High-Intensity Focused Ultrasound (HIFU) for Prostate Cancer
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
- AURO (2009) The association of Italian urologists: guidelines, prostate cancerGoogle Scholar
- Borghede G, Aldenborg F, Wurzinger E, Johansson KA, Hedelin H (1997) Analysis of the local control in lymph-node staged localized prostate cancer treated by external beam radiotherapy, assessed by digital rectal examination, serum prostate-specific antigen and biopsy. Br J Urol 80(2):247–255PubMedCrossRefGoogle Scholar
- Bratan F, Niaf E, Chesnais AL, Souchon R, Mège-Lechevalier F, Rouvière O (2011) Detection and localization of prostate cancers using multiparametric magnetic resonance imaging. 97th scientific assembly and annual meeting of the Radiological Society of North America, Chicago, 27 Nov–2 Dec 2011Google Scholar
- Crouzet S, Murat FJ, Rouviere O, Poissonnier L, Martin X, Colombel M et al (2010) Outcomes of HIFU for prostate cancer in 880 consecutive patients. In: AUA annual meeting, San Francisco, 2010; MP58(1006962)Google Scholar
- Melodelima D, Salomir R, Mougenot C, Prat F, Theillere Y, Moonen C et al (2004) Intraluminal ultrasound applicator compatible with magnetic resonance imaging “real-time” temperature mapping for the treatment of oesophageal tumours: an ex vivo study. Med Phys 31(2):236–244PubMedCrossRefGoogle Scholar
- Murat FJ, Poissonnier L, Rabilloud M, Belot A, Bouvier R, Rouviere O et al (2009) Mid-term results demonstrate salvage high-intensity focused ultrasound (HIFU) as an effective and acceptably morbid salvage treatment option for locally radiorecurrent prostate cancer. Eur Urol 55(3):640–647PubMedCrossRefGoogle Scholar
- Niaf E, Lartizien C, Rouvière O (2011) Computer-aided diagnosis for prostate cancer detection in the peripheral zone via multisequence MRI. In: SPIE conference Munich, GermanyGoogle Scholar
- Paparel P, Chapelon JY, Bissery A, Chesnais S, Curiel L, Gelet A (2008) Influence of the docetaxel administration period (neoadjuvant or concomitant) in relation to HIFU treatment on the growth of dunning tumors: results of a preliminary study. Prostate Cancer Prostatic Dis 11(2):181–186PubMedCrossRefGoogle Scholar
- Pasticier G, Riviere J, Wallerand H, Robert G, Bernhard JC, Ferriere JM, et al (2010) Salvage radiotherapy (SRT) for local recurrence of prostate adenocarcinoma after primary treatment with high intensity focused ultrasound (HIFU): first series of 100 patients. 2010 ASCO annual meeting Chicago, USAGoogle Scholar
- Ripert T, Bayoud Y, Messaoudi R, Menard J, Azemar MD, Duval F, et al (2011) Salvage radiotherapy after high-intensity focused ultrasound treatment for localized prostate cancer: feasibility, tolerance and efficacy. Canadian Urological Association journal = Journal de l’Association des urologues du Canada. 1 May, pp 1–5Google Scholar
- Rouviere O, Valette O, Grivolat S, Colin-Pangaud C, Bouvier R, Chapelon JY et al (2004) Recurrent prostate cancer after external beam radiotherapy: value of contrast-enhanced dynamic MRI in localizing intraprostatic tumor–correlation with biopsy findings. Urology 63(5):922–927PubMedCrossRefGoogle Scholar
- Rouvière O, Glas L, Girouin N, Mège-Lechevallier F, Gelet A, Dantony E et al (2011) Prostate cancer ablation with transrectal high-intensity focused ultrasound: Assessment of tissue destruction with contrast-enhanced. US Radiol 259:583–591Google Scholar
- Sylvester JE, Grimm PD, Wong J, Galbreath RW, Merrick G, Blasko JC (2011) Fifteen-year biochemical relapse-free survival, cause-specific survival, and overall survival following I(125) prostate brachytherapy in clinically localized prostate cancer: Seattle experience. Int J Radiat Oncol Biol Phys 81:376–381PubMedCrossRefGoogle Scholar
- Uchida T, Illing RO, Cathcart PJ, Emberton M (2006c) To what extent does the prostate-specific antigen nadir predict subsequent treatment failure after transrectal high-intensity focused ultrasound therapy for presumed localized adenocarcinoma of the prostate? BJU Int 98(3):537–539PubMedCrossRefGoogle Scholar
- Villers A, Puech P, Mouton D, Leroy X, Ballereau C, Lemaitre L (2006) Dynamic contrast enhanced, pelvic phased array magnetic resonance imaging of localized prostate cancer for predicting tumor volume: correlation with radical prostatectomy findings. J Urol 176(6 Pt 1):2432–2437PubMedCrossRefGoogle Scholar