Steven J. Frank, MD, FACR, FABS, FASTRO, presented “MRI-Assisted Radiosurgery (MARS) Management of High Risk and Recurrent Prostate Cancer” during the 35th International Prostate Cancer Update conference on February 9, 2025, in Vail, Colorado.

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How to cite: Frank, Steven J. “MRI-Assisted Radiosurgery (MARS) Management of High Risk and Recurrent Prostate Cancer.” February 9, 2025. Accessed Mar 2025. https://grandroundsinurology.com/mri-assisted-radiosurgery-mars-management-of-high-risk-and-recurrent-prostate-cancer/

MRI-Assisted Radiosurgery (MARS) Management of High Risk and Recurrent Prostate Cancer – Summary

Steven J. Frank, MD, FACR, FABS, FASTRO, Professor of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, discusses advancements in MRI-assisted radiosurgery (MARS) for prostate cancer. In this 17-minute presentation, Dr. Frank focuses on its application in high-risk and recurrent cases. 

Dr. Frank highlights the significance of MRI in improving post-implant assessments for brachytherapy, which addresses the limitations of traditional ultrasound and CT imaging. The development of an MRI-positive contrast marker that enhances the visualization of implanted seeds and ensures precise quality control. This also reduces complications such as strictures and fistulas while preserving continence and erectile function.

Dr. Frank presents data from a 15,000-patient series that supports a PSA threshold of 0.2 ng/mL at four years as a biochemical definition of cure. Early outcomes using MRI-integrated proton therapy and low-dose-rate brachytherapy boost, demonstrate its effectiveness in high-risk patients. The use of hydrogel spacers and fiducials further optimizes implant accuracy and minimizes toxicity.

Dr. Frank emphasizes that MRI should be utilized at every stage of the treatment process to enhance outcomes and reduce complications. Data supports MARS as a safe and effective option for managing complex prostate cancer cases.

 

About the 35th International Prostate Cancer Update:

The International Prostate Cancer Update (IPCU), is a multi-day, CME-accredited conference focused on new developments in prostate cancer treatment, diagnosis, and prevention. IPCU 35 will feature lectures, interactive discussions, panel roundtables, debates, and case reports. This conference is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer.

The goal of this educational program is to equip healthcare professionals involved in the diagnosis and treatment of prostate cancer with the up-to-date clinical knowledge and tools they need to best treat their patients. The program will discuss the treatment of prostate cancer from diagnosis to treating advanced and metastatic disease. The conference aims to give physicians exposure to a comprehensive review of treating prostate cancer patients and to give them a chance to discuss the issues with peers and experts. You can learn more about the conference here.

ABOUT THE AUTHOR

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Steven J. Frank, MD, is an endowed tenured professor of Radiation Oncology and holds the Bessie McGoldrick Professorship in Clinical Research at The University of Texas MD Anderson Cancer Center. Dr. Frank is the Executive Director of the Particle Therapy Institute and Deputy Head of Strategy for the Division of Radiation Oncology.
Dr. Frank was instrumental in facilitating the restructuring of MD Anderson’s Proton Therapy Center through an asset acquisition and a subsequent expansion of a second Proton Therapy Center to advance Intensity Modulated Proton Therapy (IMPT). Dr. Frank is amongst the first, if not the first, to use IMPT to treat head and neck tumors, and he is the Principal Investigator of an NIH/NCI -sponsored multi-institutional Phase II/III randomized trial in advanced-stage oropharyngeal cancer that compares outcomes after chemoradiation given by IMRT versus IMPT.
Dr. Frank has approximately 300 peer-reviewed publications, has authored many book chapters, and has recently published the first textbook on Proton Therapy, based on the MD Anderson experience. Dr. Frank’s lab is studying the biologic enhancement factor of proton therapy and FLASH radiotherapy for head and neck cancer, as well as MRI-Assisted Radiosurgery (MARS) as the next generation of prostate brachytherapy. Dr. Frank’s expertise in MRI radiotherapy has led to the development and FDA approval of multiple novel positive-contrast implantable markers for use in MRI-guided LDR and HDR prostate brachytherapy and external beam radiation therapy.
As founder of the company, C4 Imaging, Dr. Frank has developed the MRI marker technology at MD Anderson, has been granted 31 national and international patents, developed three FDA-approved products, and has established MRI-Assisted Radiosurgery (MARS) at MD Anderson for the treatment of prostate cancer. He has funding from the NIH, the Prostate Cancer Foundation, the Texas Ignition Fund, Hitachi, and MD Anderson, and he has also raised multiple rounds of private equity financing to advance C4 technology.
Dr. Frank has served as the past President and Chairman of the Board of the American Brachytherapy Society and is the 2023 recipient of the Ulrich Henschke Award, the highest honor awarded by the ABS to a practitioner of brachytherapy. Dr. Frank has served as the chair for the head and neck oral boards for the American Board of Radiology over the last six years and will join the Board of Trustees in October 2023. Dr. Frank is a fellow of the ABS, ACR, and ASTRO.
Prior to entering medicine, Dr. Frank served in the military as a U.S. Navy Diver and submarine officer on the fast attack nuclear submarine USS Batfish (SSN-681). He is married to Dr. Ivy Frank, a veterinarian, and his hobbies include golf, flying, and coaching softball for his four daughters.