69 year-old male with history of prostate cancer in the right mid 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, three laser ablations with 15-W, 92 % power was performed within the left mid lateral peripheral zone of the prostate. The needles are then placed into more medial aspect of the lesion, however, due to the malfunction of the pacer generator, the procedure was aborted. The patient tolerated the procedure well without any immediate complications.Pre-and postcontrast axial MR images are obtained before and after administration of 14 cc MultiHance, upon completion of the procedure. On MR images of ablation defect was noted within and around the posterior apical peripheral zone.
MR guided laser ablation of the part of the left mid peripheral zone lesion. The patient will be brought back to complete the ablation.