Transperineal focal laser ablation (TPLA) has the potential to obtain oncological control, while sparing nearby tissue to preserve continence and erectile function with a low toxicity profile. However, registration and prediction of the ablation zone is essential for TPLA to become a clinal standard of care treatment. In this study we investigated the capability of MRI and CEUS to image the treated volume. We show that the treatment effects of TPLA can reliably be visualized using these techniques and that the results are in good agreement with histopathology. These results are essential first steps towards improved planning and performance of TPLA.
Despite improved surgical techniques, the reported rate of positive surgical margins (PSM) after robotic-assisted laparoscopic prostatectomy remains as high as 20-40%. These PSM are associated with disease progression after surgery and should be avoided. Currently, there is no technique available to detect PSM intraoperatively. Diffuse Reflectance Spectroscopy (DRS) is proposed as a technique to detect tumor tissue at the surgical resection margin, intraoperatively. Over 800 measurements were performed on the prostate surface and, to mimic a PSM, on the cleaved prostate surface. A machine learning-based classification model was able to discriminate healthy tissue from tumor tissue with sufficient accuracy.
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