A20 Session 6: Case studies in ablative therapy : Robotic acoustic ablation with HIFU: Technology and clinical outcomes

Abstract

High Intensity Focused Ultrasound (HIFU) is a minimally invasive technology that produces thermal ablation of soft tissues. HIFU has been employed to treat prostate cancer and transrectal prostate HIFU devices have been in use worldwide since the mid 1990s. Prostate HIFU is not FDA approved in the United States; however, two manufacturers have HIFU devices currently under evaluation in the United States by the FDA. Prostate HIFU has been used to treat primary and radiation recurrent prostate cancer. In this presentation, the Sonablate (Sonacare Medical) and Ablatherm (EDAP) prostate HIFU devices will be compared. Published clinical outcomes for primary and salvage total and partial gland HIFU ablation will be presented. Long term studies document good clinical efficacy with biochemical recurrence, overall survival, and metastasis free survival similar to standard prostate cancer treatments. The advantages of HIFU ablation are similar to other ablation technologies: HIFU is an outpatient, minimally invasive treatment with low rates of ED and incontinence and can be repeated if there is local recurrence. Focal treatment with HIFU is a promising treatment strategy and the use of advanced MRI imaging to diagnose prostate cancer and to direct HIFU ablation will be presented. High patient demand for minimally invasive prostate cancer ablative treatments will inspire urologists interested in thermal ablation to obtain training and achieve competence in prostate HIFU therapy.