影像引导下的自适应冷冻疗法用于前列腺癌治疗。

Image-Guided Adaptive Cryotherapy for Prostate Cancer Treatment.

作者信息

Beek Eva, Hata Nobuhiko, Tuncali Kemal, Moreira Pedro

机构信息

Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, 75 Francis St., Boston, 02115, MA, USA.

Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.

出版信息

Ann Biomed Eng. 2025 Aug 29. doi: 10.1007/s10439-025-03833-9.

DOI:10.1007/s10439-025-03833-9

PMID:40883549

Abstract

PURPOSE

Focal cryoablation is an effective treatment for localized and recurrent prostate cancer, offering reduced risks of side effects. However, treatment success depends on physician experience, as intraprocedural adjustments are required due to needle deflection. To determine whether an image-guided adaptive treatment strategy could reduce the required years of experience, we developed Image-guided Adaptive Cryotherapy (ImAC). We hypothesize that ImAC can be successfully implemented in MRI-guided cryotherapy to optimize needle placement. To test this hypothesis, we conducted a retrospective study comparing the performance of an experienced physician to that of ImAC.

METHODS

ImAC was designed to calculate the best subsequent needle location while accounting for needle deflection and iceball formation. After development, its performance was evaluated by simulating 21 needle insertions.

RESULTS

We found that ImAC achieved a higher median minimum ablation margin than the physician (5.0 vs 3.4 mm) while maintaining similar needle placement adjustments (± 7.5 mm).

CONCLUSION

These results suggest that ImAC has the potential to optimize needle placement and may reduce the years of experience required for effective cryoablation.

摘要

目的

聚焦冷冻消融是治疗局限性和复发性前列腺癌的有效方法，副作用风险较低。然而，治疗的成功取决于医生的经验，因为由于针的偏转需要在手术过程中进行调整。为了确定图像引导的自适应治疗策略是否可以减少所需的经验年限，我们开发了图像引导自适应冷冻疗法（ImAC）。我们假设ImAC可以成功应用于MRI引导的冷冻疗法，以优化针的放置。为了验证这一假设，我们进行了一项回顾性研究，比较了一位经验丰富的医生和ImAC的性能。