Imaging And Focal Therapy Of Early Prostate Cancer

Imaging and Focal Therapy of Early Prostate Cancer evaluates the scientific evidence for the evolving trend to treat low to intermediate risk, clinically localized prostate cancer in a focally ablative manner with novel gland-preserving, focal therapy methods. Various ablative devices such as high intensity focused ultrasound, irreversible electroporation, photodynamic therapy, cryotherapy and laser ablation, among others, are discussed in regard to their strengths and limitations as a therapeutic modality. Emphasis is placed on tumor stage shift towards early stage disease with an increase in unilateral versus bilateral cancers validated by final pathology assessment of large prostatectomy series. Current and new approaches to image cancer foci within the prostate (3-Dimensional contrast-enhanced transrectal ultrasonography, multiparametric magnetic resonance image with spectroscopy, ETC) are presented along with biopsy techniques to map prostate cancer. Patient selection, treatment strategy, outcomes and safety concerns that may provide acceptable cancer control and improved quality of life for patients are all covered in detail. Written by experts in the field and lavishly illustrated with detailed line-art and photographs, Imaging and Focal Therapy of Early Prostate Cancer is a resourceful volume beneficial to practitioners specializing in the treatment and management of prostate cancer.

This text encompass an up-to-date, comprehensive review of the state-of-the-art for gland preserving therapies. Fully updated and revised, this text evaluates the scientific evidence for the evolving trend to treat intermediate risk, clinically localized prostate cancer in a focally ablative manner with novel gland-preserving, focal therapy methods. Various ablative devices such as high intensity focused ultrasound, irreversible electroporation, photodynamic therapy, cryotherapy and laser ablation, among others, is discussed in regard to their strengths and limitations as a therapeutic modality. Emphasis is placed on patient selection and outcomes utilizing both advanced imaging techniques and pathologic evaluation. Current and new approaches to image cancer foci within the prostate (multiparametric ultrasonography, multiparametric magnetic resonance image, etc) are presented along with various biopsy techniques, including robotics to map prostate cancer. Patient selection based on imaging and genomic classification, adjuvants to enhance therapy, treatment strategy, outcomes and patient centered concerns is discussed, providing an acceptable balance between cancer control and improved quality of life for patients. Written by experts in the field and lavishly illustrated with detailed line-art and photographs, Imaging and Focal Therapy of Early Prostate Cancer, Second Edition is designed as a comprehensive resource for urologists, radiation oncologists, medical oncologists, radiologists, uropathologists, molecular biologists, biomedical engineers, other clinicians –- residents, fellows, nurses and allied professionals -- and researchers with an interest in the diagnosis and novel treatment of prostate cancer. It will provide insight into the latest research and clinical applications of image-guided diagnosis and minimally invasive focal, gland-preserving treatment for prostate cancer.

Focal therapy is a promising option for selected patients who have localized low or intermediate-risk prostate cancer, providing a compelling alternative between active surveillance and radical therapies by targeting the index lesion and preserving as much tissue as possible. Numerous cohort studies have already investigated multiple focal techniques, such as cryotherapy, high-intensity focused ultrasound, brachytherapy, photodynamic therapy, laser therapy, irreversible electroporation and cyberknife methods, all of which have demonstrated positive oncological outcomes with 70 to 90 % negative follow-up biopsy. These various ablative techniques have produced only minor side-effects concerning urinary function, a low rate of erectile dysfunction, and have demonstrated a limited rectal toxicity. As a result, the primary end-point has now shifted and a new strategy needs to be established for patient follow-up and for defining treatment failure. Written by international experts in the field, this book is mainly focused on new techniques, all of which are amply illustrated. Technical Aspects of Focal Therapy in Localized Prostate Cancer will be of great practical value to all urologists and oncologists.

This book covers novel strategies and state of the art approaches for automated non-invasive systems for early prostate cancer diagnosis. Prostate cancer is the most frequently diagnosed malignancy after skin cancer and the second leading cause of cancer related male deaths in the USA after lung cancer. However, early detection of prostate cancer increases chances of patients’ survival. Generally, The CAD systems analyze the prostate images in three steps: (i) prostate segmentation; (ii) Prostate description or feature extraction; and (iii) classification of the prostate status. Explores all of the latest research and developments in state-of-the art imaging of the prostate from world class experts. Contains a comprehensive overview of 2D/3D Shape Modeling for MRI data. Presents a detailed examination of automated segmentation of the prostate in 3D imaging. Examines Computer-Aided-Diagnosis through automated techniques. There will be extensive references at the end of each chapter to enhance further study.

This book provides a 2015 state of the art update on the hot topic of focal prostate cancer therapy, which offers a means of preserving the prostate and avoiding major side-effects associated with conventional treatment strategies. In so doing, focal therapy meets the desire of many patients, especially those with low-risk disease, to avoid or postpone radical therapies in order to preserve quality of life. A wide range of aspects are covered, including the role of imaging-guided targeted biopsies, the pros and cons of surveillance in comparison with focal therapy, focal hemiablation and focal salvage therapy, multifocal therapies, focal cryotherapy. The potential role of various new diagnostic technologies as well as specific therapeutic devices as "Focal.One" robotic high-intensity focused ultrasound are explained. The authors are all international experts who are long-term proponents of non-invasive treatment of prostate cancer. "Focal Therapy of Prostate Cancer" will be an invaluable source of information for urologists, oncologists, radiation oncologists, and general practitioners, and also for patients wishing to learn more about this new treatment option.

Image-Guided Prostate Cancer Treatments is a comprehensive reference and practical guide on the technology and application of ultrasound and MRI in the male pelvis, with special attention to the prostate. The book is organized into three main sections, the first of which is devoted to general aspects of imaging and image-guided treatments. The second section provides a systematic overview of the application of ultrasound and MRI to the diagnosis and treatment of diseases of the lower urinary tract. Performance of the ultrasound and MRI studies is explained, and the normal and abnormal pathological anatomy is reviewed. Correlation with the ultrasound in the same plane is provided to assist in understanding the MRI sequences. Biopsy and interventional procedures, ultrasound-MRI fusion techniques, and image-guided therapies, including focused ultrasound, photodynamic therapy, microwave and laser ablation, are all fully covered. The third section focuses on securing treatment effectiveness and the use of follow-up imaging to ensure therapeutic success and detect tumor recurrence at an early stage, which is vital given that prompt focal treatment of recurrence is very successful. Here, particular attention is paid to the role of Doppler ultrasound and DCE-MRI technologies. This book, containing a wealth of high-quality illustrations based on high-end equipment, will acquaint beginners with the basics of prostate ultrasound and MRI, while more advanced practitioners will learn new skills, means of avoiding pitfalls, and ways of effectively relating the imaging and image-guided treatments to the clinical situation. The information provided will permit a tailored approach in dealing with specific pathologic issues.

This issue of Radiologic Clinics of North America focuses on MR Imaging of the Prostate, and is edited by Dr. Aytekin Oto. Articles will include: Prostate cancer diagnosis and management: A urologist’s perspective; MRI of prostate zonal anatomy; Technique of Multi-parametric MRI of the prostate; Multi-parametric MRI- interpretation including PIRADS v2; Prostate MRI for screening and active surveillance; Prostate MRI for staging; Prostate MRI for post-treatment evaluation and recurrence; Pitfalls in prostate MRI; MRI-targeted prostate biopsies; MRI-guided focal treatment for prostate cancer; Role of Prostate MRI in radiation oncology; Challenges and future directions of prostate MRI; and more!

This text provides a comprehensive, state-of-the art review of this field, and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in early prostate cancer. The book reviews new data about genetic markers, transperineal mapping biopsy and mpMRI, how to apply each of these technologies in patients with elevated PSA, when a prior prostate biopsy performed by the standard TRUS method is negative and in cases where low risk disease is already diagnosed, how to differentiate those men who might harbor more aggressive disease from those who do not. Over 75% of newly diagnosed prostate cancer meets the criteria for low risk disease which has created a dilemma for both patients and clinicians. Active surveillance programs have been initiated and are reviewed. How the new technologies impact surveillance programs is addressed. Clinical stage designation is updated and a new intra-prostatic staging system is discussed. Prostate biopsy techniques utilizing transrectal ultrasound, transperineal mapping, elastography and mpMRI are compared. Finally, utilization of this new technology in the application of focal therapy is reviewed. The Prostate Cancer Dilemma will serve as a very useful resource for physicians and researchers dealing with, and interested in this challenging malignancy. Chapters are written by experts in their fields and include the most up to date scientific and clinical information as well as links to procedural video content.