Focal therapy with high-intensity focused ultrasound for the localized prostate cancer for Asian based on the localization with MRI-TRUS fusion image-guided transperineal biopsy and 12-cores transperineal systematic biopsy: prospective analysis of oncological and functional outcomes

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

“…Our series made use of a trimodality assessment which includes PSA, MRI, and biopsy for follow-up after HIFU focal therapy. In contrast to von Hardenberg et al who found that out of the 20 patients that had biopsies at 12 months, 8 patients had a positive biopsy within the ablation zone, and our series did not reveal any in-field recurrence [ 23 ] which was similar to Shoji et al [ 21 ]. The two significant prostate cancers picked up by follow-up biopsy in the series could not be identified with PSA and MRI alone early in the follow-up period.…”

“…PSA has been commonly used for follow-up after focal therapy. Some series have adopted the Phoenix ASTRO definition as a way to document biochemical recurrence [ 20 , 21 ]. On the other hand, Huber et al found that PSA criteria have significant variability in performance characteristics to rule out or detect failure after focal HIFU therapy.…”

Analysis of oncological outcomes of whole-gland therapy with high-intensity focused ultrasound for localized prostate cancer in clinical and technical aspects: a retrospective consecutive case-series analysis with a median 5-year follow-up

“…Therefore, the combination of NHT and compression methods has the potential to improve oncological outcomes in patients in the high-risk group. After focal therapy, there was a difference in the detection of csPC from 0% to 26.5% in follow-up biopsy from the treated area in recent studies [15][16][17][18][19][20][21][22]; this could be due to influences and differences in treatment techniques Gleason score (cases) during the studies. The compression method has the potential to improve precise lesion-target focal therapy with HIFU because the intra-prostatic target point shift is suppressed.…”

Editorial Comment from Dr Shoji to Focal bipolar radiofrequency ablation for localized prostate cancer: Safety and feasibility

“…HIFU destroys PC within the prostate through heat coagulation and mechanical effects, and the size of a single therapeutic focus of HIFU is a few millimeters in diameter, with a distinct margin between the treated area and the adjacent untreated tissue. 4 These characteristics make HIFU an attractive therapeutic modality for focal therapy in patients with PC. 2,4 However, the use of transrectal HIFU is limited in patients with an anteriorly localized target in a large prostate (≥50 mL) or large calcification in the prostate (diameter of ≥10 mm).…”

“…4 These characteristics make HIFU an attractive therapeutic modality for focal therapy in patients with PC. 2,4 However, the use of transrectal HIFU is limited in patients with an anteriorly localized target in a large prostate (≥50 mL) or large calcification in the prostate (diameter of ≥10 mm). Therefore, the proper use of the modalities was proposed based on the tumor location and other conditions.…”