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Prostate Cancer: MR Imaging–guided Galvanotherapy—Technical Development and First Clinical Results¹

¹ From the Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe-University, Theodor-Stern Kai 7, D-60590 Frankfurt am Main, Germany (T.J.V., S.Z., F.B.M.); Institute of Minimal Invasive Tumor Therapy, Regensburg, Germany (H.P.M.); and Department of Radiology, Medical University of South Carolina, Charleston, SC (J.B.S., H.A.). From the 2005 RSNA Annual Meeting. Received September 20, 2006; revision requested November 9; revision received December 14; accepted January 22, 2007; final version accepted June 11. Address correspondence to T.J.V. (e-mail: t.vogl{at}em.uni-frankfurt.de).

Purpose: To prospectively evaluate the safety and effectiveness of magnetic resonance (MR) imaging–guided galvanotherapy in prostate cancer.

Materials and Methods: This prospective study was approved and authorized by the institutional review board, and patients gave informed consent. Forty-four men (mean age, 63.1 years) with histologically proved prostate cancer were treated with galvanotherapy. After transgluteal puncture of the prostate with local anesthesia, two MR imaging–compatible electrodes were positioned under MR imaging guidance in the periphery of the right and left lobes of the prostate so that they had direct tumor contact. The patients were treated three times in 1-week intervals, and direct current was applied to the localized cancer in the prostate gland with a total charge of 350 coulombs. Follow-up with laboratory testing (prostate-specific antigen [PSA] levels) and endorectal MR imaging with tumor volume measurement was performed 3, 6, and 12 months after the procedure. The Friedman test was used to compare tumor volumes and PSA levels across the four time points.

Results: All patients tolerated MR imaging–guided galvanotherapy well without any major side effects or complications. Six patients had some reversible difficulty with urination, and five reported temporary unilateral leg paresthesia. Tumor volume as determined with MR imaging decreased from a pretherapeutic median of 1.90 to 1.12 cm³, which corresponded to a significant (P < .01) reduction of 41%. One patient (2%) had complete remission and 18 (41%) had partial remission at follow-up 12 months after therapy. Twenty-three patients (52%) were classified as having stable disease. Two patients (5%) had progressive disease. Median PSA levels decreased in the 12-month control period from 7.05 to 2.4 ng/mL (66%, P < .01).

Conclusion: MR imaging–guided galvanotherapy is a safe procedure and can result in local control of prostatic carcinoma, with a concomitant reduction in the PSA level.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/245/2/895/DC1

© RSNA, 2007