Imaging and Focal Therapy of Early Prostate Cancer

Thomas J. Polascik, MD, FACSDivision of Urology, Department of Surgery
Duke Cancer Institute
Duke University School of Medicine
Durham, North Carolina, USA

Part I.  Why Consider Focal Therapy?.- 1. What is Focal Therapy for Prostate Cancer? A Guide for Patients.- 2. Evolution of Focal Therapy for Localized Breast Cancer: Lumpectomy.- 3. Image-targeted Therapy for Localized Kidney Cancer.- 4. The Patient's Perspective: What Does the Patient Want? .- Part II. Global Perspective of Active Surveillance (AS) and Focal Therapy (FT) .- 5. Intersection of AS and Radical Therapy: Opportunities for FT in North America..- 6. FT and AS of Prostate Cancer - A European Perspective.- 7. FT and AS of Prostate Cancer in Southeast Asia and the East.- 8. FT Perception and Acceptance in South America.- Part III.  The Focal Therapy Concept: Scientific Foundation.- 9. Understanding Tumor Biology and Pathology - Cancer Grade, Volume, and Spatial Location - as a Foundation for Focal Therapy.- 10. Identifying and Characterizing the Index Lesion.- 11. The Role of Molecular Techniques to Distinguish Low Grade from Lethal Cancers.- 12. Utilizing Biopsy-based Genomic Assays to Risk Stratify Patients for Active Treatment.- 13.  Can Understanding and Utilizing the Tumor Microenvironment Enhance the Therapeutic Efficacy of FT? .- 14. Differences between MRI Visible vs Invisible Cancers: Biology and Outcomes.- Part IV.  Prostate Imaging and Staging.- 15. PIRADS Reporting Standards and Limitations for Cancer Detection in the Peripheral Zone vs Transition Zone, PI-QUAL, and Standardization in MR Quality.- 16. Employing a Quality Improvement Program to Optimize mpMRI-directed Fusion Biopsy.- 17. Multiparametric Ultrasound for Prostate Imaging and Targeting.- 18. What is Necessary for FT Staging: Cross-sectional vs PET vs Nil?.- Part V.  Image-Targeted Prostate Biopsy Techniques.- 19. mpMRI-TRUS Prostate Fusion Biopsy Commercial Systems.-20. Comparison of Outcomes with Transperineal vs Transrectal Image-targeted Prostate Biopsy.- 21. Using Multicore, Transperineal Prostate Mapping Biopsy to Detect, Localize and Treat the mpMRI Invisible Lesion.- 22. Multi-parametric Ultrasound (mpUS) Biopsy.- 23. Diagnostic Performance of PET-based Targeted Fusion Biopsy in Prostate Cancer.- 24. Optimizing biopsy core quality for diagnosis.- Part VI.  Patient Selection and Ablation Treatment Schema.- 25. Patient Selection: What Tumors Should Be Treated Based on Grade, Size, Location, Genetics and Risk Category?.- 26. Definitions and Common Terminology for Focal Prostate Ablation.- 27. Focal Therapy for Anterior Cancers.- 28. Office-based Outpatient Focal Therapy.- Part VII.  Transperineal Technologies for Focal Therapy.- 29. Focal Brachytherapy and IMRT.- 30. In-bore Transperineal MRI-Guided Laser Ablation.- 31. Focal Cryoablation.- 32. Irreversible Electroporation for Partial Gland Ablation: Clinical Application and Outcomes.- 33. Photodynamic Therapy.- Part VIII.  Transurethral Technologies for Focal Therapy.- 34. Role of TULSA as a Focal Therapy in Prostate Cancer.- 35. Transurethral Vapor Ablation in Prostate Cancer.- Part IX.  Transrectal Technologies for Focal Therapy.- 36. Robotic High-Intensity Focused Ultrasound.- 37. Transrectal laser ablation of prostate cancer.- Part X.  Post-treatment Assessment of Focal Therapy Outcomes.- 38. Role of Prostate MRI for Post-treatment Assessment and Surveillance.- 39. Measuring patient-based outcomes: setting realistic expectations when balancing functional outcomes with cancer control.- 40. Assessing Functional Outcomes after Focal Therapy.- 41. Biochemical Assessment of Cancer Outcomes following Focal Therapy.- 42. Pathologic Assessment and Implications following Prostate Focal Therapy.- 43. Salvage Options after Focal Therapy Recurrence.- Part XI. Looking forward.- 44. Design of Payment and Reimbursement Strategies for Focal Therapy for Acceptance in Value Based Care Models.- 45. The Horizon: Future of Focal Therapy in Prostate Cancer.