High intensity focused ultrasound (HIFU) for prostate cancer: Current clinical status, outcomes and future perspectives

Abstract

Two devices are currently available for the treatment of prostate cancer with HIFU: Sonablate® and Ablatherm®. The outcomes achieved for primary-care patient are very promissing with mid- and long-term progression-free survival rates around 70%, negative postoperative prostate biopsies almost 85%, and an excellent morbidity profile. Moreover, HIFU has a considerable potential for local recurrence after radiation failure. Recently, some early experiences on focal therapy suggest that HIFU could be an excellent option for highly selected patient.

Investigation of power and frequency for 3D conformal MRI-controlled transurethral ultrasound therapy with a dual frequency multi-element transducer

“…Other investigations have demonstrated the capability of highintensity ultrasound energy for treating prostate tissues using transrectal, interstitial or transurethral devices [13][14][15][16][17]. Long-term clinical follow-up of ultrasound-guided transrectal HIFU confirms that this treatment of localised prostate cancer is feasible, and can achieve acceptable local control of disease with the potential for a reduced impact on quality of life [7,8,[18][19][20].…”

Pubic Bone Osteomyelitis after Salvage High-Intensity Focused Ultrasound for Prostate Cancer

“…The documented complications of HIFU, according to the European Multicentre Study (Thuroff et al 2003), include impotence (of patients potent preoperatively, 35%), mild-moderate incontinence (14%), UTIs (13.8%), prolonged retention (9%), urethral stenosis (3.6%), severe incontinence (1.5%) and rarely rectourethral fistula (1.2%) [2,5,][6]. Our patient experienced several of these complications including urinary retention from prostatic slough, urethral stricture, severe stress incontinence and multiple UTIs.…”

“…Although the American Urologic Association guidelines do not formally recommend HIFU for the treatment of prostate cancer, many patients have been treated with this modality, and identifying adverse effects is important. The principle mechanism of HIFU involves the generation of ultrasound waves directed transrectally to the prostatic bed, resulting in focal destruction of prostatic tissue through coagulative necrosis [1,2]. Known complications from HIFU include urinary retention, urethral stenosis, impotence, stress incontinence, urinary tract infections (UTIs), and rarely, rectourethral or rectovesicular fistula [3,4,5].…”

Quality assurance for clinical high intensity focused ultrasound fields

“…High intensity focused ultrasound (HIFU) is being developed for use in the clinic, with the aim of enabling thermal ablation of tumours [1][2][3][4][5], drug delivery [6][7][8], and a number of other applications. As its use becomes more widespread, there is an ever increasing need to standardise the way in which the delivery of HIFU therapy is described and reported.…”