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Part VII Transperineal Technologies for Focal Therapy
27 Focal Brachytherapy (Interventional Radiotherapy)
and IMRT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
Luca Tagliaferri, Bruno Fionda, Jeremy Grummet, Andrew See, and György Kovács
28 Focal Cryotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Kae Jack Tay, Sriram Deivasigamani, Aaron Katz, and Thomas J. Polascik
29 Irreversible Electroporation for Partial Gland
Ablation: Clinical Application and Outcomes . . . . . . . . . . . . . . . 345
Jonathan Fainberg, Jonathan Coleman, Giancarlo Marra, Phillip Stricker, and Nathan Lawrentschuk
Part VIII Transurethral Technologies for Focal Therapy
30 Role of Transurethral Ultrasound Ablation (TULSA)
in Prostate Cancer Focal Therapy . . . . . . . . . . . . . . . . . . . . . . . . . 355
Joseph L. Chin, Xiaosong Meng, and Emily Bochner
31 Transurethral Vapor Ablation in Prostate Cancer. . . . . . . . . . . . 373
Jamie S. Pak, Christopher M. Dixon, and Samir S. Taneja
Contents
Part IX Transrectal Technologies for Focal Therapy
32 Robotic High-Intensity Focused Ultrasound
of the Prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389
Lorenzo Storino Ramacciotti, Massimo Valerio, Sebastien Crouzet, and Andre Abreu
33 Transrectal Laser Focal Therapy of Prostate Cancer . . . . . . . . . 405
John F. Feller, Bernadette M. Greenwood, Aaron Harman, and Ara Karamanian
Part X Post-treatment Assessment of Focal Therapy Outcomes
34 Role of Prostate MRI for Postfocal Treatment
Assessment and Surveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419
Omer Tarik Esengur, David G. Gelikman, and Baris Turkbey
35 Measuring Patient-Based Outcomes: Setting
Realistic Expectations When Balancing Functional
Outcomes with Cancer Control . . . . . . . . . . . . . . . . . . . . . . . . . . . 431
Alexander Light, Deepika Reddy, and Srinivas Vourganti
Contents
xiii
36 Assessing Functional Outcomes After Focal Therapy . . . . . . . . . 441
Jason Jung, Matthijs J. Scheltema, and Phillip D. Stricker
37 Biochemical Assessment of Cancer Outcomes
Following Focal Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449
Alireza Ghorei and Amir H. Lebastchi
38 Pathologic Assessment and Implications Following
Focal Therapy of Prostate Cancer . . . . . . . . . . . . . . . . . . . . . . . . . 455
Rafael E. Jimenez, Divyangi Paralkar, Alessia Cimadamore, Andrew Evans, and Mahul B. Amin
39 Salvage Treatment Following Focal Therapy . . . . . . . . . . . . . . . . 469
Theo M. de Reijke and Derek Lomas
Part XI Looking Forward
40 Design of Payment and Reimbursement Strategies
for Focal Therapy for Acceptance in Value-Based
Care Models . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 477
Avinash Maganty, Neil Mendhiratta, Alexander P. Kenigsberg, David Johnson, Cary N. Robertson, and Vishnukamal Golla
41 The Horizon: Future of Focal Therapy in Prostate
Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489
Alessandro Marquis and Ardeshir R. Rastinehad
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493

Contributors

Andre Abreu Clinical Urology and Radiology, Image-Guided Surgery, Focal Therapy and Articial Intelligence for Prostate Cancer, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Center for Image-Guided Surgery, Focal Therapy and Articial Intelligence for Prostate Cancer, USC Institute of Urology Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
EricS. Adams Department of Urology, Duke University Medical Center, Durham, NC, USA
ArdalanAhmad Division of Urology, Department of Surgery, University Health Network Princess Margaret Cancer Center, Toronto, ON, Canada
Mahul B. Amin Pathology and Lab Medicine, University of Tennessee Health Sciences System, Memphis, TN, USA
USC Keck School of Medicine, LabCorp, Los Angeles, CA, USA
PaulB.Arangua Department of Urologic Oncology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
Pier Paolo Avolio Department of Surgery, Division of Urology, McGill University, Montréal, QC, Canada
Department of Biomedical Sciences, Humanitas University, Milan, Italy
Mohannad A. Awad Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia
EzequielBecher CDU—Centro de Urologia, Buenos Aires, Argentina
FernandoJ.Bianco Urological Research Network, Miami, USA
EmilyBochner University of Texas Southwestern, Dallas, TX, USA
AlbertoBriganti Division of Oncology/Unit of Urology, Soldera Prostate
Cancer Lab, URI, IRCCS Ospedale San Raffaele, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
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Giovanni Enrico Cacciamani Center for Image-Guided Surgery, Focal Therapy and Articial Intelligence for Prostate Cancer, USC Institute of Urology Catherine and Joseph Aresty Department of Urology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Jeffrey A. Cadeddu Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Arie Carneiro Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil
Francesco Cei Center for Image-Guided Surgery, Focal Therapy and Articial Intelligence for Prostate Cancer, USC Institute of Urology Catherine and Joseph Aresty Department of Urology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
Derek Chan Department of Biomedical Engineering, Duke University, Durham, NC, USA
Contributors
JosephL.Chin Western University, London, ON, Canada
PeterKa-FungChiu SH Ho Urology Centre, Department of Surgery, Prince
of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China
Alessia Cimadamore Department of Medicine (DAME), University of Udine, Institute of Surgical Pathology, Udine, Italy
Jonathan Coleman Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
E. David Crawford University of San Diego, Koman Family Outpatient Pavilion, La Jolla, CA, USA
Sebastien Crouzet Department of Urology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
SriramDeivasigamani Duke Cancer Institute and Duke University Medical Center, Durham, NC, USA
Department of Urologic Surgery, Duke University Medical Center, Durham, NC, USA
ChristopherM.Dixon Bon Secours Urology, WMC Health Good Samaritan Hospital, Suffern, NY, USA
Francis Medical Inc., Maple Grove, MN, USA
Contributors
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Heying Duan Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, CA, USA
BehfarEhdaie Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Cameron Englman Division of Surgery and Interventional Science, University College London, London, UK
Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
OmerTarikEsengur Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
Andrew Evans Genitourinary Pathology, Cortellucci Vaughan Hospital, Mackenzie Health, Vaughan, ON, Canada
Jonathan Fainberg Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Fabian Falkenbach Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
JohnF.Feller HALO Precision Diagnostics, Indian Wells, CA, USA
Department of Radiology, Loma Linda University School of Medicine, Loma Linda, CA, USA
Bruno Fionda U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Jurgen J. Fütterer Department of Medical Imaging, Radboudumc, Nijmegen, The Netherlands
GiorgioGandaglia Division of Oncology/Unit of Urology, Soldera Prostate Cancer Lab, URI, IRCCS Ospedale San Raffaele, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
DavidG.Gelikman Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
Pejman Ghanouni Division of Body MRI, Department of Radiology, Stanford University, Stanford, CA, USA
Alireza Ghorei Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Francesco Giganti Division of Surgery and Interventional Science, University College London, London, UK
Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
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Vishnukamal Golla Department of Urology, Duke University School of Medicine, Durham, VA, USA
Department of Surgery, Division of Urology, Durham, VA, USA
PaoloGontero Molinette Hospital, Turin, Italy
Bernadette M. Greenwood Department of Radiologie and Nuclear
Medicine, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands
HALO Precision Diagnostics, Indian Wells, CA, USA
JeremyGrummet Department of Surgery, Central Clinical School, Monash University, Melbourne, VIC, Australia
RajanT.Gupta Duke Cancer Institute and Duke University Medical Center, Durham, NC, USA
AaronHarman HALO Precision Diagnostics, Indio, CA, USA
OmarHayek Department of Urology, University of Alabama at Birmingham,
Birmingham, AL, USA
JimC.Hu Department of Urology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA
Contributors
Andrei Iagaru Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, CA, USA
KennethA.Iczkowski Department of Pathology and Laboratory Medicine, University of California—Davis, Sacramento, CA, USA
MichaelC.Ivey Duke Cancer Institute and Duke University Medical Center, Durham, NC, USA
RafaelE.Jimenez Division of Anatomic Pathology, Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
David Johnson Department of Urology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
JasonJung Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Sydney, NSW, Australia
St. Vincent’s Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia
MasatomoKaneko Center for Image-Guided Surgery, Focal Therapy and Articial Intelligence for Prostate Cancer, USC Institute of Urology Catherine and Joseph Aresty Department of Urology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
AraKaramanian HALO Precision Diagnostics, Indio, CA, USA
AliKasraeian Kasraeian Urology, Jacksonville, FL, USA
Contributors
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AaronKatz Department of Urology, NYU-Langone Long Island School of Medicine, New York, NY, USA
Alexander P. Kenigsberg Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
LaurenceKlotz Sunnybrook Chair of Prostate Cancer Research, Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
György Kovács Gemelli-INTERACTS, Università Cattolica del Sacro Cuore, Rome, Italy
PilarLaguna Department of Urology, Medipol University, Istanbul, Turkey
Nathan Lawrentschuk Department of Surgery, University of Melbourne,
Parkville, VIC, Australia
Urology Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
Amir H. Lebastchi Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Riccardo Leni Division of Oncology/Unit of Urology, Soldera Prostate Cancer Lab, URI, IRCCS Ospedale San Raffaele, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
HerbertLepor Department of Urology, NYU Langone Health, NYU School of Medicine, New York, NY, USA
AlexanderLight Imperial Prostate, Imperial College London, London, UK
DerekLomas Department of Urology, Mayo Clinic, Rochester, MN, USA
Giovanni Lughezzani Department of Biomedical Sciences, Humanitas
University, Milan, Italy
Luca Lunelli Department of Urology, Hôpital Louis Pasteur, Chartres, France
PetrMacek Department of Urology, Institut Montsouris, Paris, France
Avinash Maganty From the Dow Division of Health Services Research,
Department of Urology, University of Michigan, Ann Arbor, MI, USA
GiuseppeMaiolino Urological Research Network, Miami, USA
AlessandroMarquis Northwell Health System, Smith Institute for Urology
at Lenox Hill, Lake Success, NY, USA
Department of Surgical Sciences, Division of Urology, Molinette Hospital and University of Turin, Turin, Italy
GiancarloMarra Molinette Hospital, Turin, Italy
Department of Surgical Sciences, Molinette Hospital, AOU Città della Salute e della Scienza and University of Turin, Turin, Italy
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JodieMcDonald Department of Urology, St Vincents Hospital Melbourne, Melbourne, VIC, Australia
Neil Mendhiratta Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
XiaosongMeng University of Texas Southwestern, Dallas, TX, USA
Caroline M. Moore Division of Surgery and Interventional Science,
University College London, London, UK
Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
MarcoMoschini Division of Oncology/Unit of Urology, Soldera Prostate Cancer Lab, URI, IRCCS Ospedale San Raffaele, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
Mahdi Mottaghi Duke Cancer Institute and Duke University Medical Center, Durham, NC, USA
JuddW.Moul Department of Urology, NYU Langone Health, New York, NY, USA
Department of Urology and Duke Cancer Institute, University Medical Center, Durham, NC, USA
Contributors
Bruno Nahar Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
Kathryn Nightingale Department of Biomedical Engineering, Duke University, Durham, NC, USA
Ruben Olivares Associate Professor of Urology, Glickman Urological Institute, Cleveland Clinic, Cleveland, OH, USA
Jonathan Olivier Univ. Lille, CHU Lille, Service Urologie, Andrologie, Transplantation Rénale, Lille, France
JamieS.Pak Division of Urologic Oncology, Department of Urology, NYU Langone Health, New York, NY, USA
Divyangi Paralkar University of Southern California Keck School of Medicine, Los Angeles, CA, USA
ThomasJ.Polascik Duke Cancer Institute, Duke Prostate and Urological Cancer Center, Durham, NC, USA
SoroushRais-Bahrami Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA
Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
Contributors
xxi
Lorenzo Storino Ramacciotti Center for Image-Guided Surgery, Focal Therapy and Articial Intelligence for Prostate Cancer, USC Institute of Urology Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Ardeshir R. Rastinehad Smith Institute for Urology at Lenox Hill, Northwell Health, Lake Success, New York, NY, USA
DeepikaReddy Imperial Prostate, Imperial College London, London, UK
TheoM.de Reijke Department of Urology, Amsterdam UMC, University
of Amsterdam, Amsterdam, The Netherlands
Cary N. Robertson Department of Urology, Duke University School of Medicine, Durham, VA, USA
Department of Surgery, Division of Urology, Durham, VA, USA
Craig G. Rogers Vattikuti Urology Institute, Henry Ford Health, Detroit, MI, USA
Francisco G. La Rosa Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
MichaelB.Rothberg, MD Division of Urologic Oncology, Department of Urology, Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University School of Medicine, Durham, NC, USA
GeorgSalomon Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
RafaelSanchez-Salas Department of Surgery, Division of Urology, McGill University, Montreal, QC, Canada
Matthijs J. Scheltema Garvan Institute of Medical Research & The Kinghorn Cancer Centre, Sydney, NSW, Australia
St. Vincent’s Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia
AndrewSee Icon Cancer Centre, Richmond, VIC, Australia
Denis Seguier Univ. Lille, CHU Lille, Service Urologie, Andrologie,
Transplantation Rénale, Lille, France
GeoffreyA. Sonn Department of Urology, Stanford University, Stanford, CA, USA
Nicolas Soputro Associate Professor of Urology, Glickman Urological Institute, Cleveland Clinic, Cleveland, OH, USA
ArmandoStabile Division of Oncology/Unit of Urology, Soldera Prostate Cancer Lab, URI, IRCCS Ospedale San Raffaele, Milan, Italy
Vita-Salute San Raffaele University, Milan, Italy
PhillipD.Stricker Urology Department, St. Vincent’s Hospital, St. Vincent’s Prostate Cancer Research Centre, Darlinghurst, NSW, Australia
xxii
Garvan Institute of Medical Research and Kinghorn Cancer Centre, Darlinghurst, NSW, Australia
St. Vincent’s Clinical School, UNSW, Sydney, NSW, Australia
Luca Tagliaferri U.O.C. Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica Ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
SamirS.Taneja Division of Urologic Oncology, Department of Urology, NYU Langone Health, New York, NY, USA
WeiPhin Tan Department of Urology, NYU Langone Health, New York, NY, USA
BenjaminTavya Smith Institute for Urology, Northwell Health, New York, NY, USA
Kae Jack Tay Department of Urology, Singapore General Hospital, Singapore, Singapore
Division of Surgery & Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
Singapore General Hospital, Singapore, Singapore
Department of Urology, NUS-Duke Health, Singapore, Singapore
Contributors
SauloBorborema Teles Department of Urology, Hospital Israelita Albert Einstein, São Paulo, Brazil
Sameer Thakker Department of Urology, NYU Langone Health, New York, NY, USA
Rafael Tourinho-Barbosa Department of Urology, Hospital Cardio Pulmonar—Rede D’Or, Salvador, Brazil
Department of Urology, Institut Montsouris, Paris, France
Baris Turkbey Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
OsamuUkimura Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
Massimo Valerio Department of Urology, Geneva University Hospital, Geneva, Switzerland
Arnauld Villers Univ. Lille, CHU Lille, Service Urologie, Andrologie, Transplantation Rénale, Lille, France
SrinivasVourganti RUSH Medical College, Chicago, IL, USA
Yuzhi Wang Vattikuti Urology Institute, Henry Ford Health, Detroit, MI,
USA
JohnF.Ward Department of Urology, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA