Imaging and Focal Therapy of Early Prostate Cancer (Current Clinical Urology)

This text encompass an up-to-date, comprehensive review of the state-of-the-art for gland preserving therapies. Fully updated and revised, this text evaluates the scientific evidence for the evolving trend to treat intermediate risk, clinically localized prostate cancer in a focally ablative manner with novel gland-preserving, focal therapy methods. Various ablative devices such as high intensity focused ultrasound, irreversible electroporation, photodynamic therapy, cryotherapy and laser ablation, among others, is discussed in regard to their strengths and limitations as a therapeutic modality. Emphasis is placed on patient selection and outcomes utilizing both advanced imaging techniques and pathologic evaluation. Current and new approaches to image cancer foci within the prostate (multiparametric ultrasonography, multiparametric magnetic resonance image, etc) are presented along with various biopsy techniques, including robotics to map prostate cancer. Patient selection based on imaging and genomic classification, adjuvants to enhance therapy, treatment strategy, outcomes and patient centered concerns is discussed, providing an acceptable balance between cancer control and improved quality of life for patients. Written by experts in the field and lavishly illustrated with detailed line-art and photographs, __Imaging and Focal Therapy of Early Prostate Cancer, Second Edition__ is designed as a comprehensive resource for urologists, radiation oncologists, medical oncologists, radiologists, uropathologists, molecular biologists, biomedical engineers, other clinicians –- residents, fellows, nurses and allied professionals -- and researchers with an interest in the diagnosis and novel treatment of prostate cancer. It will provide insight into the latest research and clinical applications of image-guided diagnosis and minimally invasive focal, gland-preserving treatment for prostate cancer. Front Matter....Pages i-xx Front Matter....Pages 1-1 Evolution in the Concept of Focal Therapy: The Story of Breast Cancer and Prostate Cancer....Pages 3-19 Targeted Therapy for Localized Kidney Cancer....Pages 21-38 Focal Therapy for Prostate Cancer: A Guide for Patients....Pages 39-48 Front Matter....Pages 49-49 Low-Risk Prostate Cancer in North America: Rationale, Uptake, and Limitations of Active Surveillance and Opportunities for Focal Therapy....Pages 51-56 Focal Therapy and Active Surveillance in Europe....Pages 57-74 Focal Therapy and Active Surveillance of Prostate Cancer in East and Southeast Asia....Pages 75-81 Front Matter....Pages 83-83 Pathologic Rationale for Focal Therapy of Prostate Cancer: Elucidating Tumor Characteristics and Biology....Pages 85-104 Identifying and Characterizing the Index Lesion....Pages 105-113 Utilizing Biopsy-Based Genomic Assays to Risk-Stratify Patients....Pages 115-128 Patient Selection for Focal Therapy of Prostate Cancer....Pages 129-137 Prostate Focal Therapy: Definitions and Common Terminology....Pages 139-144 Front Matter....Pages 145-145 Reading and Reporting Standards: The Prostate Imaging Reporting and Data System—What Is It and What Can It Do?....Pages 147-159 Role of Magnetic Resonance Imaging in Prostate Cancer Assessment....Pages 161-176 Optimizing Multiparametric Magnetic Resonance Imaging for a Focal Therapy Practice: Quality Improvement....Pages 177-192 Acoustic Radiation Force Impulse Imaging for Targeting: Correlation with Histology....Pages 193-202 Front Matter....Pages 203-203 In-Bore Magnetic Resonance Imaging-Targeted Prostate Biopsy....Pages 205-218 Multiparametric MRI/TRUS Fusion Biopsy, Outcomes, and Commercial Systems....Pages 219-237 Detecting, Localizing, and Treating the Multiparametric Magnetic Resonance Imaging Invisible Lesion: Utilizing Three-Dimensional Transperineal Mapping....Pages 239-250 Multiparametric Transrectal Ultrasound Biopsy....Pages 251-263 Robotic Magnetic Resonance Imaging Targeting for Biopsy and Therapy....Pages 265-273 Front Matter....Pages 275-275 In-Bore Transperineal Magnetic Resonance Imaging-Guided Laser Ablation....Pages 277-282 Focal Cryotherapy....Pages 283-291 Photodynamic Therapy for Early Prostate Cancer....Pages 293-306 Front Matter....Pages 307-307 High-Intensity Focused Ultrasound....Pages 309-323 Transrectal Laser Focal Therapy of Prostate Cancer....Pages 325-343 Front Matter....Pages 345-345 Focal Therapy for Prostate Cancer: A Molecular Biology Approach with TRAIL....Pages 347-354 Focal Brachytherapy and Intensity-Modulated Radiation Therapy....Pages 355-371 Focal Therapy for Anterior Cancers (Originated from Transition Zone)....Pages 373-382 Front Matter....Pages 383-383 The Story of Adjuvants to Boost the Performance of Cryoablation....Pages 385-397 5-Alpha-Reductase Inhibition as a Secondary Preventive Strategy....Pages 399-405 Front Matter....Pages 407-407 Measuring Patient-Based Outcomes: Setting Realistic Expectations When Balancing Functional Outcomes with Cancer Control....Pages 409-416 Pathologic Assessment and Implications Following Focal Therapy of Prostate Cancer....Pages 417-429 Posttreatment Surveillance Using Multiparametric Magnetic Resonance Imaging....Pages 431-441 Determining Focal Therapy Failure and Salvage Options....Pages 443-446 Positioning Focal Therapy from Consensus to Guidelines....Pages 447-463 Back Matter....Pages 465-483 Imaging and Focal Therapy of Early Prostate Cancer evaluates the scientific evidence for the evolving trend to treat low to intermediate risk, clinically localized prostate cancer in a focally ablative manner with novel gland-preserving, focal therapy methods. Various ablative devices such as high intensity focused ultrasound, irreversible electroporation, photodynamic therapy, cryotherapy and laser ablation, among others, are discussed in regard to their strengths and limitations as a therapeutic modality. Emphasis is placed on tumor stage shift towards early stage disease with an increase in unilateral versus bilateral cancers validated by final pathology assessment of large prostatectomy series. Current and new approaches to image cancer foci within the prostate (3-Dimensional contrast-enhanced transrectal ultrasonography, multiparametric magnetic resonance image with spectroscopy, ETC) are presented along with biopsy techniques to map prostate cancer. Patient selection, treatment strategy, outcomes and safety concerns that may provide acceptable cancer control and improved quality of life for patients are all covered in detail. Written by experts in the field and lavishly illustrated with detailed line-art and photographs, Imaging and Focal Therapy of Early Prostate Cancer is a resourceful volume beneficial to practitioners specializing in the treatment and management of prostate cancer This book evaluates the trend to treat low risk, clinically localized prostate cancer in a focally ablative manner with novel gland-preserving, focal therapy methods. It examines the latest clinical applications of image-guided diagnosis and treatment