MRI-guided prostate cryoablation

Focal therapy for prostate cancer has undergone a renaissance during recent years. The advent and utilisation of high quality multiparametric prostate MRI has meant that a growing number of men are able to have small but suspicious prostate lesions detected and ultimately targeted for biopsy. Undoubtedly the PROMIS and PRECISION trials have played a significant part in allowing NICE to recommend multiparametric prostate MRI as a first-line investigation for clinically suspected localised prostate cancer. The identification of often asymptomatic but clinically significant disease in an increasingly youthful and less co-morbid population may help to explain the expanding utilisation of focal therapy techniques for localised prostate cancer. For some men diagnosed with small volume and low grade prostate cancer, the conventional options of radical prostatectomy or radiotherapy may have unpalatable rates of negative side effects. A major advantage of focal therapy is that it has the potential to avoid or minimise the likelihood of urinary incontinence and impotence.

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