High-Intensity Focused Ultrasound (HIFU) Focal Therapy for Localized Prostate Cancer with MRI-US Fusion Platform

Overview

Journal Adv Urol

Publisher Wiley

Specialty Urology

Date 2021 Dec 24

PMID 34950204

Citations 6

Authors

Chi-Hang Yee

Peter Ka-Fung Chiu

Jeremy Yuen-Chun Teoh

Chi-Fai Ng

Chi-Kwok Chan

See-Ming Hou

Affiliations

Soon will be listed here.

Abstract

Objective: The study aimed at investigating the outcome of prostate HIFU focal therapy using the MRI-US fusion platform for treatment localization and delivery.

Methods: It is a prospectively designed case series of HIFU focal therapy for localized prostate cancer. The inclusion criteria include clinical tumor stage ≤T2, visible index lesion on multiparametric MRI less than 20 mm in diameter, absence of Gleason 5 pattern on prostate biopsy, and PSA ≤ 20 ng/ml. HIFU focal therapy was performed in the conventional manner in the beginning 50% of the series, whereas the subsequent cases were performed with MRI-US fusion platform. The primary outcome was treatment failure rate which is defined by the need of salvage therapy. Secondary outcomes included tumor recurrence in follow-up biopsy, PSA change, perioperative complications, and postoperative functional outcomes.

Results: Twenty patients underwent HIFU focal ablation. HIFU on an MRI-US fusion platform had a trend of a longer total operative time than the conventional counterpart (124.2 min vs. 107.1 min, =0.066). There was no difference in the mean ablation volume to lesion volume ratio between the two. The mean PSA percentage change from baseline to 6-month is more significant in the conventional group (63.3% vs. 44.6%, =0.035). No suspicious lesion was seen at 6-month mpMRI in all 20 patients. Two patients, one from each group, eventually underwent radical treatment because of the presence of clinically significant prostate cancer in the form of out-of-field recurrences during follow-up biopsy. No significant difference was observed before and after HIFU concerning uroflowmetry, SF-12 score, and EPIC-26 score. It was observed that energy used per volume was positively correlated with PSA density of the patient ( = 0.6364, =0.014).

Conclusion: In conclusion, HIFU with conventional or MRI-US fusion platform provided similar oncological and functional outcomes.

Citing Articles

Established focal therapy-HIFU, IRE, or cryotherapy-where are we now?-a systematic review and meta-analysis.

Tay K, Fong K, Stabile A, Dominguez-Escrig J, Ukimura O, Rodriguez-Sanchez L Prostate Cancer Prostatic Dis. 2024; .

PMID: 39468217 DOI: 10.1038/s41391-024-00911-2.

MRI accuracy for recurrence after partial gland ablation with HIFU for localized prostate cancer. A systematic review and meta-analysis.

Seguier D, Puech P, Barret E, Leroy X, Labreuche J, Penna R Prostate Cancer Prostatic Dis. 2024; .

PMID: 39256551 DOI: 10.1038/s41391-024-00885-1.

High-intensity focused ultrasound with visually directed power adjustment for focal treatment of localized prostate cancer: systematic review and meta-analysis.

Peretsman S, Emberton M, Fleshner N, Shoji S, Bahler C, Miller L World J Urol. 2024; 42(1):175.

PMID: 38507093 PMC: 10954869. DOI: 10.1007/s00345-024-04840-6.

Functional outcomes and safety of focal therapy for prostate cancer: a systematic review on results and patient-reported outcome measures (PROMs).

Nicoletti R, Alberti A, Castellani D, Yee C, Zhang K, Poon D Prostate Cancer Prostatic Dis. 2023; 27(4):614-622.

PMID: 37491432 DOI: 10.1038/s41391-023-00698-8.

Diagnostic performance of MRI for prediction of recurrent prostate cancer after high-intensity focused ultrasound: a systematic review and meta-analysis.

Ahn H, Hwang S, Lee H, Kim S, Cho J, Lee H Prostate Int. 2023; 11(2):59-68.

PMID: 37409098 PMC: 10318330. DOI: 10.1016/j.prnil.2022.12.004.

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