The PROFTH project has demonstrated the feasibility of an intelligent planning environment for prostate cryoablation, combining patient-specific imaging, physical simulation, and robotic guidance. This represents a significant step toward standardized and personalized focal therapies with improved clinical safety and efficacy.
A key innovation was the development of a full simulation workflow, validated on phantom experiments and based on real imaging data. By fusing segmented MRI and ultrasound datasets, a 3D anatomical model was created, providing the basis for biomechanical and thermal simulations. The integration of force-sensing technology allowed the assignment of realistic mechanical parameters, producing reliable simulations of probe insertion and iceball formation.
Thermal modeling made it possible to evaluate the effect of different cryoprobe arrangements in treating various tumor locations, ensuring that efficacy targets were met while respecting anatomical safety constraints. The system is now evolving toward automatic treatment planning, where the platform identifies the region of interest, calculates safety margins around critical structures such as the urethra and rectum, and determines the optimal number, position, and duration of cryoprobes for each patient.
To achieve clinical integration, further steps are required. These include validation on in vivo datasets, demonstration of workflow integration within surgical environments, and adaptation to different ablation platforms. Regulatory approval, system interoperability, and strategic pathways for technology transfer and commercialization will also be essential. With continued development, this platform could fundamentally transform focal therapy planning, supporting the transition to precision, simulation-based robotic treatments in oncology.
References
[1] Culp, M.B.; Soerjomataram, I.; Efstathiou, J.A.; Bray, F.; Jemal, A. Recent Global Patterns in Prostate Cancer Incidence and Mortality Rates. Eur. Urol. 2020
[2] Hoffman, K.E.; Penson, D.F.; Zhao, Z.; Huang, L.C.; Conwill, R.; Laviana, A.A.; Joyce, D.D.; Luckenbaugh, A.N.; Goodman, M.; Hamilton, A.S.; et al. Patient-Reported Outcomes through 5 Years for Active Surveillance, Surgery, Brachytherapy, or External Beam Radiation with or without Androgen Deprivation Therapy for Localized Prostate Cancer. JAMA 2020, 323, 149–163.
[3] Aghayev, Ayaz, and Servet Tatli. "The use of cryoablation in treating liver tumors." Expert Review of Medical Devices 11.1 (2014): 41-52.
