MRI-guided Minimally Invasive Focal Therapies for Prostate Cancer

MR-guided Focused Ultrasound Focal Therapy for Prostate Cancer

Prostate cancer (PCa) is a prevalent malignancy in men, and the management of localized disease has evolved significantly in recent years. Focal therapy, wherein the biopsy confirmed site of tumor with margins is treated leaving the remaining gland intact, has emerged as a promising strategy for treating localized clinically significant PCa, minimizing side effects associated with radical therapies. We present the technical aspects, a summary of the most relevant evidence to date on the performance and safety of this technique, and the characteristic MR imaging findings during treatment, in the early posttreatment period and in the long term.

Focal therapy for prostate cancer

Traditional treatments for localized prostate cancer include radical prostatectomy or radiation therapy but pose challenges due to treatment related side effects, namely erectile dysfunction and urinary incontinence. In recent years, focal therapy has emerged as a viable treatment option for localized low-intermediate risk prostate cancer in carefully selected patients. Short and medium-term studies show acceptable cancer control outcomes and reduced morbidity when comparing focal therapy to whole gland treatment for prostate cancer, however there is paucity of long-term studies. Here we review focal ablative therapies commonly used, discuss the role of imaging in monitoring treatment, and summarize oncologic outcomes based on studies to date.