I’m excited to announce news about a new way to quantify the effects of focal laser ablation (FLA) in a way that may allow us to predict long term treatment success. I was a member of a research team out of Case Western Reserve University that developed an innovative way to use MRI before, during and after focal laser ablation in order to compute and quantify the tissue changes.[i]
Our team utilized MRI images from eight FLA cases. The images were captured before, during and after FLA, and showed not only how ablation reduced the volume of the gland, but ways in which the actual form of the gland was affected. According to an April 19, 2016 press release,
To see the changes, the team developed a tool for co-registration—that is, aligning and fusing the before-and-after treatment images. In addition, the tool takes into account whether deformation is caused by such things as a full bladder or other changes in surrounding organs. It subtracts those influences on the prostate, leaving only the changes due to ablation.[ii]
Essentially, we are asking if there are patterns of prostate change that are associated with success or failure in the ablation zone. Our goal is to expand this study to at least 40 more patients, tracking all of them plus these first eight cases for 3-5 years as we monitor the outcomes of their treatment. By correlating all the images over time, as well as their clinical characteristics such as PSA, follow-up MRIs, any biopsy results (if needed) and other health information, we will see if initial changes in the shape of the prostate give us clues as to long-term ablation results. As our body of knowledge grows, it will increase our confidence in the effectiveness of FLA, as well as the news we deliver to each patient shortly after his treatment. The earlier we can deliver good news, the better for the patient.
Perhaps even more exciting, the image fusion analysis method developed by our team can be used with other organs and ablation treatments for the same purpose. We can now provide physicians who offer image-guided interventions a tool for accurate assessment of the effects of their treatment, almost immediately after the treatment.
It is both humbling yet exhilarating to contribute to the advances in imaging and image-guided treatments that are now increasing treatment success while also improving patient quality of life in the same way that FLA reduces prostate cancer treatment side effects to practically zero.
[i] Toth R, Sperling D, Madabhushi A (2016) Quantifying Post- Laser Ablation Prostate Therapy Changes on MRI via a Domain-Specific Biomechanical Model: Preliminary Findings. PLoS ONE 11(4): e0150016.