@Article{,
AUTHOR = {James Wysock, Jesse Persily, Angela Tong, Eli Rapoport, Ben Zaslavsky, Majlinda Tafa, Herbert Lepor},
TITLE = {Implications of MRI contrast enhancement following focal prostate cancer cryoablation},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {31},
YEAR = {2024},
NUMBER = {5},
PAGES = {11986--11991},
URL = {http://www.techscience.com/CJU/v31n5/59562},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> Local disease recurrence following focal
therapy (FT) for prostate cancer may be due to failure to
eradicate focal disease or development of disease in the
untreated prostate (in- and out-of-field recurrences). Several
studies suggest in-field contrast enhancement (CE) on post
treatment multi-parametric (mp) MRI between 6-12 months
following FT indicates residual disease. The present study
assesses the incidence and oncologic implications of early
CE observed following primary partial gland cryoablation
(PPGCA).<br/>
<b>Material and methods: </b>The surveillance protocol for
men enrolled in our prospective outcomes study following
PPGCA included mpMRI at 6-12 months, 2 years, 3.5
years, and 5 years. All cases of in-field early CE were re
reviewed retrospectively and graded using the previously described Prostate Imaging after Focal Ablation scoring
system. All patients exhibiting early CE were re-evaluated
by a single radiologist at 2-year mpMRI<br/>
<b>Results:</b> A total of 320 men enrolled in our PPGCA
outcomes study had at least 6 months of follow up. Three
hundred fifteen (98%) of these men had undergone post
PPGCA mpMRI at 6-12 months. Of these men, 9 were
found to have early in-field CE and 8 underwent repeat
MRI at 2 years. In all 8 cases, the CE resolved on the
2-year mpMRI. Of these 8 patients, seven underwent
repeat protocol biopsy at 2 years and in-field significant
disease was detected in only 1 case.<br/>
<b>Conclusions:</b> The most compelling evidence that early
CE is not indicative of prostate cancer recurrence is that
all lesions resolved within 24 months. While incidence of
early CE is low, its consistent resolution calls into question
the clinical significance of this finding after PPGCA.},
DOI = {}
}