Effect of irreversible electroporation of prostate cancer on microcirculation: Imaging findings in contrast-enhanced T1-weighted 3D MRI.

Irreversible electroporation (IRE) is a novel focal ablation technique applicable for treatment of prostate cancer (PCa). We aim to evaluate imaging findings of T1-weighted contrast-enhanced MRI after percutaneous IRE of low-risk PCa.

A total of 13 male patients underwent IRE of focal low-risk PCa and were included in this analysis. Prostate IRE was conducted using 2-4 electrodes being placed under CT-fluoroscopy guidance. Dynamic contrast-enhanced 3D isotropic fat-saturated T1-weighted MRI (DCE-MRI) was performed 24-72 hours before and 24-72 hours after ablation.

Ablated prostate was either homogeneously (8/13 [62%]) or heterogeneously (5/13 [38%]) hypo attenuating. Peripheral contrast enhancement manifesting as a hyper attenuating margin was observed during the arterial (60 sec) (3/13 [23%]) and venous (240 sec) (10/13 [77%]) phase. The ablation defect showed a sharp (8/13 [62%]) or blurry (5/13 [38%]) margin.

The results show a venous peripheral rim enhancement in most of the cases, indicating reactive hyperaemia. The heterogeneous appearance of the defect zone in some cases may be secondary to sustained vascularization.

Clinical hemorheology and microcirculation. 2017 Sep 04 [Epub ahead of print]

L P Beyer, B Pregler, N Verloh, K Brünn, M Haimerl, C Stroszczynski, E M Jung, P Wiggermann

Department of Radiology, University MedicalCenter Regensburg, Germany.