Applying Focal Therapy to Lesions Detected via Magnetic Resonance Imaging: Delivering Cancer Ablation Beyond the Visibility Phenomenon
The inclusion of imaging as a triage test in diagnostic guidelines for prostate cancer (PC) has introduced a visible target for guiding treatment allocation and disease management. Focal therapy (FT) is a promising approach with a low side-effect profile for treating magnetic resonance imaging (MRI)...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | European Urology Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168325000515 |
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| author | Clement Orczyk Teresa Marsden Francesco Giganti Joseph M. Norris Santosh Waigankar Louise Dickinson Shonit Punwani Alex Kirkham Alex Freeman Aiman Haider Caroline M. Moore Arnauld Villers Clare Allen Mark Emberton |
| author_facet | Clement Orczyk Teresa Marsden Francesco Giganti Joseph M. Norris Santosh Waigankar Louise Dickinson Shonit Punwani Alex Kirkham Alex Freeman Aiman Haider Caroline M. Moore Arnauld Villers Clare Allen Mark Emberton |
| author_sort | Clement Orczyk |
| collection | DOAJ |
| description | The inclusion of imaging as a triage test in diagnostic guidelines for prostate cancer (PC) has introduced a visible target for guiding treatment allocation and disease management. Focal therapy (FT) is a promising approach with a low side-effect profile for treating magnetic resonance imaging (MRI)-visible PC within a limited framework of guideline recommendations or clinical trials. On the basis of accumulated clinical and research experience, we present a systematic approach to FT indications for ablation of visible targets that includes imaging findings, margin delineation, and energy selection. Confirmation of eligibility for FT is associated with the choice of energy source. We propose a 10-step framework that incorporates the contribution of all MRI sequences, the cancer growth pattern within the zonal anatomy to establish a margin around the MRI-visible lesion, safeguards for critical anatomic structures, and guidance for energy selection on the basis of specific properties. We discuss the key principles underlying this process. The aim of this methodology is to standardise FT interventions for MRI-visible PC and contribute to the development of a reproducible, stable treatment protocol. Quality control of the ablation procedure is crucial for broadening access to this technique beyond the confines of current regulatory pathways. Patient summary: We propose a method for using results from magnetic resonance imaging (MRI) scans to guide targeted treatment of visible prostate cancer lesions. This will help to ensure accurate coverage and eradication of all of the cancer while minimising side effects. |
| format | Article |
| id | doaj-art-1d41c1ff6b6648e581b15e4d3eff0ba0 |
| institution | Kabale University |
| issn | 2666-1683 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj-art-1d41c1ff6b6648e581b15e4d3eff0ba02025-02-12T05:32:50ZengElsevierEuropean Urology Open Science2666-16832025-02-01723641Applying Focal Therapy to Lesions Detected via Magnetic Resonance Imaging: Delivering Cancer Ablation Beyond the Visibility PhenomenonClement Orczyk0Teresa Marsden1Francesco Giganti2Joseph M. Norris3Santosh Waigankar4Louise Dickinson5Shonit Punwani6Alex Kirkham7Alex Freeman8Aiman Haider9Caroline M. Moore10Arnauld Villers11Clare Allen12Mark Emberton13Division of Surgery and Interventional Science University College London London UK; Department of Urology University College London Hospitals NHS Foundation Trust London UK; Corresponding author. Division of Surgery and Interventional Science, University College London, Charles Bell House, 43–45 Foley Street, London W1W 7TS, UK.Division of Surgery and Interventional Science University College London London UKDivision of Surgery and Interventional Science University College London London UK; Department of Radiology University College London Hospitals NHS Foundation Trust London UKDivision of Surgery and Interventional Science University College London London UKDepartment of Urology University College London Hospitals NHS Foundation Trust London UKDepartment of Radiology University College London Hospitals NHS Foundation Trust London UKDepartment of Radiology University College London Hospitals NHS Foundation Trust London UKDepartment of Radiology University College London Hospitals NHS Foundation Trust London UKDepartment of Pathology University College London Hospitals NHS Foundation Trust London UKDepartment of Pathology University College London Hospitals NHS Foundation Trust London UKDivision of Surgery and Interventional Science University College London London UK; Department of Urology University College London Hospitals NHS Foundation Trust London UKDepartment of Urology Centre Hospitalier Universitaire de Lille Lille FranceDepartment of Radiology University College London Hospitals NHS Foundation Trust London UKDivision of Surgery and Interventional Science University College London London UK; Department of Urology University College London Hospitals NHS Foundation Trust London UKThe inclusion of imaging as a triage test in diagnostic guidelines for prostate cancer (PC) has introduced a visible target for guiding treatment allocation and disease management. Focal therapy (FT) is a promising approach with a low side-effect profile for treating magnetic resonance imaging (MRI)-visible PC within a limited framework of guideline recommendations or clinical trials. On the basis of accumulated clinical and research experience, we present a systematic approach to FT indications for ablation of visible targets that includes imaging findings, margin delineation, and energy selection. Confirmation of eligibility for FT is associated with the choice of energy source. We propose a 10-step framework that incorporates the contribution of all MRI sequences, the cancer growth pattern within the zonal anatomy to establish a margin around the MRI-visible lesion, safeguards for critical anatomic structures, and guidance for energy selection on the basis of specific properties. We discuss the key principles underlying this process. The aim of this methodology is to standardise FT interventions for MRI-visible PC and contribute to the development of a reproducible, stable treatment protocol. Quality control of the ablation procedure is crucial for broadening access to this technique beyond the confines of current regulatory pathways. Patient summary: We propose a method for using results from magnetic resonance imaging (MRI) scans to guide targeted treatment of visible prostate cancer lesions. This will help to ensure accurate coverage and eradication of all of the cancer while minimising side effects.http://www.sciencedirect.com/science/article/pii/S2666168325000515Prostate cancerMagnetic resonance imagingFocal therapyTreatment planningAblationPerfusion imaging |
| spellingShingle | Clement Orczyk Teresa Marsden Francesco Giganti Joseph M. Norris Santosh Waigankar Louise Dickinson Shonit Punwani Alex Kirkham Alex Freeman Aiman Haider Caroline M. Moore Arnauld Villers Clare Allen Mark Emberton Applying Focal Therapy to Lesions Detected via Magnetic Resonance Imaging: Delivering Cancer Ablation Beyond the Visibility Phenomenon European Urology Open Science Prostate cancer Magnetic resonance imaging Focal therapy Treatment planning Ablation Perfusion imaging |
| title | Applying Focal Therapy to Lesions Detected via Magnetic Resonance Imaging: Delivering Cancer Ablation Beyond the Visibility Phenomenon |
| title_full | Applying Focal Therapy to Lesions Detected via Magnetic Resonance Imaging: Delivering Cancer Ablation Beyond the Visibility Phenomenon |
| title_fullStr | Applying Focal Therapy to Lesions Detected via Magnetic Resonance Imaging: Delivering Cancer Ablation Beyond the Visibility Phenomenon |
| title_full_unstemmed | Applying Focal Therapy to Lesions Detected via Magnetic Resonance Imaging: Delivering Cancer Ablation Beyond the Visibility Phenomenon |
| title_short | Applying Focal Therapy to Lesions Detected via Magnetic Resonance Imaging: Delivering Cancer Ablation Beyond the Visibility Phenomenon |
| title_sort | applying focal therapy to lesions detected via magnetic resonance imaging delivering cancer ablation beyond the visibility phenomenon |
| topic | Prostate cancer Magnetic resonance imaging Focal therapy Treatment planning Ablation Perfusion imaging |
| url | http://www.sciencedirect.com/science/article/pii/S2666168325000515 |
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