Treatment options for patients with prostate cancer vary depending on a number of factors including, but not limited to age, weight, overall health, grade and stage of disease and other medical conditions. Patients diagnosed with intermediate grade prostate cancer face the decision of going on active surveillance or opting for surgery, radiation therapy or hormone therapy. Some patients undergo a combination of therapies for their cancer. These decisions are not easy since the morbidity associated with whole-gland therapy concerns both patients and their partners.
Many men and their partners are seeking focal therapy as a solution. In this case study we describe the technical aspects of MR-guided laser interstitial thermal therapy utilizing a trans-rectal approach with real-time thermometry feedback. The patient underwent multiparametric MRI (MPMRI) following a positive trans-rectal ultrasound (TRUS)-guided biopsy in the left side of the gland and persistently rising PSA utilizing a 3Tesla MR scanner (TimTrio, Siemens, Erlangen, Germany). A lesion was identified in the anterior aspect of the prostate gland on the left (figure 1 above).