Image-Guided Cryoablation of the Prostate

  • Sutchin R. Patel
  • Gyan Pareek
  • Jasjit S. Suri


Minimally invasive treatments continue to evolve as an alternative means for the treatment of prostatic tumors. Of the mainstream ablative procedures reported in the literature, the cryotherapy data appear to be the most durable. The technological innovations in the use of urethral warming devices and real-time transrectal ultrasound sonography have lead to effective tumor ablation with a reduction in the morbidity of the procedure. Although limited long-term survival data utilizing cryotherapy are available, recent series have provided compelling results, promoting interest in prostatic cryoablation. This chapter assesses the importance of imaging technology in the current status of cryotherapy for prostate tumors.


Prostate Specific Antigen Freezing Process Biochemical Failure Rectourethral Fistula Nadir Prostate Specific Antigen 
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  1. 1.
    Chosy SG, Nakada SY, Lee FT et al (1998) Monitoring kidney cryosurgery: predictors of tissue necrosis in swine. J Urol 159:1370–1374CrossRefPubMedGoogle Scholar
  2. 2.
    Baust JG, Gage AA, Robilotto AT, Baust JM (2009) The pathophysiology of thermoablation: optimizing cryoablation. Curr Opin Urol 19:127–132CrossRefPubMedGoogle Scholar
  3. 3.
    Klossner PD, Baust JM, VanBuskirk RG, Gage AA, Baust JG (2008) Cryoablative response of prostate cancer cells is influenced by androgen receptor expression. BJU Int 101:1310–1316CrossRefPubMedGoogle Scholar
  4. 4.
    Gage AA, Baust JG (1998) Mechanisms of tissue injury in cryosurgery. Cryobiology 37:171–186CrossRefPubMedGoogle Scholar
  5. 5.
    Arnott J (1850) Practical illustrations of the remedial efficacy of a very low or anesthetic temperature I: in cancer. Lancet 2:257–259CrossRefGoogle Scholar
  6. 6.
    Gage AA (1992) Cryosurgery in the treatment of cancer. Surg Gynecol Obstet 174:73–92PubMedGoogle Scholar
  7. 7.
    Cooper IS, Lee A (1961) Cryostatic congelation: a system for producing a limited controlled region of cooling or freezing of biologic tissues. J Nerv Ment Dis 133:259–263CrossRefPubMedGoogle Scholar
  8. 8.
    Gonder MJ, Soanes WA, Shulman S (1966) Cryosurgical treatment of the prostate. Invest Urol 3:372–378PubMedGoogle Scholar
  9. 9.
    Flocks RH, Nelson CM, Boatman DL (1972) Perineal cryosurgery for prostatic carcinoma. J Urol 108:933–935PubMedGoogle Scholar
  10. 10.
    Megalli MR, Gursel EO, Veenema RJ (1974) Closed perineal cryosurgery in prostatic cancer. New probe and technique. Urology 4:220–222Google Scholar
  11. 11.
    Reuter HJ (1972) Endoscopic cryosurgery of prostate and bladder tumors. J Urol 107:389–393PubMedGoogle Scholar
  12. 12.
    Cox RL, Crawford ED (1995) Complications of cryosurgical ablation of the prostate to treat localized adenocarcinoma of the prostate. Urology 45:932–935CrossRefPubMedGoogle Scholar
  13. 13.
    Porter MP, Ahaghotu CA, Loening SA et al (1997) Disease-free and overall survival after cryosurgical monotherapy for clinical stages B and C carcinoma of the prostate: a 20-year follow-up. J Urol 158:1466–1469CrossRefPubMedGoogle Scholar
  14. 14.
    Pisters LL, Dinney CP, Pettaway CA et al : (1999) A feasibility study of cryotherapy followed by radical prostatectomy for locally advanced prostate cancer. J Urol 161:509–514CrossRefPubMedGoogle Scholar
  15. 15.
    Shinohara K, Connolly JA, Presti JC et al (1996) Cryosurgical treatment of localized prostate cancer (stages T1 to T4): preliminary results. J Urol 156:115–120CrossRefPubMedGoogle Scholar
  16. 16.
    Ghafar MA, Johnson CW, De La Taille A et al (2001) Salvage cryotherapy using an argon based system for locally recurrent prostate cancer after radiation therapy: the Columbia experience. J Urol 166:1333–1337CrossRefPubMedGoogle Scholar
  17. 17.
    Zisman A, Pantuck AJ, Cohen JK et al (2001) Prostate cryoablation using direct transperineal placement of ultra thin probes through a 17-gauge brachytherapy template-technique and preliminary results. Urology 58:988–993CrossRefPubMedGoogle Scholar
  18. 18.
    Onik G, Cobb C, Cohen J, Zabkar J, Porterfield B (1988) US characteristics of frozen prostate. Radiology 168:629–631CrossRefPubMedGoogle Scholar
  19. 19.
    Saliken JC, Donnelly BJ, Rewcastle JC (2002) The evolution and state of modern technology for prostate cryosurgery. Urology 60(suppl 2A):26–33Google Scholar
  20. 20.
    Onik G (2007) Percutaneous image-guided prostate cancer treatment: cryoablation as a successful example. Tech Vasc Interv Radiol 10:149–158CrossRefPubMedGoogle Scholar
  21. 21.
    Chalasani V, Gardi L, Martinez CH, Downey DB, Fenster A, Chin JL (2009) Contemporary technique of intraoperative 3-dimensional ultrasonography-guided transperineal prostate cryotherapy. Can Urol Assoc J 3:136–141PubMedCentralPubMedGoogle Scholar
  22. 22.
    Shen F, Shinohara K, Kumar D, Khemka A, Simoneau AR, Werahera PN, Li L, Guo Y, Narayanan R, Wei L, Barqawi A, Crawford ED, Davatzikos C, Suri JS (2008) Three-dimensional sonography with needle tracking. J Ultrasound Med 27:895–905PubMedCentralPubMedGoogle Scholar
  23. 23.
    Onik G, Barzell W (2008) Transperineal 3D mapping biopsy of the prostate: an essential tool in selecting patients for focal prostate cancer therapy. Urol Oncol 26:506–510CrossRefPubMedGoogle Scholar
  24. 24.
    Mitri FG, Davis BJ, Alizad A, Greenleaf JF, Wilson TM, Mynderse LA, Fatemi M (2008) Prostate cryotherapy monitoring using vibroacoustography: preliminary results of an ex vivo study and technical feasibility. IEEE Trans Biomed Eng 55:2584–2592CrossRefPubMedCentralPubMedGoogle Scholar
  25. 25.
    Futterer JJ (2007) MR imaging in local staging of prosate cancer. Eur J Radiol 63:328–334CrossRefPubMedGoogle Scholar
  26. 26.
    van den Bosch MA, Josan S, Bouley DM, Chen J, Gill H, Rieke V, Butts-Pauly K, Daniel BL (2008) MR imaging-guided percutaneous cryoablation of the prostate in an animal model: in vivo imaging of cryoablation-induced tissue necrosis with immediate histopathologic correlation. J Vasc Interv Radiol 20:252–258CrossRefPubMedGoogle Scholar
  27. 27.
    Xu S, Kruecker J, Turkbey B, Glossop N, Singh AK, Choyke P, Pinto P, Wood BJ (2008) Real-time MRI-TRUS fusion for guidance of targeted prostate biopsy. Comput aided Surg 13:255–264CrossRefPubMedCentralPubMedGoogle Scholar
  28. 28.
    Babaian RJ, Donnelly B, Bahn D, Baust JG, Dineen M, Ellis D, Katz A, Pisters L, Rukstalis D, Shinohara K, Thrasher JB (2008) Best practice statement on cryosurgery for the treatment of localized prostate cancer. J Urol 180:1993–2004CrossRefPubMedGoogle Scholar
  29. 29.
    Cohen JK, Miller RJ, Shuman BA et al (1995) Cryosurgical ablation of the prostate: patterns of failure and 2 year post treatment data as compared to external beam radiation therapy (abstract). J Urol 153(suppl):503AGoogle Scholar
  30. 30.
    Miller RJ Jr, Cohen JK, Shuman BA et al (1996) Percutaneous transperineal cryosurgery of the prostate as salvage therapy for post radiation recurrence of adenocarcinoma. Cancer 77:1510–1514CrossRefPubMedGoogle Scholar
  31. 31.
    Pisters LL, Rewcastle JC, Donnelly BJ, Lugnani FM, Katz AE, Jones JS (2008) Salvage prostate cryoablation: initial results from the cryo on-line data registry. J Urol 180:559–564CrossRefPubMedGoogle Scholar
  32. 32.
    De La Taille A, Benson MC, Bagiella E et al (2000) Cryoablation for clinically localized prostate cancer using an argon-based system: complication rates and biochemical recurrence. BJU Int 85:281–286CrossRefGoogle Scholar
  33. 33.
    Theodorescu D (2004) Cancer cryotherapy: evolution and biology. Rev Urol 6(suppl 4): S9–S19PubMedCentralPubMedGoogle Scholar
  34. 34.
    Aus G, Pileblad E, Hugosson J (2002) Cryosurgical ablation of the prostate: 5-year follow-up of a prospective study. Eur Urol 42:133–138CrossRefPubMedGoogle Scholar
  35. 35.
    Donnelly BJ, Saliken JC, Ernst DS et al (2002) Prospective trial of cryosurgical ablation of the prostate: five-year results. Urology 60:645–649CrossRefPubMedGoogle Scholar
  36. 36.
    Gillett MD, Gettman MT, Zincke H et al (2004) Tissue ablation technologies for localized prostate cancer. Mayo Clin Proc 79(12):1547–1555CrossRefPubMedGoogle Scholar
  37. 37.
    Bahn DK, Lee F, Badalament R, Kumar A, Greski J, Chemick M (2002) Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer. Urology 60(suppl 1):3–11CrossRefPubMedGoogle Scholar
  38. 38.
    Cohen JK (2004) Cryosurgery of the prostate: techniques and indications. Rev Urol 6:S20PubMedCentralPubMedGoogle Scholar
  39. 39.
    Han KR, Cohen JK, Miller RJ et al (2003) Treatment of organ confined prostate cancer with third generation cryosurgery: preliminary multi-center experience. J Urol 170(4, pt 1):1126–1130Google Scholar
  40. 40.
    Cohen JK, Miller RJ, Ahmed S, Lotz MJ, Baust J (2008) Ten-year biochemical disease control for patients with prostate cancer treated with cryosurgery as primary therapy. Urology 71:515–518CrossRefPubMedGoogle Scholar
  41. 41.
    Jones SJ, Rewcastle JC, Donnelly BJ, Lugnani FM, Pisters LL, Katz AE (2008) Whole gland primary prostate cryoablation: initial results from the cryo on-line data registry. J Urol 180:554–558CrossRefPubMedGoogle Scholar
  42. 42.
    Levy DA, Pisters LL, Jones JS (2009) Primary cryoablation nadir prostate specific antigen and biochemical failure. J Urol 182:931–937CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Sutchin R. Patel
    • 1
  • Gyan Pareek
    • 1
  • Jasjit S. Suri
    • 2
    • 3
  1. 1.Division of Urology, Section of Minimally Invasive Urologic SurgeryThe Warren Alpert Medical School of Brown University, Rhode Island HospitalProvidenceUSA
  2. 2.Biomedical Technologies, Inc.DenverUSA
  3. 3.Idaho State University (Affiliated)PocatelloUSA

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