HIFU ablation is not a proven standard treatment for localized prostate cancer

So, Alan

doi:10.5489/cuaj.11232

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…It was not until the 1990s that MRI guidance was first used with HIFU in prostate cancer (11,12). In 2011, HIFU ablation was still not considered a standard treatment option for localized prostate cancer, likely due to the positive repeat biopsy rates ranging from 4.9%-65%, which resulted in retreatment rates varying 7.7%-43% (13). In a retrospective study by Boutier et al (14), 99 patients were treated with HIFU using the Ablatherm system (EDAP SA, Lyon, France).…”

Section: High-intensity Focused Ultrasoundmentioning

confidence: 99%

Image-guided focal therapy for prostate cancer

Sankineni

Wood²,

Rais‐Bahrami³

et al. 2014

Diagn Interv Radiol

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M agnetic resonance imaging (MRI) is a widely used diagnostic tool for breast imaging in daily practice, with its high sensitivity to detect primary, recurrent, and residual breast cancer. Breast MRI serves as a reliable problem-solving tool in case of inconclusive mammography and ultrasonography (US) findings. It can be used to monitor the results of neoadjuvant chemotherapy and it may also contribute to preoperative evaluation of known lesions. With increasing use of MRI, number of breast lesions visible only on MRI and need for MRI-guided breast biopsy have increased (1). Second-look US can also be used for re-evaluation of these lesions; because US-guided biopsy is an easier, cheaper, and faster method if these lesions are visible on second-look US. According to a recently published meta-analysis, lesion detection rates with second-look US are variable in the literature (22.6%-82.1%). Mass lesions and malignant lesions were more likely to be detected at second-look US; average detection rates were 66% for masses, 29% for non-mass-like enhancement (NME) (2, 3). However, focal or NME lesions, which are less detectable than masses on second-look US, require MRI-guided biopsy in the majority of cases. According to the MRI-guided biopsy series in the literature, approximately 25%-35% of these lesions are diagnosed as malignant (4-9).Within this context, the aim of the present study is to assess the effectiveness of MRI-guided 10 Gauge (G) vacuum-assisted breast biopsies (VABB) performed at our institution and to examine the relationship between lesion characteristics and histopathologic results. B R E A S T I MAG I N G O R I G I N A L A R T I C L E PURPOSEWe aimed to assess the effectiveness of magnetic resonance imaging (MRI)-guided vacuum-assisted breast biopsy (VABB), evaluate and compare the characteristics and histopathologic findings of lesions, and overview the follow-up results of benign lesions. METHODSMRI findings and histopathologic results of breast lesions biopsied by MRI-guided VABB between 2013 and 2016 were retrospectively analyzed. MRI findings closely related with malignancy were investigated in particular. Follow-up results of benign lesions were evaluated. RESULTSMRI-guided VABB was applied to 116 lesions of 112 women. Of the lesions, 75 (65%) were benign, while 41 (35%) were malignant. Segmental (94%), clustered (89%), and clustered ring (67%) nonmass-like enhancement patterns were found to be more related with malignancy. False-negative rate of MRI-guided VABB was 12%, underestimation rate was 21%. One of the 54 followed-up benign lesions had a malignant result. CONCLUSION MRI-guided VABB is a reliable method for the diagnosis of breast lesions that are positive only on MRI. Follow-up results show that cancer detection rate is low for radio-pathologically concordant lesions. Further multicenter studies with larger patient population are needed to elucidate these results.You may cite this article as: Taşkın F, Soyder A, Tanyeri A, Öztürk VS, Ünsal A. Lesion characteristics, histopathologic r...

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Section: High-intensity Focused Ultrasoundmentioning

confidence: 99%

Image-guided focal therapy for prostate cancer

Sankineni

Wood²,

Rais‐Bahrami³

et al. 2014

Diagn Interv Radiol

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“…Apart from direct heating, HIFU, especially with high pressure (>10 MPa), short pulse width (<20 μ s) at a low duty cycle (<1%) [ 9 ], [ 10 ], has been shown to induce inertial acoustic cavitation, in which submicron/micron-sized gas bubbles form from cavitation nuclei and collapse rapidly after growth, causing destructive mechanical damage from shock waves or high-speed microjets [ 11 ]. Although both heat and cavitation effectively destroy tumor cells, nearby normal tissue in the target area is also affected by the non-specific damage during the treatment, causing unwanted side effects, or even resulting in loss of bodily function on some critical parts of the body [ 12 ]–[ 15 ]. As a result, most clinical treatment with HIFU must operate under the guidance of external imaging methods [ 4 ] such as magnetic resonance imaging (MRI) [ 1 ], [ 5 ], [ 6 ] or ultrasound imaging [ 9 ], greatly increasing the cost and complexity of the procedure.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Non-Thermal, Selective Cancer Treatment With High-Frequency Medium-Intensity Focused Ultrasound

Tang¹,

Chen

Zhang

et al. 2021

IEEE Access

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Focused ultrasound (FUS) has proven its efficacy in non-invasive, radiation-free cancer treatment. However, the commonly used low-frequency high intensity focused ultrasound (HIFU) destroys both cancerous and healthy tissues non-specifically through extreme heat and inertial cavitation with low spatial resolution. To address this issue, we evaluate the therapeutic effects of pulsed (60 Hz pulse repetition frequency, 1.45 ms pulse width) high-frequency (20.7 MHz) medium-intensity (spatial-peak pulse-average intensity ISPPA < 279.1 W/cm , spatial-peak temporal-average intensity ISPTA < 24.3 W/cm 2 ) focused ultrasound (pHFMIFU) for selective cancer treatment without thermal damage and with low risk of inertial cavitation (mechanical index < 0.66), in an in vivo subcutaneous B16F10 melanoma tumor growth model in mice. The pHFMIFU with 104 μm focal diameter is generated by a microfabricated self-focusing acoustic transducer (SFAT) with a Fresnel acoustic lens. A three-axis positioning system has been developed for automatic scanning of the transducer to cover a larger treatment volume, while a water-cooling system is custom-built for dissipating non-acoustic heat from the transducer surface. Initial testing revealed that pHFMIFU treatment can be applied to a living animal while maintaining skin temperature under 35.6 °C without damaging normal skin and tissue. After eleven days of treatment with pHFMIFU, the treated tumors were significantly smaller with large areas of necrosis and apoptosis in the treatment field compared to untreated controls. Potential mechanisms of this selective, non-thermal killing effect, as well as possible causes of and solutions to the variation in treatment results, have been analyzed and proposed. The pHFMIFU could potentially be used as a new therapeutic modality for safer cancer treatment especially in critical body regions, due to its cancer-specific effects and high spatial resolution.INDEX TERMS High-frequency focused ultrasound, in vivo experiment, non-invasive therapy, selective cancer treatment, self-focusing acoustic transducers (SFAT), ultrasound therapy. * The average density of soft tissues [37] ** From measurement (described in Appendix B) *** Used the values for water [38] due to similar acoustic properties

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“…Although other modalities of thermal ablation currently exist (radiofrequency ablation and microwave ablation), HIFU offers a distinct advantage over these methods in that it is the only non-invasive hyperthermic modality 5 . HIFU has attained mixed results in the clinic and is currently only available in clinical trials [8][9][10][11] . Nevertheless, the limited success it has achieved, and the very promising in vivo data acquired from preclinical mammalian models have demonstrated the potential of ultrasound in cancer therapy.…”

Section: Introductionmentioning

confidence: 99%