Rectal fistulae after salvage high‐intensity focused ultrasound for recurrent prostate cancer after combined brachytherapy and external beam radiotherapy

Ahmed, Hashim U.; Ishaq, Ahtsham; Zacharakis, Evangelos; Shaw, Greg; Illing, Rowland; Allen, Clare; Kirkham, Alex; Emberton, Mark

doi:10.1111/j.1464-410x.2008.08026.x

Cited by 49 publications

(21 citation statements)

References 13 publications

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“…No rectal complications were observed, but 11% of patients required a urinary sphincter implantation. Complications reported in the recent literature include rectal fi stulas, urethral strictures, and bladder neck contracture ( 75,76 ).…”

Section: Review: Mr Imaging Of Treated Prostate Cancermentioning

confidence: 99%

MR Imaging of Treated Prostate Cancer

Vargas

Wassberg²,

Akın³

et al. 2012

Radiology

126

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Many management options are available to patients with newly diagnosed prostate cancer. Magnetic resonance (MR) imaging plays an important role in initial staging of prostate cancer, but it also aids in tumor detection when there is clinical or biochemical suspicion of residual or recurrent disease after treatment. The purpose of this review is to describe the normal appearances of the prostatic region after different kinds of treatment for prostate cancer and to discuss how these appearances differ from those of recurrent and residual disease. Several MR imaging techniques used in evaluating patients with prostate cancer are described, including conventional MR imaging sequences (mainly T1- and T2-weighted sequences), MR spectroscopic imaging, diffusion-weighted imaging, and dynamic contrast agent-enhanced MR imaging. Clinical considerations, together with the different approaches for interpreting serum prostate-specific antigen values in the posttreatment setting, are also presented. All forms of treatment alter the MR imaging features of the prostatic region to a greater or lesser extent, and it is important to be able to recognize expected posttreatment appearances and distinguish them from the features of recurrent or residual cancer to aid subsequent clinical management.

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Section: Review: Mr Imaging Of Treated Prostate Cancermentioning

confidence: 99%

MR Imaging of Treated Prostate Cancer

Vargas

Wassberg²,

Akın³

et al. 2012

Radiology

126

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“…56,85,86 Dynamic contrast-enhanced MRI alone has been evaluated against T2W imaging used in combination with diffusion-weighted imaging (DWI) in detecting recurrence of prostate cancer after high-intensity focused ultrasound ablation: no significant difference in accuracy or receiver operating characteristics area under the curve between T2W + DWI and DCE-MRI alone was found; DCE-MRI was more sensitive but less specific than T2W + DWI. 87 The addition of DCE to a standard MRI protocol has shown significant improvement in the detection of prostate cancer's local recurrence after radical prostatectomy.…”

Section: Prostate Cancer Treatment Follow-upmentioning

confidence: 99%

Dynamic Contrast-Enhanced Magnetic Resonance Imaging in the Evaluation of the Prostate

Bonekamp

Macura

2008

Topics in Magnetic Resonance Imaging

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Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a novel MR technique that allows to interrogate pharmacokinetic processes in the tissues at a voxel level and to generate parametric maps that can be displayed for clinical interpretation. Dynamic contrast-enhanced MRI is an important imaging technique for the imaging of angiogenesis and vasculogenesis because it probes the microvascular networks at a microscopic level by being sensitive to the compartmentalization of tissue into the vascular and extravascular-extracellular space and to the diffusion of contrast molecules across the vascular endothelium and capillary boundaries. Dynamic contrast-enhanced MRI has already shown to improve detection and localization of prostate cancer, to improve prediction of extracapsular extension, determination of tumor volume, and after treatment follow-up. In this article, we outline the fundamental principles of DCE-MRI and describe the application of DCE methods in the imaging of the prostate.

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“…12 Five cases of rectal fistula have been reported in patients who had previously undergone brachytherapy and/or radiotherapy. 5,13 Rectal fistulas can be prevented by monitoring rectal wall thickness (o6 mm), better knowledge of heat diffusion and better real-time control of the HIFU shots and of the cooling system. 1 Treatment parameters need to be adapted in cases of hypovascularized irradiated tissue as such tissue conducts less heat and generates higher temperatures.…”

Section: Discussionmentioning

confidence: 99%

Transrectal high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer: review of technical incidents and morbidity after 5 years of use

Ripert

Azemar

Menard

et al. 2010

Prostate Cancer Prostatic Dis

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The objective of this study was to report on technical incidents and early and late complications occurring in high-intensity focused ultrasound (HIFU) treatment of patients with localized prostate cancer. We performed a retrospective review of patients who were treated by Ablatherm at our centre. We recorded all technical incidents, treatment discontinuations and early (o1 month) and late complications. A total of 74 HIFU procedures were performed in 65 patients (55 first-line HIFU treatments and 10 cases of salvage therapy after radiotherapy) over a 5-year period. Median followup was 41 months (10-64 months). All the procedures were well tolerated and no intra-or perioperative deaths occurred. Six technical incidents in the overall population (8.1%) led to discontinuation of the procedure. The early complication rate in patients undergoing first-line HIFU was 36.4%: urinary retention (20%), dysuria (5.4%), urinary infection (3.6%), haematuria (3.6%) and urethral stenosis (3.6%). The late complication rate was 12.7%: urethral stenosis (9%) and dysuria (3.6%). There were no cases of rectourethral fistula. The long-term urinary incontinence rate was 20% and the de novo erectile dysfunction rate was 77.1%. Nine complications (16.4%) required surgical management. The overall complication rate was 49%. Ablatherm is a reliable technique with a relatively high complication rate. However, most complications were minor and required surgical management in a few cases only. Our results confirm that all patients who are offered HIFU treatment should be properly informed of the risks, in particular with regard to continence and sexual function.

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Rectal fistulae after salvage high‐intensity focused ultrasound for recurrent prostate cancer after combined brachytherapy and external beam radiotherapy

Cited by 49 publications

References 13 publications

MR Imaging of Treated Prostate Cancer

MR Imaging of Treated Prostate Cancer

Dynamic Contrast-Enhanced Magnetic Resonance Imaging in the Evaluation of the Prostate

Transrectal high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer: review of technical incidents and morbidity after 5 years of use

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