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Record W1555389375 · doi:10.5489/cuaj.1044

Contrast-enhanced ultrasonography for real-time monitoring of interstitial laser thermal therapy in the focal treatment of prostate cancer

2013· article· en· W1555389375 on OpenAlexafffundvenue
Mostafa Atri, Mark R. Gertner, Masoom A. Haider, Robert Weersink, John Trachtenberg

Bibliographic record

VenueCanadian Urological Association Journal · 2013
Typearticle
Languageen
FieldEngineering
TopicUltrasound and Hyperthermia Applications
Canadian institutionsUniversity of TorontoToronto Metropolitan UniversityUniversity Health NetworkMount Sinai Hospital
FundersUniversity of TorontoPrincess Margaret Hospital FoundationUniversity Health Network
KeywordsMedicineProstate cancerRadiologyProstateLesionAblationTransrectal ultrasonographyMagnetic resonance imagingBiopsyCryotherapyNuclear medicineCancerSurgeryInternal medicine

Abstract

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Introduction: We report a case study of the application of contrastenhancedultrasonography (CEUS) for intraoperative monitoringof thermal ablation of a single focus of prostate cancer.Methods: A patient presented with biopsy-proven, solitary-focus,low-risk prostate cancer and was recruited into a clinical trial ofinterstitial laser thermal focal therapy. Multiparametric magneticresonance imaging (MRI) was used to locate the single dominantfocus, and photothermal ablation was performed at the tumoursite under the guidance of transrectal ultrasonography. TransrectalCEUS using systemic bolus injections of the intravascular contrastagent Definity was performed immediately before, several timesduring and on completion of therapy. Lesions observed on CEUSwere compared with treatment effect as measured by tissue devascularizationon 1-week gadolinium (Gd)–enhanced MRI.Results: Baseline images showed CEUS contrast-agent signalthroughout the prostate. During and after treatment, large hypocontrastregions were observed surrounding the treatment fibres, indicatingthe presence of an avascular lesion resulting from photothermaltherapy. Lesion size was found to increase during the deliveryof thermal energy. Lesion size measured using CEUS (16 × 11 mm)was similar to the 7-day lesion measured using Gd-enhancedT1-weighted MRI.Conclusion: Focal therapy for prostate cancer requires both completetreatment of the dominant tumour focus and minimal morbidity.The application of CEUS during therapy appears to providean excellent measure of the actual treatment effect. Hence, it can beused to ensure that the therapy encompasses the whole target butdoes not extend to surrounding critical structures. Future clinicalstudies are planned with comparisons of intraoperative CEUS toGd-enhanced MRI at 7 days and whole-mount pathology samples.Introduction : Nous décrivons un cas d’application de la techniqued’échographie de contraste pour la surveillance peropératoire pendantl’ablation thermique d’un cancer de la prostate à foyer unique.Méthodologie : Le patient présentait un cancer de la prostate à faiblerisque et à foyer unique confirmé par biopsie et a été inscrit àun essai clinique portant sur la thérapie thermique interstitiellepar laser. Après une épreuve d’IRM à paramètres multiples en vuede localiser le foyer dominant unique, on a procédé à une ablationphotothermique guidée par échographie transrectale. On aeffectué une échographie transrectale à l’aide d’injections bolusintravasculaires de l’agent de contraste Definity immédiatementavant l’ablation, de même que plusieurs fois pendant l’interventionet à la fin de celle-ci. Les lésions observées lors de l’échographiede contraste ont été comparées à l’effet du traitement, tel quemesuré par la dévascularisation tissulaire lors d’une épreuve d’IRMavec injection de Gd une semaine plus tard.Résultats : Les images initiales montrent le signal de l’agent decontraste dans toute la prostate. Pendant et après le traitement, degrandes zones d’hypocontraste ont été observées autour des zonesde traitement, indiquant la présence d’une lésion avasculairecausée par la thérapie photothermique. La taille de la lésion s’estaccrue pendant la libération de l’énergie thermique. La taille dela lésion, telle que mesurée par échographie de contraste (16 ×11 mm) n’avait pas changé une semaine plus tard lors de l’épreuved’IRM T1 avec injection de Gd.Conclusion : La thérapie focale appliquée à la prostate requiert letraitement complet du foyer tumoral dominant et une morbiditéminimale. Le recours à l’échographie de contraste durant le traitementsemble un excellent moyen de mesurer l’effet réel du traitement.On peut donc l’utiliser pour assurer que le traitement englobetoute la zone cible sans s’étendre aux structures adjacentes.D’autres études cliniques comparant les résultats à ceux de l’IRMavec injection de Gd après 7 jours et des échantillons anatomopathologiquesin toto sont prévues.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.285
Threshold uncertainty score0.250

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.010
GPT teacher head0.219
Teacher spread0.209 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations51
Published2013
Admission routes3
Has abstractyes

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