MIS Image Guided/ Focal-cryo/RFA/HIFU: Prostate

Moderated Poster Session

MP23-13 - MR/US Fusion Guided Ultra-Focal Gold Silica Nanoshell Directed Laser Ablation of Prostate Tumors: Side effects and functional outcomes from 12 patients. Phase I/II Clinical Trial

Saturday, September 22
2:00 PM - 4:00 PM
Location: Room 253

Introduction & Objective :

Multiparametric MRI (mpMRI) has made it possible to visualize, biopsy, and treat specific lesions in the prostate using focal therapy (FT). The rationale behind FT is to achieve cancer control while minimizing side effects associated with surgery and/or radiation. Gold silica nanoshell (GSN) directed laser ablation of prostate tumors is a novel FT modality, currently under investigation


Methods : To be eligible for this trial, patients must have a biopsy confirmed, Gleason ≤ 7 MR visible prostate cancer (PCa) lesion. In addition, PSA must be under 15 or PSA density must be under 0.15, and clinical stage cannot be higher than T2a. On day 1, patients received a 7.5mL/Kg GSN infusion which subsequently accumulated in PCa lesions due defective cancerous endothelium. On day 2, laser ablation of PCa was performed using an electromagnetically tracked MR/US fusion guided transperineal approach. The near-infrared laser wavelength used is converted to heat by the GSN (residing in PCa), while healthy tissue (primarily composed of water and hemoglobin) is affected mildly. This results in focal ablation of PCa, while sparing the rest of the prostate. Side effects within the 30-day postoperative period and change in IPSS and SHIM scores at 3 months follow-up were recorded


Results : We report the results from the first twelve patients enrolled in our institution. The median PSA was 6.15 (range: 0.82-11.96), the median size of the lesions treated was 0.475 (range: 0.06-1.56), and the median duration of the procedure was 224 min (range: 115-345). One patient experienced self-resolving epigastric-subcostal pain during GNS infusion, and did not complete treatment. The remaining 11 patients completed treatment in an outpatient setting. Self-resolving CTCAE grade I/II hematuria was universally experienced by all 11 patients. 4 out of 11 failed the trial of void and a Foley catheter was left in place for 1-2 days (CTCAE grade II). The median IPSS score dropped from 12 (range: 3-19) at baseline to 8 (range:2-10) at 3 months f/u. In sexually active patients, the median SHIM score dropped from 21 (range: 8-25) at baseline to 17 (range: 7-24) at 3 months f/u


Conclusions : GNS laser ablation is a novel treatment modality for localized PCa and demonstrates a favorable side effect profile and improved functional outcomes.  Although these early results are favorable, long term follow-up is needed before drawing any meaningful conclusions

Harry Anastos

The Icahn School of Medicine at Mount Sinai, Department of Urology

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    Saikrishnaraya Doppalapudi

    Medical Student
    Rutgers - New Jersey Medical School

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      Jared Winoker

      Resident Physician
      The Icahn School of Medicine at Mount Sinai, Department of Urology

      Jared Winoker is a resident physician in the department of Urology at the Icahn School of Medicine at Mount Sinai.

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        Pratik Shukla

        The Icahn School of Medicine at Mount Sinai, Department of Radiology

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          Shivaram Cumarasamy

          Icahn School of Medicine at Mount Sinai

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            John Sfakianos

            Assistant Professor of Urology
            Icahn School of Medicine at Mount Sinai

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              Michael R. Carrick

              The Icahn School of Medicine at Mount Sinai, Department of Radiology

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                Cynthia J. Knauer

                The Icahn School of Medicine at Mount Sinai, Department of Urology

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                  Bachir Taouli

                  Professor of Radiology
                  Icahn School of Medicine at Mount Sinai

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                    Sara C. Lewis

                    Assistant Professor of Radiology
                    Icahn School of Medicine at Mount Sinai

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                      Art Rastinehad

                      The Icahn School of Medicine at Mount Sinai, Department of Urology

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                        MP23-13 - MR/US Fusion Guided Ultra-Focal Gold Silica Nanoshell Directed Laser Ablation of Prostate Tumors: Side effects and functional outcomes from 12 patients. Phase I/II Clinical Trial



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