leeuwen, Tuan V Nguyen, Theo M de Reijke, Amila R Siriwardana, James E Thompson, Jean J de la Rosette, Phillip D Stricker
PURPOSE: The design, conduct and completion of randomized trials for curative prostate cancer (PCa) treatments are challenging. To evaluate the effect of robot-assisted radical prostatectomy (RARP) versus focal irreversible electroporation (IRE) on patient-reported quality of life (QoL) and early oncological control using propensity-scored matching. METHODS: Patients with T1c-cT2b significant PCa (high-volume ISUP 1 or any 2/3) who received unifocal IRE were pair-matched to patients who received nerve-sparing RARP...
March 28, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29589155/accuracy-of-tumor-segmentation-from-multi-parametric-prostate-mri-and-18-f-choline-pet-ct-for-focal-prostate-cancer-therapy-applications
#8
Morand Piert, Prasad R Shankar, Jeffrey Montgomery, Lakshmi Priya Kunju, Virginia Rogers, Javed Siddiqui, Thekkelnaycke Rajendiran, Jason Hearn, Arvin George, Xia Shao, Matthew S Davenport
BACKGROUND: The study aims to assess the accuracy of multi-parametric prostate MRI (mpMRI) and18 F-choline PET/CT in tumor segmentation for clinically significant prostate cancer.18 F-choline PET/CT and 3 T mpMRI were performed in 10 prospective subjects prior to prostatectomy. All subjects had a single biopsy-confirmed focus of Gleason ≥ 3+4 cancer. Two radiologists (readers 1 and 2) determined tumor boundaries based on in vivo mpMRI sequences, with clinical and pathologic data available...
March 27, 2018: EJNMMI Research
https://www.readbyqxmd.com/read/29556348/porphyrin-grafted-lipid-microbubbles-for-the-enhanced-efficacy-of-photodynamic-therapy-in-prostate-cancer-through-ultrasound-controlled-in-situ-accumulation
#9
Yujia You, Xiaolong Liang, Tinghui Yin, Min Chen, Chen Qiu, Chuang Gao, Xiaoyou Wang, Yongjiang Mao, Enze Qu, Zhifei Dai, Rongqin Zheng
Photodynamic therapy (PDT) holds promise for focal therapy of prostate cancer (PCa). However, the therapeutic efficacy needs improvement, and further development of PDT for PCa has challenges, including uncertainty of photosensitizers (PSs) accumulation at the tumor site and difficulty in visualizing lesions using conventional ultrasound (US) imaging. We have developed novel porphyrin-grafted lipid (PGL) microbubbles (MBs; PGL-MBs) and propose a strategy to integrate PGL-MBs with US imaging to address these limitations and enhance PDT efficacy...
2018: Theranostics
https://www.readbyqxmd.com/read/29511576/multiparametric-magnetic-resonance-imaging-overview-of-the-technique-clinical-applications-in-prostate-biopsy-and-future-directions
#10
REVIEW
Hüseyin Cihan Demirel, John Warren Davis
Multiparametric magnetic resonance imaging (mpMRI) has managed to change the paradigms on prostate cancer detection and risk classification. The most clear-cut indication of mpMRI in guidelines is the patients with a history of negative biopsy/increasing prostate-specific antigen (PSA), and presence of additional findings supporting its use in non biopsied patients and active surveillance. mpMRI complements standard clinical exam, PSA measurements, and systematic biopsy, and will miss some tumors that lack enough size or change in tissue density...
March 2018: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29510957/ideal-2a-phase-ii-study-of-ultrafocal-brachytherapy-for-low-and-intermediate-risk-prostate-cancer
#11
Pierre Graff, Daniel Portalez, Amélie Lusque, Thomas Brun, Richard Aziza, Jonathan Khalifa, Mathieu Roumiguié, Marie-Laure Quintyn Ranty, Thomas Filleron, Jean-Marc Bachaud, Bernard Malavaud
PURPOSE: Focal therapy of prostate cancer requires precise positioning of therapeutic agents within well-characterized index tumors (ITs). We assessed the feasibility of low-dose-rate ultrafocal brachytherapy. METHODS AND MATERIALS: The present study was an institutional review board-approved European Clinical Trials Database-registered phase II protocol. Patients referred (October 2013 to August 2016) for active surveillance (prostate-specific antigen <10 ng/mL, cT1c-cT2a, Gleason score on referring biopsy specimens ≤6 (3+3), ≤3 positive biopsy cores, ≤50% of cancer) were preselected...
February 2, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29492583/validation-of-the-current-eligibility-criteria-for-focal-therapy-in-men-with-localized-prostate-cancer-and-the-role-of-mri
#12
Raisa S Pompe, Bieke Kühn-Thomä, Yamini Nagaraj, Valia Veleva, Felix Preisser, Sami-Ramzi Leyh-Bannurah, Markus Graefen, Hartwig Huland, Derya Tilki, Georg Salomon
PURPOSE: To validate current eligibility criteria for focal therapy (FT) in prostate cancer men undergoing radical prostatectomy (RP) and to assess the role of magnetic resonance imaging (MRI). METHODS: Retrospective analysis of 217 RP patients (2009-2016) with preoperative MRI (almost all in external institutions) and fulfillment of different FT eligibility criteria: unilateral tumor, clinical tumor stage ≤ cT2a, prostate volume ≤ 60 mL and either biopsy Gleason 3 + 3 or ≤ 3 + 4 and PSA ≤ 10 or ≤ 15 ng/mL...
February 28, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29461667/computer-vision-detects-subtle-histological-effects-of-dutasteride-on-benign-prostate
#13
Amit Sethi, Lingdao Sha, Neeraj Kumar, Virgilia Macias, Ryan J Deaton, Peter H Gann
OBJECTIVE: To determine whether a computer vision-based approach applied to H&E prostate biopsy images can distinguish dutasteride-treated tissue from placebo, and identify features associated with degree of responsiveness to 5α-reductase inhibitor (5ARI) therapy. SUBJECTS AND METHODS: Our study population comprised 100 treatment-compliant men without prostate cancer assigned to dutasteride or placebo in the REDUCE trial who had slides available from mandatory Year 4 biopsies...
February 20, 2018: BJU International
https://www.readbyqxmd.com/read/29439879/can-focal-therapy-replace-radical-therapy-for-prostate-cancer-against-focal-therapy
#14
Chad Reichard, Brian Francis Chapin
Until prospective data demonstrate the oncologic efficacy of focal therapy for clinically significant, localized prostate cancer, it should be considered as experimental and only performed within the confines of a clinical trial.
February 10, 2018: European Urology Focus
https://www.readbyqxmd.com/read/29432339/18f-choline-pet-mr-can-detect-and-delineate-local-recurrence-after-high-intensity-focused-ultrasound-therapy-of-prostate-cancer
#15
Irene A Burger, Andrei Gafita, Julian Müller, Benedikt Kranzbühler, Olivio F Donati, Daniel Eberli
Restaging local recurrence after high-intensity focused ultra-sound (HIFU) is based on multiparametric MRI (mpMRI). However, postinterventional changes of the tissue, such as edema or hemorrhage, are limiting tumor detection on mpMRI. We present a case of a rising prostate-specific antigen values, negative mpMRI, and a Gleason score of 4+4 on template biopsy after HIFU. On F-choline PET/MR, high focal uptake was detected at the location of positive biopsy. Re-HIFU based on the fused F-choline PET/MR images was performed, followed by a recurrence-free period of 11 months...
April 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29420984/mr-imaging-guided-focal-treatment-of-prostate-cancer-an-update
#16
REVIEW
Sherif G Nour
Focal treatment of prostate cancer has evolved from a concept to a practice in the recent few years and is projected to fill an existing need, bridging the gap between conservative and radical traditional treatment options. With its low morbidity and rapid recovery time compared with whole-gland treatment alternatives, focal therapy is poised to gain more acceptance among patients and health care providers. As our experience with focal treatment matures and evidence continues to accrue, the landscape of this practice might look quite different in the future...
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29420981/prostate-mr-imaging-for-posttreatment-evaluation-and-recurrence
#17
REVIEW
Sonia Gaur, Baris Turkbey
Prostate multiparametric MR imaging (mpMRI) plays an important role in local evaluation after treatment of prostate cancer. After radical prostatectomy, radiation therapy, and focal therapy, mpMRI can be used to visualize normal post-treatment changes and to diagnose locally recurrent disease. An understanding of the various treatments and expected changes is essential for complete and accurate post-treatment mpMRI interpretation.
March 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29373215/focal-therapy-in-primary-localised-prostate-cancer-the-european-association-of-urology-position-in-2018
#18
Henk G van der Poel, Roderick C N van den Bergh, Erik Briers, Philip Cornford, Alex Govorov, Ann M Henry, Thomas B Lam, Malcolm D Mason, Olivier Rouvière, Maria De Santis, Peter-Paul M Willemse, Hendrik van Poppel, Nicolas Mottet
Radical treatment of localised prostate cancer is recognised to be an unnecessary intervention or overtreatment in many men. Consequently, there has been a rapid uptake in the use of focal ablative therapies. However, there are several biological and practical concerns about such approaches as they have yet to be proved as robust treatment options. In particular, the multifocal nature of prostate cancer argues against unifocal treatment, while limitations in imaging can preclude the accurate identification of the number, location, and extent of prostate cancer foci...
January 17, 2018: European Urology
https://www.readbyqxmd.com/read/29373089/multiparametric-mr-imaging-of-the-prostate-after-treatment-of-prostate-cancer
#19
Pritesh Patel, Melvy S Mathew, Igor Trilisky, Aytekin Oto
The use of multiparametric magnetic resonance (MR) imaging in prostate cancer therapy is increasing, as newer treatment methods and management approaches emerge. The mainstays of therapy-radiation and surgery-are being supplemented (and even replaced) by novel focal therapy methods. Laser and ultrasonographic ablation, photodynamic therapy, electroporation, and cryoablation are the most common focal therapies, each with its own imaging findings. Typical ablation zones have a central focus of enhancement with peripheral rim enhancement; thus, dynamic contrast material-enhanced (DCE) MR imaging is the most important sequence for evaluation of treatment in the immediate posttherapeutic setting...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29336835/standard-whole-prostate-gland-radiotherapy-with-and-without-lesion-boost-in-prostate-cancer-toxicity-in-the-flame-randomized-controlled-trial
#20
Evelyn M Monninkhof, Juliette W L van Loon, Marco van Vulpen, Linda G W Kerkmeijer, Floris J Pos, Karin Haustermans, Laura van den Bergh, Sofie Isebaert, Gill M McColl, Robert Jan Smeenk, Juus Noteboom, Iris Walraven, Petra H M Peeters, Uulke A van der Heide
PURPOSE: To compare toxicity rates in patients with localized prostate cancer treated with standard fractionated external beam radiotherapy (EBRT) with or without an additional integrated boost to the macroscopically visible tumour. MATERIAL AND METHODS: FLAME is a phase 3 multicentre RCT (NCT01168479) of patients with pathologically confirmed localized intermediate or high-risk prostate cancer. The standard treatment arm (n = 287) received a dose to the entire prostate of 77 Gy in 35 fractions...
January 11, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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