Southampton experts to perform UK's first MRI-led freezing procedure for prostate cancer

Frozen probe

Clinicians at Southampton’s university hospitals are set to become the first in the UK to treat prostate cancer using frozen needles guided by magnetic resonance imaging (MRI).

The non-surgical procedure, known as MRI-guided cryotherapy, will be performed by urologists and radiologists at Southampton General Hospital supported by clinicians from Strasbourg, France.

It involves placing hollow needles into the prostate and passing through compressed argon gases which cool rapidly to around minus 40°C to freeze and destroy cancer cells in the affected part of the gland.

Traditionally, the procedure is carried out using ultrasound imaging to guide the needles through the skin between the anus and scrotum and into the prostate.

However, although cancerous tissue is identified by MRI, clinicians can only see the ice grow on the edge of the needles facing the ultrasound probe – reducing its effectiveness through a lack of precision.

Using MRI, they are able to watch ice develop on the needles in 3D and in real-time, providing much more detail and enabling more accuracy when destroying tumours through the ability to 'sculpt' balls of ice to cover the affected area.

Most patients who undergo the treatment, which takes around two hours to complete under general anaesthetic, return home the same day.

The treatment offers an alternative for men who have undergone unsuccessful radiotherapy and are not suitable for High Intensity Focused Ultrasound (HIFU), a technique which uses high frequency sound waves.

Although HIFU is another recent development and also enables clinicians to deliver treatment without the need for surgery, it is not effective if the prostate is too big, there is too much build up of calcium which blocks the sounds waves or if the cancer is at the front of the gland.

"This is a fantastic development in how we deliver cryotherapy for patients with prostate cancer,” said Tim Dudderidge, a consultant urological surgeon at University Hospital Southampton NHS Foundation Trust.

“The tumour is much more visible on MRI and we can place needles to get optimum ice coverage into the most aggressive part of the tumour."

Mr Dudderidge and consultant radiologist Dr Alex King will perform the first case of MRI-guided cryotherapy at Southampton General Hospital tomorrow (Tuesday) alongside consultant abdominal radiologist and associate professor of radiology Dr David Breen.

Dr Breen added: "This forms part of a growing range of image-guided surgeries for cancer which have been developed in interventional radiology in Southampton."

Posted on Monday 26 June 2017