One-year data of localized prostate cancer patients treated with MRI-guided transurethral ultrasound ablation (TULSA) suggests 96% of patients achieved 75% or more reduction in PSA, with low rates of severe toxicity and residual grade group 2 disease.
While more research is needed, investigators suggest this incision-free technique might also effectively treat benign prostate gland enlargement.
Researchers presented data on the TULSA-PRO ablation clinical trial, or TACT, at the 2019 Radiological Society of North America annual meeting in Chicago (RSNA).
TULSA is a disruptive technology that requires urologists and radiologists to work collaboratively, according to study co-author Steven S. Raman, MD, of the University of California at Los Angeles. Urologist Laurence Klotz, MD, and radiologist Masoom Haider, MD, both at the University of Toronto, developed TULSA, which is FDA cleared for prostate tissue ablation, according to Dr. Raman.
“I think this is a potentially great option for patients who opt for either whole- or partial-gland treatment. It is an inside-out, not an outside-in treatment. Its main advantages are real-time noninvasive monitoring of the thermal dose and immediate assessment of ablative effect,” Dr. Raman told Urology Times.
TULSA allows for customized prostate ablation using directional ultrasound under MRI thermometry feedback control. Study investigators used TULSA to perform whole-gland ablation, while sparing the urethra and urinary sphincter. To perform the procedure, they inserted the technology’s rod-shaped device, which has 10 ultrasound-generating elements that can treat the entire prostate gland, into the urethra.
“One or more of the elements are used to send out sound waves that heat and destroy the target prostate tissue. The elements are controlled automatically by a software algorithm that can adjust the shape, direction, and strength of the therapeutic ultrasound beam. The entire procedure takes place in an MRI scanner so that doctors can closely monitor treatment and assess the degree and location of heating,” according to an RSNA press release on the study.
TACT enrolled 115 localized prostate cancer patients at 13 sites. Sixty-three percent, or 72, of the men had grade group 2 disease.