High-intensity focused ultrasound treatment of prostate cancer

Abstract

In the last decade, over 40,000 prostate cancer patients have been treated by HIFU systems in over 30 countries. These treatments have been conducted using two ultrasound image guided hifu devices—Ablatherm (EDAP, Lyon, France) and Sonablate® 500 (Focus Surgery, Inc., Indianapolis, IN). In addition, there is a shift in the management of prostate cancer from whole gland radical prostatectomy and radiation to focal treatment of prostate cancer. The focal treatment is guided by meticulous pretreatment imaging with multi-parametric MRI to accurately localize the index lesion. The MRI images are used to render 3D deformable model of the prostate gland and provide fusion of US and MRI to guide HIFU treatment resulting in reduced complications of rectal fistula, erectile dysfunction, and urinary incontinence. The results of the clinical studies indicate that patients with recurrent cancer post radiation can benefit from HIFU treatment. Both these devices are marketed in many countries and recently have submitted PMA applications to the FDA to receive clearance to market in the United States. Long term clinical results and status of HIFU devices will be presented.