Reply to the Letter to the Editor: “MRI targeted single fraction HDR Brachytherapy for localized Prostate Carcinoma: a feasibility study of focal radiation therapy (ProFocAL)”

by Frank Fischbach (frank.fischbach@med.ovgu.de)

MRI targeted single fraction HDR Brachytherapy for localized Prostate Carcinoma: a feasibility study of focal radiation therapy (ProFocAL)

Dear Professor Menu, Dear Editors,

Many thanks for the comments and recommendation of Dr Abhinav Sidana and his team for the study of MR guided, targeted and single fraction HDR Brachytherapy for localized Prostate Carcinoma. Of course, we cannot comment on therapeutic efficacy and late effects as follow up is not completed and the number of patients treated is low.

Further patients are included, and all patients are followed up for at least 2 years with subsequent targeted and randomized biopsy for the assessment of therapy success. Therefore, the paper is an interim report of the study. Aim of the presented data is the introduction of a new method that is safe and feasible.

Control of PSA values is the method of choice after percutaneous radiation. In our study a targeted and randomized re-biopsy and repeated multiparametric MR imaging was added. The triple assessment is sufficient to identify residual or recurrent carcinoma, from our point of view.

Otherwise as assumed, MR imaging is still feasible without reduction of reliability. Only the area of radiation shows a decrease in the signal of T2w imaging, whereas the majority of the gland presents signal characteristics equally to MR imaging preceding the therapy.

I would appreciate if you could consider our comments in addition.
Many thanks for your efforts.