Case Study

Presented by Martin Cohen, MD
and Robert Princenthal, MD Co-Directors of RadNet’s Prostate Program

PATIENT HISTORY: 65 year old male with elevated PSA, 7.6

Prostate TULSA Procedure Case Study

Multiparametric MRI demonstrated a 1.0 CM hypointense nodule left apex (Fig. 1 top left). Low signal on the ADC map-restricted diffusion (bottom left). Increased perfusion (Fig. 1 top & bottom right).

Biopsy performed by the urologist showed Gleason 3+4 left apex 30% core. Additional Gleason 3+3 carcinoma left mid gland and left base 15% core and left apex 5% core.


Prostate TULSA Procedure Case Study

The patient elected to undergo whole gland TULSA ablation as an alternative to radiation therapy or radical prostatectomy. A disposable rotating urethral ultrasound device with 10 treating elements is placed by the urologist. A rectal cooling device is also inserted to protect the rectum from heating (fig.2 – sagittal).


Prostate TULSA Procedure Case StudyProstate TULSA Procedure Case Study

The treatment plan is outlined by the radiologist to preserve the neurovascular bundles and urethral sphincter. During the TULSA procedure the radiologist continuously monitors gland temperature using MRI thermometry. Optimal temperature for irreversible tissue ablation is 55°C (yellow).

  • Fig. 3 shows initial treatment in progress (axial)
  • Fig. 4 following the entire gland treatment (lower midgland level)
  • Fig. 5 shows lack of perfusion in the ablated zone following intravenous contrast enhancement.

Following recovery from general anesthesia, the patient is sent home with a Foley catheter for 7 to 10 days.

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We Want To Hear From You

Prostate MRI

Call and we'll help schedule your Prostate MRI screening appointment and answer your questions.


Arizona: (480) 455-1850

Fresno: (559) 474-4290

Coachella Valley: (760) 318-2988

Victor Valley: (760) 951-2867

Inland Empire: (951) 682-1099

Antelope Valley: (661) 945-5855

Long Beach: (714) 784-1643

Los Angeles: (310) 854-7722

San Fernando Valley: (818) 616-6538

San Gabriel Valley: (626) 445-4850

Temecula Valley: (951) 587-8956

Ventura County: (805) 357-0067

Orange County: (714) 784-1643

Bakersfield: (661) 324-7000

TULSA Procedure

Call or submit the form to start the TULSA Procedure process with our team. We're here to guide you through each step and answer any questions you have.


TULSA Procedure Phone: (818) 480-7266

TULSA Procedure Fax: (818) 827-5152

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