SIR 2024
Men's Health
Aliza Mushtaq, MD
Postdoctoral Research Fellow
Emory University
Financial relationships: Full list of relationships is listed on the CME information page.
Daniel Adamo, M.D.
Assistant Professor of Radiology
Mayo Clinic
Disclosure information not submitted.
Scott M. Thompson, MD., Ph.D (he/him/his)
Associate Professor of Radiology
Mayo Clinic Rochester
Financial relationships: Full list of relationships is listed on the CME information page.
Aiming Lu, Ph.D
Assistant Professor of Medical Physics
Mayo Clinic
Disclosure information not submitted.
Ali Ganjizadeh, MD
Postdoctoral Research Fellow
Mayo AI Lab, Department of Radiology, Mayo Clinic
Disclosure information not submitted.
David Woodrum, MD, PhD (he/him/his)
Professor of Interventional Radiology
Mayo Clinic
Financial relationships: Full list of relationships is listed on the CME information page.
To determine the safety and efficacy of MRI-guided cryoablation of prostate cancer rib metastasis for locoregional tumor control and PSA decrease.
Materials and Methods:
This single institution retrospective study includes data from October 2017 to October 2022 with 11 patients treated; mean age 71.5±5.2, range 65-84 years; who underwent 12 MRI-guided cryoablation procedures for 12 metastatic rib lesions; mean size 29.1±13.9 mm, range: 5-49 mm; in patients with prostate cancer. Patients were followed up on PET-CT 11-C Choline scans, initially at 3±1 months and then up to median 1 and a half year (range 6 months to 3 years). Locoregional tumor control was assessed on initial post-ablation PET-CT scan. Disease-free state in the patient and recurrent metastasis in the treated rib was assessed on all follow-up imaging. PSA difference was calculated by comparing pre-ablation PSA and post-ablation PSA at mean 3 months. Any reported complication was graded according to the Society of Interventional Radiology Adverse Events classification system.
Results:
Loco-regional tumor control was achieved in 9 out of 11 patients (81%) at initial PET-CT scan at mean 3 months. For the 9 of 11 with initial local control, one patient at 7-month follow-up demonstrated subtle choline activity at the ablation site. One patient stayed disease-free until 7 months post-ablation where a metastatic lesion was observed in another rib. In 2 of 11 (18.1%) patients, although local control was achieved in the target lesion, metastatic disease travelled further down the rib as demonstrated on PET-CT at 3- and 12-months interval. PSA decrease was recorded as 3.29±11.09 on average. Two (18.1%) minor complications were presented post-procedure.
Conclusion: MRI-guided percutaneous cryoablation of prostate cancer metastasis to the rib is safe and can achieve good locoregional tumor control with subsequent PSA decrease in patients with oligometastatic prostate cancer disease.