Effect of irreversible electroporation of prostate cancer on microcirculation: Imaging findings in contrast-enhanced T1-weighted 3D MRI
Issue title: Selected papers of the 36th Conference of the German Society for Clinical Microcirculation and Hemorheology, 5–8. June, 2017, Greifswald, Germany
Guest editors: M. Jünger, A. Krüger-Genge and F. Jung
Affiliations: Department of Radiology, University Medical Center Regensburg, Germany
Correspondence:
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Corresponding author: Lukas P. Beyer, Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany. Tel.: +49 941 944 7401; E-mail: lukas@lukasbeyer.com.
Abstract: OBJECTIVES:Irreversible electroporation (IRE) is a novel focal ablation technique applicable for treatment of prostate cancer (PCa). We aim to evaluate imaging findings of T1-weighted contrast-enhanced MRI after percutaneous IRE of low-risk PCa. METHODS:A total of 13 male patients underwent IRE of focal low-risk PCa and were included in this analysis. Prostate IRE was conducted using 2–4 electrodes being placed under CT-fluoroscopy guidance. Dynamic contrast-enhanced 3D isotropic fat-saturated T1-weighted MRI (DCE-MRI) was performed 24–72 hours before and 24–72 hours after ablation. RESULTS:Ablated prostate was either homogeneously (8/13 [62%]) or heterogeneously (5/13 [38%]) hypo attenuating. Peripheral contrast enhancement manifesting as a hyper attenuating margin was observed during the arterial (60 sec) (3/13 [23%]) and venous (240 sec) (10/13 [77%]) phase. The ablation defect showed a sharp (8/13 [62%]) or blurry (5/13 [38%]) margin. CONCLUSIONS:The results show a venous peripheral rim enhancement in most of the cases, indicating reactive hyperaemia. The heterogeneous appearance of the defect zone in some cases may be secondary to sustained vascularization.
