69 year-old male with history of prostate cancer in the left peripheral zone. Patient used prophylactic antibiotics before and after the procedure as prescribed. The patient received antibiotic prophylaxis with oral Ciprofloxacin 500 mg bid starting the night before the procedure. He took 2 tablets of Ciprofloxacin 500 mg before the procedure and will take two tablets after the procedure. Following the discussion of the risks, benefits, and alternatives of the procedure, informed consent was obtained for the research study. The procedure was performed under moderate conscious sedation.MRI focus in the left mid peripheral zone suspicious for patient's known cancer was localized with T2 weighted MR images. Following preparation, Medtronic laser ablation template was placed in the perineum on the patient and localized on MR images and registered to the MR images where prostate lesion could be visualized.Following local anesthesia with lidocaine, 14-gauge MR- compatible needles were inserted into the left side of the prostate to stabilize the prostate. Upon confirmation of the tip of the needle on the left side close to the known lesion, two laser ablations with 15-W, 92 % power was performed within the left base and two ablations were performed within the left mid and left apical peripheral zone of the prostate. The patient tolerated the procedure well without any immediate complications.Pre-and postcontrast axial MR images are obtained before and after administration of 5 cc MultiHance, upon completion of the procedure. On MR images of ablation defect was noted within the left peripheral zone in the location of the biopsy proven prostate cancer.
MR guided laser ablation of the lesions in the left peripheral zone lesion. 