High-intensity focused ultrasound (HIFU) for prostate cancer

Abstract

High-intensity focused ultrasound (HIFU) is a nonsurgical treatment that uses a nonionizing physical agent. Focused ultrasound applied to tissue produces three effects (mechanical, thermal, and cavitation) all of which induce irreversible tissue damage. Based on these physical 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. 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 in primary care patients and early identified local relapse after radiation therapy.