High-Intensity Focused Ultrasound (HIFU) for Prostate Cancer
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High-intensity focused ultrasound (HIFU) is a nonsurgical treatment that uses a nonionizing physical agent. The focused ultrasound applied to tissue produces three effects (mechanical, thermal and cavitation) all of which induce irreversible tissue damage. Based on these biological effects, there is no maximum dose for HIFU, nor is there any diffusion to other organs outside of the targeted volume, and it can also be used with external beam radiotherapy (EBRT) (before or after HIFU), and it can be repeated. The HIFU treatment is performed under real-time monitoring with ultrasound (US). Two indications are validated today: primary care treatment and EBRT failure.
The results of HIFU for primary care treatment are similar to standard conformal EBRT, even though no randomized comparative studies have been performed and that no follow-up >10 years is available yet for HIFU.
Salvage HIFU after EBRT failure is increasing and one with oncological outcomes similar to those achieved with surgery but with the advantage of fewer injurious effects.
HIFU is an evolving technology perfectly adapted for focal treatment. With it, we are able to monitor temperature with MRI or US, track in real time the tissue modification with elastography and ultimately control the ablated area with MRI or contrasted US. All those technologies will be available on future HIFU devices.
KeywordsProstate Cancer Radical Prostatectomy Focal Therapy HIFU Treatment HIFU Ablation
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