High-Intensity Focused Ultrasound

Abstract

High-intensity focused ultrasound (HIFU) is an effective noninvasive procedure for the focal treatment of prostate cancer (PCa). The possibility of inducing precise coagulative necrosis of the tumor with sharp boundaries makes HIFU one of the best options for focal therapy. Ablation of the tissue is achieved by the application of high-intensity ultrasound waves focused on a fixed focal point, resulting in maximum pressure converted into heat, thus inducing thermal ablation of the targeted area without affecting the surrounding tissues. Different devices are available for HIFU therapy, all allowing the precise localization and treatment of the cancerous area via a transrectal approach. The feasibility of focal HIFU for primary treatment of low- to intermediate-risk PCa patients was demonstrated in several studies reporting short- to midterm follow-up. Published data show satisfactory oncologic outcomes, with low rates of disease recurrence and progression. As a noninvasive modality, focal HIFU led to excellent functional results in terms of both urinary continence and erectile function recovery rates, with a low overall morbidity rate. Encouraging results have also been reported in the setting of focal salvage treatment of recurrent PCa after either radiotherapy or brachytherapy. Focal HIFU should be considered an effective option for selected patients with clinically significant localized PCa.