The index lesion and focal therapy: an analysis of the pathological characteristics of prostate cancer

Abstract

RESULTSOverall, 374 foci were examined. The median number of tumours per patient was 3.5 (range 1-15). The overall median tumour volume was 1.4 mL (range 0.1-18.2), the median volume of the largest (index) tumour was 0.95 mL (range 0.1-18.2) and the median volume of the largest secondary tumour was 0.2 mL (range 0.05-1

Performance of transrectal prostate biopsies in detecting tumours and implications for focal therapy

“…Several studies have yielded similarly discouraging results [18,19]. There have been interesting reports from groups investigating the possibility of administering focal therapy in cases where only insignificant tumours exist contralaterally to the index tumour [20,21]. The situation where only insignificant disease exists in addition to the index tumour can be described as biologically unifocal as opposed to anatomically unifocal disease [22].…”

18F-fluorocholine for prostate cancer imaging: a systematic review of the literature

“…Dynamic acquisition over the pelvis followed by a whole-body PET or PET/CT static acquisition including the pelvis has been proposed as allowing visualization of pelvic disease without interference from bladder uptake (dynamic imaging) while allowing maximum sensitivity for distant disease (delayed whole-body PET or PET/CT). 20,21,24,34,35,37,38,42,57 Early time points for imaging (0-15 min post-intravenous injection) and/or delayed imaging time points (30,40,45,60, 90-120 and 65-200 min post-intravenous injection) have been also described in the published literature. 22,23,[27][28][29][30][31][32][33]36,39,40,41,[43][44][45][46][47][48][49][50][51][52][54][55][56] 34 16…”

“…In PCa patients under hormone therapy, 18 F-fluorocholine for prostate cancer imaging G Bauman et al have one or two dominant intra-prostatic lesions (DILs) suggest lesions that could serve as a target for focal dose escalation. 60,61 Such a strategy requires accurate localization of DILs through combinations of biopsy information and imaging. 62 Pinkawa et al 49 described the use of 18 F-FCH PET/CT for delineation of DILs in radiation treatment planning for 66 PCa patients.…”

Focal Cryotherapy in the Treatment of Localized Prostate Cancer

“…It is hypothesized that the index lesion (largest tumor volume within the prostate) and occasionally a secondary index lesion will determine the biological potential of the cancer. Bott et al 7 reported that the index lesion comprised 73% of tumor volume in a total of 374 tumor foci examined. This has led to considering a more preservative approach to treating prostate cancer, including hemi-ablation (half-gland treatment) and focal ablation.…”