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Radiology, Vol 202, 232-236, Copyright © 1997 by Radiological Society of North America

ARTICLES

Laser ablation-induced changes in the prostate: findings at endorectal MR imaging with histologic correlation

RA Boni, T Sulser, W Jochum, B Romanowski, JF Debatin and GP Krestin
Department of Radiology, University Hospital, Zurich, Switzerland.

PURPOSE: To correlate laser ablation-induced changes in the prostate as depicted at endorectal magnetic resonance (MR) imaging with results at histologic examination. MATERIALS AND METHODS: In eight patients with prostate carcinoma, visually guided laser ablation was performed during lymphadenectomy. Radical prostate resection was performed 4-9 days (mean, 6.9 days) after ablation in seven patients and at 70 days in one patient. The study protocol consisted of (a) endorectal T2-weighted fast spin-echo imaging, (b) dynamic T1-weighted spoiled gradient-echo imaging prior to and after injection of contrast material, and (c) gadolinium-enhanced T1-weighted spin-echo imaging. Imaging findings were correlated with macroscopic and histologic findings. RESULTS: Histologic examination revealed periurethral necrosis with a marginal zone that consisted of partially necrotic tissue, dilated vessels, and hemorrhagic areas. Considerable interindividual difference was observed in the extent of morphologic alterations (area, 0-18.0 cm3). Gadolinium- enhanced images were best suited for assessment of laser ablation- induced changes. The correlation between the volume of altered tissue measured on MR images and in macroscopic specimens was excellent (r2 = .96). CONCLUSION: MR imaging helped monitor changes induced with laser ablation (which differed greatly among individuals). MR monitoring may thus be useful in patients with obstructive benign prostatic hyperplasia after laser ablation.


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