{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T21:14:30Z","timestamp":1782249270162,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the oncological and functional outcomes of magnetic resonance imaging\u2010ultrasonography (MRI\u2010US) fusion\u2010guided focal cryoablation (FC) using a novel three\u2010dimensional Advanced Annotation Platform (AAP) in patients with localised prostate cancer (PCa) and compare results between expert and beginner surgeons to evaluate the impact of prior focal therapy (FT) experience on FT outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>A prospective single\u2010arm trial enrolled 50 men with low\u2010 to intermediate\u2010risk PCa who underwent FC between December 2020 and September 2023. MRI\u2010US fusion\u2010guided FC was performed using the UroNav AAP by two surgeons with different FT experience (&gt;200 vs 0), with 19 cases carried out by an expert and 31 by a beginner surgeon. Follow\u2010up included prostate\u2010specific antigen, multiparametric MRI, and protocol biopsy at 1\u2009year. The primary outcome was failure\u2010free survival (FFS), defined as the transition to radical salvage treatment or to systemic therapy, development of PCa metastases, or PCa\u2010specific death. Secondary outcomes included oncological control and functional outcomes. Post hoc analyses were performed to assess learning curves and compare outcomes between surgeons with different experience levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 2\u2010year FFS was 96% (95% confidence interval [CI] 90.7\u2013100%). The 1\u2010year protocol biopsy showed a 6% in\u2010field (IFR) and 12% out\u2010of\u2010field recurrence (OFR) rates. Urinary function fully recovered at 3\u2009months. Among men with baseline Sexual Health Inventory for Men score \u226517, 85% recovered erectile function at 1\u2009year, with baseline function as the main predictor of recovery at 1\u2009year. All complications (26%) were Common Terminology Criteria for Adverse Events Grade 1\u20132. There was no significant difference in FC outcomes between surgeons. Learning curves were demonstrated primarily for ablation time with a decrease of 1.44\u2009min per case (95% CI \u22121.98 to \u22120.90), with small effects for number of cryoprobes (0.041 decrease per case, 95% CI \u22120.067 to \u22120.014) and OFR rate (0.014 decrease per case, 95% CI \u22120.028 to \u22120.0003), but not for the IFR rate and complications. No differences in learning patterns were observed between surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fusion\u2010guided FC using the UroNav AAP demonstrated good oncological control and safety profile. The device allowed precise MRI\u2010US fusion\u2010guided treatment while minimising the learning curve difference between expert and beginner surgeons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70014","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T14:00:14Z","timestamp":1760018414000},"page":"189-200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Novel MRI\u2010US fusion with advanced annotation in focal cryoablation for prostate cancer: medium\u2010term outcomes and learning curve insights"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6808-148X","authenticated-orcid":false,"given":"Alessandro","family":"Marquis","sequence":"first","affiliation":[{"name":"Northwell Urology New Hyde Park, NY and Zucker School of Medicine at Hofstra\/Northwell  Hempstead NY USA"},{"name":"Division of Urology, Department of Surgical Sciences, City of Health and Science at Molinette University Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Northwell Urology New Hyde Park, NY and Zucker School of Medicine at Hofstra\/Northwell  Hempstead NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Armache","sequence":"additional","affiliation":[{"name":"Northwell Urology New Hyde Park, NY and Zucker School of Medicine at Hofstra\/Northwell  Hempstead NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Solosky","sequence":"additional","affiliation":[{"name":"Northwell Urology New Hyde Park, NY and Zucker School of Medicine at Hofstra\/Northwell  Hempstead NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravleen","family":"Kaur","sequence":"additional","affiliation":[{"name":"Northwell Urology New Hyde Park, NY and Zucker School of Medicine at Hofstra\/Northwell  Hempstead NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia J.","family":"Knauer","sequence":"additional","affiliation":[{"name":"Northwell Urology New Hyde Park, NY and Zucker School of Medicine at Hofstra\/Northwell  Hempstead NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Thompson","sequence":"additional","affiliation":[{"name":"Disease Management Solutions Philips Healthcare  Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel W.","family":"Coons","sequence":"additional","affiliation":[{"name":"Disease Management Solutions Philips Healthcare  Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Urologic Oncology Branch National Cancer Institute at the National Institutes of Health  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardeshir R.","family":"Rastinehad","sequence":"additional","affiliation":[{"name":"Northwell Urology New Hyde Park, NY and Zucker School of Medicine at Hofstra\/Northwell  Hempstead NY 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