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High Intensity Ultrasound for Prostate Cancer

Posted Feb 19 2010 10:30am

In HIFU therapy, ultrasound beams are focused on diseased tissue, and due to the significant energy deposition at the focus, temperature within the tissue rises to 65° to 85°C, destroying the diseased tissue by coagulation necrosis. Each sonication of the beams treats a precisely defined portion of the targeted tissue and is computer modeled. Anesthesia is not required but recommended.

High Intensity Ultasound (HIFU) was initially reported to provide a safe and effective control rate for early localized prostate cancer. Early HIFU case studies showing promising results have been widely publicised generating more clinician awareness and interest. However, subequently, less axciting data began to accumulate. National Institute for Clinical Excellence (NICE) in the UK initially supported HIFU but has subsequently changed its guidance and now recommend using it only within clinical trials.

There is a significant lack of good quality outcomes and efficacy data as patients often refuse to enter randomised controlled surgical trials.ONce it bacame more widespead, many urologists were unable to match traditional treatment modalities (minimally-invasive radical prostatectomy, external beam radiotherapy or brachytherapy) for oncological efficacy. In addition HIFU generated significant and devastating complications in some patients. It uses Sonablate® 500 which is not approved for use in the U.S. The Sonablate® 500 remains investigational in the U.S. and is being studied for the treatment of prostate cancer in clinical trials in the U.S. FDA has made no decision as to the safety or efficacy of the Sonablate®500 for the treatment of prostate cancer.

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