Back to the list
Congress: ECR25
Poster Number: C-12633
Type: Poster: EPOS Radiologist (educational)
Authorblock: A. L. Lai1, J. Velaga2, G. Hang1, N. Lath1, K. J. Tay1, Y. M. Law1; 1Singapore/SG, 2Melbourne/AU
Disclosures:
Anna Lois Lai: Nothing to disclose
Jyothirmayi Velaga: Nothing to disclose
Guanqi Hang: Nothing to disclose
Narayan Lath: Nothing to disclose
Kae Jack Tay: Grant Recipient: Dr KJ Tay received funding support from National Medical Research Council, Singapore. Grant number - TA20nov-0011.
Yan Mee Law: Nothing to disclose
Keywords: Genital / Reproductive system male, Oncology, MR, Diagnostic procedure, Treatment effects, Cancer
Learning objectives 1. Review aspects of focal therapy in treatment of localised primary prostate cancer2. Discuss pretreatment considerations on multiparametric MRI (mpMRI)3. Review expected post focal therapy changes in the prostate on mpMRI4. Review in- and out-of-field tumour recurrence using histology proven cases5. Discuss pearls and pitfalls in mpMRI detection of post focal therapy tumour recurrence6. Review aspects in surveillance of the post focal therapy prostate
Read more Background Oncologic basis of focal therapyIn this era of personalised precision medicine, focal therapy is an emerging middle ground between active surveillance and radical whole gland therapy for treatment of localised primary prostate cancer (Figure 1). [fig 1] Evidence suggests although prostate cancer is often multifocal, it is the pathologic characteristics of the largest or most aggressive cancer focus (index lesion) that determines tumour progression and metastasis risk [1]. It may hence be sufficient to treat the index lesion and adopt active surveillance for...
Read more Findings and procedure details Pretreatment considerations on mpMRISuccess in focal therapy is contingent on accurate pre-treatment patient selection and precise disease localization.The 2017 International Delphi Consensus Project on patient selection for prostate focal therapy provides recommendations on ideal cancer foci for focal therapy (Figure 4) [3]. [fig 4] Before focal therapy, patients must undergo prostate mpMRI and targeted and systematic mapping biopsy to delineate the index lesion and exclude non-MRI visible clinically significant lesions.In pretreatment planning for focal therapy, radiologists should identify even the non-dominant cancers...
Read more Conclusion Radiologists play a crucial role in pretreatment selection and post treatment surveillance of patients undergoing focal therapy for primary prostate cancer (Figure 27). Multidisciplinary discussion is vital to improve patient care and optimise oncological outcome. [fig 27]
Read more References Wise AM, Stamey TA, McNeal JE, Clayton JL. Morphologic and clinical significance of multifocal prostate cancers in radical prostatectomy specimens. Urology. 2002 Aug;60(2):264–9. doi: 10.1016/S0090-4295(02)01728-4 Lebastchi AH, George AK, Polascik TJ, Coleman J, de la Rosette J, Turkbey B, et al. Standardized Nomenclature and Surveillance Methodologies After Focal Therapy and Partial Gland Ablation for Localized Prostate Cancer: An International Multidisciplinary Consensus. Eur Urol. 2020 Sep 1;78(3):371–8. doi: 10.1016/j.eururo.2020.05.018 Tay KJ, Scheltema MJ, Ahmed HU, Barret E, Coleman JA, Dominguez-Escrig J, et al....
Read more
GALLERY