MRI-Guided Transurethral Ultrasound Ablation (TULSA) for Localized Prostate Cancer: Initial Experience

This study reports the initial experience of the first U.S. academic center to utilize MRI-guided transurethral ultrasound ablation (TULSA) for treating localized prostate cancer following FDA clearance. Between July 2020 and August 2023, 60 patients underwent TULSA, with a median procedure time of 3 hours. Ablation plans varied, with whole-gland (47%), subtotal (33%), and focal (21%) treatments performed. Of the 39 patients enrolled in the Customized TULSA-PRO Ablation Registry (CARE), the median age was 70 years, and a significant reduction in PSA levels was observed, with a nadir of 0.5 ng/ml. The histological failure rate was low, with only 8% showing residual cancer. While some patients experienced Grade III complications, overall safety and efficacy were comparable to previous studies.