This interesting paper describes a Phase-1 study on a novel focal treatment modality.
The advances in recent years in prostate MRI with standardization of imaging procedures and assessment of those have made possible a renewed approach to focal therapy of localized prostate cancer. A true focal therapy can now be delivered to the visualised lesion, with a safety margin, not comprising hemi- or full ablation of the gland. This promises less morbidity and side effects.
A paradigm shift in the treatment of localised prostate cancer might very well be in the making.
Several older and newer treatment modalities have appeared, such as HIFU, Cryotherapy, IRE etc. Most are guided and delivered by transrectal ultrasonography with or without fusion with MRI. The in-bore MRI technology without fusion with TRUS has been used for transrectal or transperineal biopsies and is now described also for guidance of treatment. On top of this, the TULSA method utilizes transurethral administration of the treatment with in-bore MRI guidance.
It remains to see, whether MRI-TRUS fusion guidance or in-bore MRI will be the method of the future, as well as transurethral versus transrectal delivery of the treatment and which energy delivery method will be the future method of choice.