Focal laser interstitial thermotherapy (LITT) at 980 nm for prostate cancer: treatment feasibility in Dunning R3327-AT2 rat prostate tumour


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Abstract

What's known on the subject? and What does the study add?Focal ablation of prostate cancer by laser interstitial thermotherapy (LITT) consists of including a tissue necrosis by thermotherapy using diffusing laser fitres located in the prostate. Because of its compatibility with magnetic resonance imaging, LITT offers the advantage in terms of lesion targeting and real-time monitoring processing over other minimally invasive techniques using transrectal ultrasound. Moreover, the feasibility of MRI thermometry allows real-time monitoring of LITT treatment.Our study proves reproducibility of laser interstitial thermotherapy at 980 nm in homogenous prostate cancer model.OBJECTIVETo examine the feasibility and reproducibility of laser interstitial thermotherapy (LITT) as a minimally invasive method for the treatment of prostate cancer.MATERIALS AND METHODSHeterotopic tumours of prostatic adenocarcinoma (Dunning R3327-AT2) were induced in 10 male Copenhagen rats.After preoperative magnetic resonance imaging (MRI), a 10-mm cylindrical diffusing fibre developed by our research department was inserted under ultrasonographic guidanceinto the tumour.LITT was performed with a 980-nm diode laser (power 5 W) for75 s (fluence rate of 1145 J/cm2).Non-enhanced T2-weighted and dynamic gadolinium-enhanced T1-weighted MRI examinations were performed at baseline, 1 and 48 h after the procedure and correlated with histological findings.RESULTSThe necrosis lesions induced by LITT were visible on MRI.The mean (SD) ellipsoid necrosis volumes were 0.748 (0.075) mL at 1 h and 0.982 (0.052) mL at 48 h after the LITT procedure, and significantly different (P < 0.001).Histological analysis showed a strong correlation (r = 0.87) with the mean necrosis volume obtained by MRI at 48 h after LITT.CONCLUSIONSIn a prostatic adenocarcinoma model, 980-nm LITT induces reproducible necrosis volumes.Further characterization of the response to LITT in an animal model and in human tissues will be important in establishing the efficacy of the procedure for prostate cancer focal therapy.

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