Bladder cancer was the 10th most prevalent cancer worldwide in 2020. Currently, the gold standard for diagnosing bladder cancer is a cystoscopy followed by a transurethral resection of the bladder tumour. The tumour invasion and grade are needed to determine the treatment plan. However, a transurethral resection is an invasive procedure, needs planning and has complication risks. Therefore, finding an alternative option to determine tumour invasion and grade is necessary. That would also enable other treatment options for bladder cancer such as laser fulguration, chemo-resection and active surveillance. Optical Coherence Tomography (OCT) has the potential to aid in the diagnosis of bladder cancer
Transperineal focal laser ablation (TPLA) has the potential to obtain oncological control, while sparing nearby tissue to preserve continence and erectile function with a low toxicity profile. However, registration and prediction of the ablation zone is essential for TPLA to become a clinal standard of care treatment. In this study we investigated the capability of MRI and CEUS to image the treated volume. We show that the treatment effects of TPLA can reliably be visualized using these techniques and that the results are in good agreement with histopathology. These results are essential first steps towards improved planning and performance of TPLA.
Transperineal laser ablation (TPLA) is a novel minimal invasive treatment of benign prostatic obstruction. TPLA can be performed in an outpatient setting under local anesthesia with optional conscious sedation. The mechanism is based on laser ablation resulting in coagulative necrosis, which is induced by the laser light of 1064 nm. Laser light is delivered in the prostate trough transperineal placed needles. This study treated 20 men using TPLA to evaluate safety, feasibility, and voiding outcomes. TPLA has the potential to become an alternative for standard treatments with urethral approach that require general or spinal anesthesia and hospital admittance.
Transperineal laser ablation (TPLA) treatment of prostate cancer allows for a minimal invasive treatment approach. However, a predictive dosimetry model for accurate treatment planning for prostate cancer is not yet available. Therefore, we simulated TPLA treatments on porcine liver and quantitatively evaluated thermal distribution and histology slides were made. Hereby, we determined the cumulative equivalent thermal isoeffect dose at 43°C (CEM43) that predicts cell death and led to the development of a dosimetry model.
Transperineal laser ablation (TPLA) treatment of prostate cancer allows for a minimal invasive treatment approach. However, understanding of the ablation zone development and the 3D size are crucial for accurate treatment of prostate cancer. Therefore, we developed an ex-vivo experimental focal laser ablation set-up using a 1064nm CW diode laser to simulate a TPLA treatment, using human prostate and porcine liver.
We quantitatively evaluated the thermal distribution and ablation zone volume on high-resolution MR imaging and histopathology to determine the 3D size of the ablation zone. These results allow for development of a dosimetry model of clinical TPLA treatments.
Transperineal laser ablation (TPLA) is a novel minimal invasive treatment of benign prostatic obstruction. TPLA can be performed in an outpatient day-care setting under local anesthesia with optional conscious sedation. The mechanism is bases on thermoablation resulting in coagulative necrosis, which is induced by the laser light of 1064nm. Laser light is delivered in the prostate trough transperineal placed needles. This study aims to treat 20 men by TPLA to evaluate safety and feasibility, and voiding outcomes. TPLA has the potential to become an alternative for standard treatments with urethral approach that require general or spinal anesthesia and hospital admittance.
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