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However, treatment success depends on physician experience, as intraprocedural adjustments are required due to needle deflection. To determine whether an image-guided adaptive treatment strategy could reduce the required years of experience, we developed Image-guided Adaptive Cryotherapy (ImAC). We hypothesize that ImAC can be successfully implemented in MRI-guided cryotherapy to optimize needle placement. To test this hypothesis, we conducted a retrospective study comparing the performance of an experienced physician to that of ImAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>ImAC was designed to calculate the best subsequent needle location while accounting for needle deflection and iceball formation. After development, its performance was evaluated by simulating 21 needle insertions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found that ImAC achieved a higher median minimum ablation margin than the physician (5.0 vs 3.4 mm) while maintaining similar needle placement adjustments (\u00b1 7.5 mm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These results suggest that ImAC has the potential to optimize needle placement and may reduce the years of experience required for effective cryoablation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10439-025-03833-9","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T18:25:11Z","timestamp":1756491911000},"page":"3237-3246","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Image-Guided Adaptive Cryotherapy for Prostate Cancer Treatment"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8709-6980","authenticated-orcid":false,"given":"Eva","family":"Beek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiko","family":"Hata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Tuncali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Moreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"issue":"3","key":"3833_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray, F., M. 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