MRT-Monitoring vor, während und nach der interstitiellen laserinduzierten Thermotherapie der benignen Prostatahyperplasie Erste klinische Erfahrungen

Müller-Lisse, G. U.; Heuck, A.; Stehling, Michael K.; Frimberger, M.; Thoma, Martin; Schneede, P.; Muschter, R.; Hofstetter, A.; Reiser, Maximilian

doi:10.1007/s001170050134

Cited by 10 publications

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“…In addition, the highly vascular nature of the prostate capsule acts as a heat sink and prevents potential coagulation of the capsule itself and adjacent structures, if the fiber is placed close. This was proven by magnetic resonance imaging studies performed during and after ILC [44, 45, 46]and by pathological studies when ILC was done before open prostatectomy [35]. However, one should avoid advancing the applicator dorsally because this prevents any theoretical risk of affecting the neurovascular bundles and rectum and yet there is little or no BPH tissue to treat.…”

Section: Methodsmentioning

confidence: 99%

Interstitial Laser Therapy of Benign Prostatic Hyperplasia

Muschter

Whitfield²

1999

European Urology

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The objective of interstitial laser coagulation (ILC) of benign prostatic enlargement is to achieve a marked volume reduction and to decrease bladder outlet obstruction and lower urinary tract symptoms with minimal morbidity. Coagulation necrosis is generated well inside the adenoma by means of specifically designed laser applicators combined with either a Nd:YAG laser or a diode laser. Because the laser applicators can be inserted as deeply and as often as necessary, it is possible to coagulate any amount of tissue at any desired location while preserving adjacent structures such as the urethra. Postprocedural, the intraprostatic lesions result in secondary atrophy and regression of the prostate lobes, rather than sloughing of necrotic tissue. Several single- armed and randomized studies indicated the effectiveness of interstitial laser coagulation of BPH-syndrome. Marked improvements in AUA score, peak flow rate, residual urine volume and prostate volume were reported. Pressure-flow studies demonstrated a sufficient decrease of the intravesical/detrusor pressure, urethral opening pressure and urethral resistance. Long-term results demonstrating sustained success for up to 3 years were reported on a series of 394 patients. ILC is suitable to debulk even large prostates and to treat highly obstructive patients. Therefore, ILC can be seen as a true alternative to TURP with certain advantages, such as almost no serious morbidity and with certain disadvantages, such as the need for postoperative catheterization. However, ILC can be done under local anesthesia and does not require hospitalization.

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Section: Methodsmentioning

confidence: 99%

Interstitial Laser Therapy of Benign Prostatic Hyperplasia

Muschter

Whitfield²

1999

European Urology

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Interstitial Laser Therapy

Muschter

2012

Smith's Textbook of Endourology

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Invited. Predictability of the size of laser‐induced lesions in T1‐weighted MR images obtained during interstitial laser‐induced thermotherapy of benign prostatic hyperplasia

Mueller‐Lisse

Heuck

Thoma

et al. 1998

Magnetic Resonance Imaging

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The purpose of this study was to predict diameters of lesions induced by laser-induced thermotherapy (LITT) of benign prostatic hyperplasia (BPH) from MRI signal/tissue temperature correlations during on-line monitoring with a temperature-sensitive fast low-angle shot (FLASH) sequence. Twenty LITT procedures with Nd:YAG (1,064 nm) and diode (830 nm) lasers were monitored on line with a T1-weighted FLASH sequence at 1.5 Tesla. Interstitial prostate temperature (T) was measured on line in 10 LITT procedures and laser energy deposition in 12. Slopes of linear regression curves for signal intensity (SI) over T were applied to determine SI at 60 degrees C to estimate diameters of intraprostatic LITT lesions. Diameters of unperfused LITT lesion cores in contrast-enhanced T1-weighted images served as gold standards. Linear regression curves with an average slope of -.54% SI/degrees C were obtained in 17 LITT procedures. Correlation coefficients were r = .92-.95 for SI/T and SI/energy deposition. Baseline variation of SI at body temperature was +/-3.9%, corresponding to +/-7 degrees C. Prediction of size (13 lesions) from on-line FLASH imaging was correct in 10 of 13, whereas 3 lesions were overestimated. Prediction of LITT lesion diameters from on-line MRI monitoring is possible with a temperature-sensitive FLASH sequence in the prostate. Accuracy may suffice to assign target regions of interest to tissue locations to be protected from coagulation.

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MRT-Monitoring vor, während und nach der interstitiellen laserinduzierten Thermotherapie der benignen Prostatahyperplasie Erste klinische Erfahrungen

Cited by 10 publications

References 0 publications

Interstitial Laser Therapy of Benign Prostatic Hyperplasia

Interstitial Laser Therapy of Benign Prostatic Hyperplasia

Interstitial Laser Therapy

Invited. Predictability of the size of laser‐induced lesions in T1‐weighted MR images obtained during interstitial laser‐induced thermotherapy of benign prostatic hyperplasia

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