Intraprostatic ethanol diffusion: comparison of two injection methods using ex vivo human prostates

King, Benjamin; Mann-Gow, Travis; Kida, Masatoshi; Plante, Mark; Perrapato, Scott D.; Zvara, Peter

doi:10.1038/pcan.2015.24

Cited by 4 publications

(2 citation statements)

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“…Thus, while these ex-vivo results are instructive of prostatic injection distribution, clinical studies are required to obtain reliable representation as to the relative contribution of the different flow mechanisms identified in these ex-vivo intraprostatic injections. However, these ex-vivo and prior comparative results of porous and standard needles indicate the porous needles provide improved distribution with the prostate [ 9 , 10 ], including one in-vivo study [ 11 ], all of which have shown porous needle superiority over standard needle injections.…”

Section: Discussionmentioning

confidence: 99%

A pilot study in intraparenchymal therapy delivery in the prostate: a comparison of delivery with a porous needle vs standard needle

Brady¹,

Coffield

Kuehl

et al. 2018

BMC Urol

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BackgroundNew biologic therapies directly injected into the prostate are in clinical trials for prostatic diseases. There is a need to understand distribution of injected therapies as a function of prostatic anatomy, physiology, and device design.MethodsA needle with a porous length of customizable-length was tested and its performance compared with a standard needle. Injections of magnetic resonance contrast reagent were placed into ex-vivo human prostates after surgical excision in standard of care therapy for invasive bladder cancer patients. Magnetic resonance images were acquired using sequences to quantify volume delivered, distributed, and backflow.ResultsMagnetic resonance images analysis revealed heterogeneity distribution with injection into the specimens. There was low resistance to flow along ductal pathways and high resistance to flow into glandular nodules and smooth muscle/fibrous parenchyma. Data confirm previous studies showing injection loss via urethra backflow, urethra, and prostatic ducts. Tissue fraction of dose was significantly higher with porous needle compared with standard needle (p = .03). We found that a greater volume of distribution divided by the amount infused (Vd/Vi) increased by 80% with the porous needle, though no statistically significant association due to small sample size.ConclusionsThis study demonstrated that prostatic tissue is anatomically heterogenic and limits distribution of needle injection. There is greater distribution in the ex-vivo prostate using a porous needle. The complexity of intra prostatic flow pathways suggests preoperative imaging and pre-treatment planning will enhance therapy.Electronic supplementary materialThe online version of this article (10.1186/s12894-018-0378-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

A pilot study in intraparenchymal therapy delivery in the prostate: a comparison of delivery with a porous needle vs standard needle

Brady¹,

Coffield

Kuehl

et al. 2018

BMC Urol

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“…We have previously demonstrated that the prostatic pseudocapsule, acts as a barrier to the diffusion of injected 96% ethanol (EtOH), thus presenting an advantage over temperature-based focal treatment options ( 6 ). We have also documented that in contrast to a standard hollow core needle with a single opening at the tip, intraprostatic injection using a needle with a porous wall allows for diffusion of EtOH along the entirety of the 1 - 3 cm long porous segment, improving injectant distribution ( 7 , 8 ). These findings provide a strong foundation for further exploration of the porous needle for intraprostatic delivery of PCa therapy.…”

Section: Introductionmentioning

confidence: 99%

Tissue distribution of ethanol after intraprostatic injection using a porous needle

Eubank

DiBona²,

Sommers³

et al. 2023

Front. Oncol.

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PurposeTo develop a safe and precise method for intraprostatic injection, and to establish correlation between the volume of ethanol injectate and the volume of subsequent infiltrated prostate tissue.Materials and methodsWe performed intraprostatic injection of 96% ethanol using a needle which has a segment of its wall made of capillary membrane with hundreds of pores in an acute and chronic canine experiment, in heart-beating cadaveric organ donors, and in a xenograft model of human prostate cancer. Whole mount tissue sections were used for three-dimensional reconstruction of the necrotic lesions and calculation of their volumes.ResultsThe ethanol injection resulted in oval shaped lesions of well-delineated coagulative necrosis. In both healthy human and canine prostates, the prostatic pseudocapsule and neurovascular bundle remained intact without evidence of disruption. There was a linear correlation between administered volume of ethanol and the volume of necrotic lesion. Regression analysis showed strong correlation in the acute canine experiments and in experiments performed on xenografts of human prostate cancer. A formula was calculated for each experiment to estimate the relationship between the injected volume and the volume of infiltrated prostate tissue area.ConclusionsIntraprostatic injection using a porous needle allows for effective and predictable tissue distribution of the injectate in the prostate. Through varying the volume of the agent injected and use of needles with a different length of the porous segment, the volume of infiltrated tissue could be adjusted allowing for targeted focal treatment.

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Ethanol Injection of the Prostate in Benign Prostatic Hypertrophy

Cheung

Millman

Lenardis

2018

A Comprehensive Guide to the Prostate

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Intraprostatic ethanol diffusion: comparison of two injection methods using ex vivo human prostates

Cited by 4 publications

References 31 publications

A pilot study in intraparenchymal therapy delivery in the prostate: a comparison of delivery with a porous needle vs standard needle

A pilot study in intraparenchymal therapy delivery in the prostate: a comparison of delivery with a porous needle vs standard needle

Tissue distribution of ethanol after intraprostatic injection using a porous needle

Ethanol Injection of the Prostate in Benign Prostatic Hypertrophy

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