2026-04-13T06:45:21Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1786762025-12-05T12:14:52Zcom_2072_1057col_2072_478916col_2072_478917

Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer Klotz, Laurence Pavlovich, Christian P. Chin, Joseph Hatiboglu, Gencay Koch, Michael Penson, David Raman, Steven Oto, Aytekin Fütterer, Jurgen Serrallach, Marc Relle, James Lotan, Yair Heidenreich, Axel Bonekamp, David Haider, Masoom Tirkes, Temel Arora, Sandeep Macura, Katarzyna J. Costa, Daniel N. Persigehl, Thorsten Pantuck, Allan J. Bomers, Joyce Burtnyk, Mathieu Staruch, Robert Eggener, Scott Càncer de pròstata Radioteràpia Prostate cancer Radiotherapy Imatges per ressonància magnètica Magnetic resonance imaging Purpose: Magnetic resonance imaging-guided transurethral ultrasound ablation uses directional thermal ultrasound under magnetic resonance imaging thermometry feedback control for prostatic ablation. We report 12-month outcomes from a prospective multicenter trial (TACT). Materials and methods: A total of 115 men with favorable to intermediate risk prostate cancer across 13 centers were treated with whole gland ablation sparing the urethra and apical sphincter. The co-primary 12-month endpoints were safety and efficacy. Results: In all, 72 (63%) had grade group 2 and 77 (67%) had NCCN® intermediate risk disease. Median treatment delivery time was 51 minutes with 98% (IQR 95-99) thermal coverage of target volume and spatial ablation precision of ±1.4 mm on magnetic resonance imaging thermometry. Grade 3 adverse events occurred in 9 (8%) men. The primary endpoint (U.S. Food and Drug Administration mandated) of prostate specific antigen reduction ≥75% was achieved in 110 of 115 (96%) with median prostate specific antigen reduction of 95% and nadir of 0.34 ng/ml. Median prostate volume decreased from 37 to 3 cc. Among 68 men with pretreatment grade group 2 disease, 52 (79%) were free of grade group 2 disease on 12-month biopsy. Of 111 men with 12-month biopsy data, 72 (65%) had no evidence of cancer. Erections (International Index of Erectile Function question 2 score 2 or greater) were maintained/regained in 69 of 92 (75%). Multivariate predictors of persistent grade group 2 at 12 months included intraprostatic calcifications at screening, suboptimal magnetic resonance imaging thermal coverage of target volume and a PI-RADS™ 3 or greater lesion at 12-month magnetic resonance imaging (p <0.05). Conclusions: The TACT study of magnetic resonance imaging-guided transurethral ultrasound whole gland ablation in men with localized prostate cancer demonstrated effective tissue ablation and prostate specific antigen reduction with low rates of toxicity and residual disease. 2021-06-25T11:07:39Z 2021-06-25T11:07:39Z 2021-03-01 2021-06-25T07:47:16Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://hdl.handle.net/2445/178676 33021440 eng Reproducció del document publicat a: https://doi.org/10.1097/JU.0000000000001362 Journal of Urology, 2021, vol. 205, num. 3, p. 769-779 https://doi.org/10.1097/JU.0000000000001362 cc by-nc-nd (c) Klotz et al., 2021 http://creativecommons.org/licenses/by-nc-nd/3.0/es/ info:eu-repo/semantics/openAccess 11 p. application/pdf Wolters Kluwer Health Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))