Histopathological changes associated with high intensity focused ultrasound (HIFU) treatment for localised adenocarcinoma of the prostate

Leenders, Geert J.L.H. van; Beerlage, Harrie P.; Ruijter, Emiel; Rosette, Jean J.M.C.H. de la; Kaa, C.A. van de

doi:10.1136/jcp.53.5.391

Cited by 97 publications

(73 citation statements)

References 15 publications

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“…However, even at a peak temperature of 70 °C or above (data not shown) a small number of tumor cells can still survive. Similarly, incomplete tissue necrosis has been observed in tissue specimens collected from prostate cancer patients following HIFU treatment (Van Leenders et al, 2000). These results are presumably caused by the heterogeneity in heat conduction and biological response of the tumor cells/tissue to HIFU therapy.…”

Section: Discussionmentioning

confidence: 83%

High intensity focused ultrasound-induced gene activation in sublethally injured tumor cells in vitro

Liu

Kon

et al. 2005

The Journal of the Acoustical Society of America

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Cultured human cervical cancer (HeLa) and rat mammary carcinoma (R3230Ac) cells were transfected with vectors encoding green fluorescent protein (GFP) under the control of hsp70B promoter. Aliquots of 10-μl transfected cells (5 × 10 7 cells/ml) were placed in 0.2-ml thin-wall polymerase chain reaction tubes and exposed to 1.1-MHz high intensity focused ultrasound (HIFU) at a peak negative pressure P − =2.68 MPa. By adjusting the duty cycle of the HIFU transducer, the cell suspensions were heated to a peak temperature from 50 to 70 °C in 1-10 s. Exposure dependent cell viability and gene activation were evaluated. For a 5-s HIFU exposure, cell viability dropped from 95% at 50 °C to 13% at 70 °C. Concomitantly, gene activation in sublethally injured tumor cells increased from 4% at 50 °C to 41% at 70 °C. A similar trend was observed at 60 °C peak temperature as the exposure time increased from 1 to 5 s. Further increase of exposure duration to 10 s led to significantly reduced cell viability and lower overall gene activation in exposed cells. Altogether, maximum HIFU-induced gene activation was achieved at 60 °C in 5 s. Under these experimental conditions, HIFU-induced gene activation was found to be produced primarily by thermal rather than mechanical stresses.

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Section: Discussionmentioning

confidence: 83%

High intensity focused ultrasound-induced gene activation in sublethally injured tumor cells in vitro

Liu

Kon

et al. 2005

The Journal of the Acoustical Society of America

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“…so these results should be considered preliminary, albeit novel. It should also be noted that we have not directly studied the effect of our treatments on cancer neo-antigens and protein structure, so any hypotheses regarding potential utility of ablation in harnessing the immune response should be considered speculative [13][14][15][16][17][18][19][20]. Delayed refers to late changes (hours to days or more after treatment), allowing for effects of regeneration.…”

Section: Discussionmentioning

confidence: 99%

Electrical Membrane Breakdown (EMB): Preliminary Findings of a New Method of Non-thermal Tissue Ablation

Gm¹,

Dg²,

Ja³

et al. 2017

J Clin Exp Pathol

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Electrical membrane breakdown (EMB) is a novel form of non-thermal treatment that has not, to our knowledge, been previously evaluated for its potential utility as an ablation mechanism. The findings with EMB immediately after treatment were compared with other forms of ablation (cryoablation and IRE (irreversible electroporation)) in the porcine liver clinically, ultrasonographically, and by light microscopy and ultrastructural analysis. Clinically, EMB did not induce muscular contractions, in contrast with IRE. By ultrasound, all lesions were hypoechoic when compared to the untreated liver. EMB created a consistent pattern of immediate tissue destruction at the light microscopic and ultrastructural level, characterized by pulse-dose-related coagulative necrosis and nuclear pyknosis, preserved blood vessels and adjacent structures, and sharply demarcated margins. We conclude that the profile of EMB ablation is distinctive and unique, inducing necrosis by immediate electrical rupture of cell membranes non-thermally while preserving proteins and adjacent vessels with potentially superior stimulation of the immune system than other ablation modalities.

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“…25 The reason for the presence of this unaffected tissue was inferred to be the result of the change in the treatment range as a consequence of prostatic swelling. 25 Therefore, it was considered that intraoperative adjustment of the treatment plan is required, depending on the amount of prostatic swelling. However, intraoperative adjustment of the treatment plan can only be carried out in the horizontal plane, but not in the vertical plane using the presently available device.…”

Section: Discussionmentioning

confidence: 99%

Morphological analysis of the effects of intraoperative transrectal compression of the prostate during high‐intensity focused ultrasound for localized prostate cancer

et al. 2015

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Abbreviations & Acronyms 3-D = three-dimensional BDFS = biochemical diseasefree survival rate DVC = dorsal vein complex HIFU = high-intensity focused ultrasound MRI = magnetic resonance imaging PSA = prostate-specific antigen PZ = peripheral zone TRUS = transrectal ultrasound TZ = transition zone Objectives: To evaluate the effects of transrectal compression of the prostate for intraoperative prostatic swelling and intraprostatic point shift during high-intensity focused ultrasound treatment of localized prostate cancer. Methods: Patients treated with whole-gland high-intensity focused ultrasound as primary monotherapy for localized prostate cancer were enrolled in the study. Using the standard and compression method, the volumes of degassed water in the balloon covering the high-intensity focused ultrasound probe were 50 mL and 80-160 mL, respectively. To identify prostatic swelling and shift during high-intensity focused ultrasound and the volume occupied by the non-enhanced area, three-dimensional prostate models were reconstructed using ultrasound and contrast-enhanced magnetic resonance imaging. Results: In comparison with the standard (n = 40) and compression (n = 48) methods, intraoperative increase in the prostate volume (21% vs 5.3%; P = 0.044), intraprostatic point shift (4 mm vs 2 mm, P = 0.040 in the transition zone; 3 mm vs 0 mm; P = 0.001 in the peripheral zone) and the volume occupied by the non-enhanced area (89% vs 96%; P = 0.001) were significantly suppressed. The biochemical disease-free survival rate in patients treated using the compression method was significantly improved relative to the standard method (92.6% vs 76.5%; P = 0.038). Regarding complications, there was no significant difference in the rate of urethral stricture (P = 0.9), urinary tract infection (P = 0.9), incontinence (P = 0.3), erectile dysfunction (P = 0.9) or recto-urethral fistula between the patients treated using the standard and compression methods. Conclusions: Intraoperative transrectal compression suppresses intraoperative increase in the prostate volume and intraprostatic point shift during high-intensity focused ultrasound, having the potential to achieve precise whole-gland and lesion-targeted focal therapy.

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Histopathological changes associated with high intensity focused ultrasound (HIFU) treatment for localised adenocarcinoma of the prostate

Cited by 97 publications

References 15 publications

High intensity focused ultrasound-induced gene activation in sublethally injured tumor cells in vitro

High intensity focused ultrasound-induced gene activation in sublethally injured tumor cells in vitro

Electrical Membrane Breakdown (EMB): Preliminary Findings of a New Method of Non-thermal Tissue Ablation

Morphological analysis of the effects of intraoperative transrectal compression of the prostate during high‐intensity focused ultrasound for localized prostate cancer

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