A pilot study in intraparenchymal therapy delivery in the prostate: a comparison of delivery with a porous needle vs standard ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-12

AUTHORS

Martin L. Brady, King Scott Coffield, Thomas J. Kuehl, Raghu Raghavan, V. O. Speights, Belur Patel, Scott Wilson, Mike Wilson, Rick M. Odland

ABSTRACT

BACKGROUND: New biologic therapies directly injected into the prostate are in clinical trials for prostatic diseases. There is a need to understand distribution of injected therapies as a function of prostatic anatomy, physiology, and device design. METHODS: A needle with a porous length of customizable-length was tested and its performance compared with a standard needle. Injections of magnetic resonance contrast reagent were placed into ex-vivo human prostates after surgical excision in standard of care therapy for invasive bladder cancer patients. Magnetic resonance images were acquired using sequences to quantify volume delivered, distributed, and backflow. RESULTS: Magnetic resonance images analysis revealed heterogeneity distribution with injection into the specimens. There was low resistance to flow along ductal pathways and high resistance to flow into glandular nodules and smooth muscle/fibrous parenchyma. Data confirm previous studies showing injection loss via urethra backflow, urethra, and prostatic ducts. Tissue fraction of dose was significantly higher with porous needle compared with standard needle (p = .03). We found that a greater volume of distribution divided by the amount infused (Vd/Vi) increased by 80% with the porous needle, though no statistically significant association due to small sample size. CONCLUSIONS: This study demonstrated that prostatic tissue is anatomically heterogenic and limits distribution of needle injection. There is greater distribution in the ex-vivo prostate using a porous needle. The complexity of intra prostatic flow pathways suggests preoperative imaging and pre-treatment planning will enhance therapy. More... »

PAGES

66

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12894-018-0378-8

DOI

http://dx.doi.org/10.1186/s12894-018-0378-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105894853

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30055610


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