Document Detail


Applicators for magnetic resonance-guided ultrasonic ablation of benign prostatic hyperplasia.
MedLine Citation:
PMID:  23462673     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aims of this study were to evaluate in a canine model applicators designed for ablation of human benign prostatic hyperplasia (BPH) in vivo under magnetic resonance imaging (MRI) guidance, including magnetic resonance thermal imaging (MRTI), determine the ability of MRI techniques to visualize ablative changes in prostate, and evaluate the acute and longer term histologic appearances of prostate tissue ablated during these studies.
MATERIALS AND METHODS: An MRI-compatible transurethral device incorporating a tubular transducer array with dual 120° sectors was used to ablate canine prostate tissue in vivo, in zones similar to regions of human BPH (enlarged transition zones). Magnetic resonance thermal imaging was used for monitoring of ablation in a 3-T environment, and postablation MRIs were performed to determine the visibility of ablated regions. Three canine prostates were ablated in acute studies, and 2 animals were rescanned before killing at 31 days postablation. Acute and chronic appearances of ablated prostate tissue were evaluated histologically and were correlated with the MRTI and postablation MRI scans.
RESULTS: It was possible to ablate regions similar in size to enlarged transition zone in human BPH in 6 to 18 minutes. Regions of acute ablation showed a central "heat-fixed" region surrounded by a region of more obvious necrosis with complete disruption of tissue architecture. After 31 days, ablated regions demonstrated complete apparent resorption of ablated tissue with formation of cystic regions containing fluid. The inherent cooling of the urethra using the technique resulted in complete urethral preservation in all cases.
CONCLUSIONS: Prostatic ablation of zones of size and shape corresponding to human BPH is possible using appropriate transurethral applicators using MRTI, and ablated tissue may be depicted clearly in contrast-enhanced magnetic resonance images. The ability accurately to monitor prostate tissue heating, the apparent resorption of ablated regions over 1 month, and the inherent urethral preservation suggest that the magnetic resonance-guided techniques described are highly promising for the in vivo ablation of symptomatic human BPH.
Authors:
Graham Sommer; Kim Butts Pauly; Andrew Holbrook; Juan Plata; Bruce Daniel; Donna Bouley; Harcharan Gill; Punit Prakash; Vasant Salgaonkar; Peter Jones; Chris Diederich
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Investigative radiology     Volume:  48     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-03     Completed Date:  2014-01-06     Revised Date:  2014-06-05    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  387-94     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Dogs
Equipment Design
Equipment Failure Analysis
High-Intensity Focused Ultrasound Ablation / instrumentation*
Magnetic Resonance Imaging / instrumentation*
Male
Prostatectomy / instrumentation*
Prostatic Hyperplasia / pathology*,  radiography*
Surgery, Computer-Assisted / instrumentation*
Transducers*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P01 CA159992/CA/NCI NIH HHS; P01 CA159992/CA/NCI NIH HHS; P30 CA124435/CA/NCI NIH HHS; R01 CA11198/CA/NCI NIH HHS; R01 CA111981/CA/NCI NIH HHS; R01 CA121163/CA/NCI NIH HHS; R01 CA122276/CA/NCI NIH HHS; R21 CA137472/CA/NCI NIH HHS; R21 CA137472/CA/NCI NIH HHS
Comments/Corrections

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