Chapter 56 - What is the Newest Technology in Treating Prostate Cancer? Transrectal High-intensity Focused Ultrasound

Abstract

This chapter focuses on transrectal high-intensity focused ultrasound (HIFU), which is the latest technology used for treating prostate cancer. HIFU is the only means currently available permitting contact- and irradiation-free in-depth tissue ablation in any solid organ accessible for ultrasound. Experimental studies have shown the capability of HIFU to ablate prostate cancer and, therefore, render this technique highly attractive as a minimally invasive treatment for localized prostate cancer. The thermal effect of HIFU on tissue is dependent on a number of factors, such as the ultrasonic site intensity throughout the tissues; the absorption coefficients of the tissues; the temperature rise throughout the exposed tissues; and the damage integral on tissue strictures, which estimates the effects of temperature elevation. Although several hundred patients have been treated with this approach predominantly in two centers in the past eight years, this technique has not gained widespread acceptance, presumably owing to the sophisticated and expensive equipment and operation room set-up, the lack of long-term data, and the difficulty in achieving reliable ablation of the entire prostate (a prerequisite of good long-term data) with the current technology.