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

Last reviewed 01/2018

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