Focal therapy using high intensity focussed ultrasound (HIFU) for localised prostate cancer

Focal therapy using high intensity focussed ultrasound (HIFU) is intended to be used in patients with localised prostate cancer - specifically patients with tumours that are confined to 1 prostatic lobe

• imaging and biopsy mapping studies are used to confirm that the tumour is suitable for focal therapy and to show its precise location
  • with the patient under local or general anaesthesia, the bladder is catheterised and the HIFU probe is inserted transrectally
    • real-time ultrasound imaging guidance and/or magnetic resonance guidance is used to position the probe and to monitor the procedure
    • pulses of HIFU are directed at the targeted part of the prostate, inducing tumour necrosis by a thermal effect and causing cavitation (which can be visualised by ultrasound to assess the adequacy of treatment) until satisfactory ablation of the target area is judged to have occurred
      
      
• after treatment patients are usually followed up regularly with prostate-specific antigen (PSA) measurements, imaging, and repeated biopsies to detect recurrence
• NICE have suggested HIFU as a management option for localised prostate cancer (1)

Reference:

• 1) NICE (April 2012).Focal therapy using high-intensity focused ultrasound for localised prostate cancer