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Prostate Cancer and HIFU

Irene A Burger, Andrei Gafita, Julian Müller, Benedikt Kranzbühler, Olivio F Donati, Daniel Eberli
Restaging local recurrence after high-intensity focused ultra-sound (HIFU) is based on multiparametric MRI (mpMRI). However, postinterventional changes of the tissue, such as edema or hemorrhage, are limiting tumor detection on mpMRI. We present a case of a rising prostate-specific antigen values, negative mpMRI, and a Gleason score of 4+4 on template biopsy after HIFU. On F-choline PET/MR, high focal uptake was detected at the location of positive biopsy. Re-HIFU based on the fused F-choline PET/MR images was performed, followed by a recurrence-free period of 11 months...
April 2018: Clinical Nuclear Medicine
Karun V Sharma, Pavel S Yarmolenko, Avinash Eranki, Ari Partanen, Haydar Celik, AeRang Kim, Matthew Oetgen, Peter C W Kim
Magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) is a novel technology that integrates magnetic resonance imaging with therapeutic ultrasound. This unique approach provides a completely noninvasive method for precise thermal ablation of targeted tissues with real-time imaging feedback. Over the past 2 decades, MR-HIFU has shown clinical success in several adult applications ranging from treatment of painful bone metastases to uterine fibroids to prostate cancer and essential tremor...
February 2018: Topics in Magnetic Resonance Imaging: TMRI
Nicholas A Faure Walker, Joseph M Norris, Taimur T Shah, Tet Yap, Paul Cathcart, Caroline M Moore, Hashim U Ahmed, Mark Emberton, Suks Minhas
OBJECTIVES: To systematically review erectile function (EF) outcomes following primary whole gland (WG) and focal ablative therapies for localized prostate cancer to ascertain whether the treatment modality or intended treatment volume affects the time taken to recover baseline EF. METHOD AND MATERIALS: A systematic review was performed according to the preferred reporting items for systematic review and meta-analysis statement. Inclusion criteria were men with localized prostate cancer treated with primary, ablative therapy...
February 2018: Urologic Oncology
Fuad F Elkhoury, Demetrios N Simopoulos, Leonard S Marks
PURPOSE OF REVIEW: Options for prostate cancer management are rapidly expanding. The recent advent of MRI technology has led to guided prostate biopsies by radiologists working in-bore or by urologists using MR/US fusion technology. The resulting tumor visualization now provides the option of focal therapy. Currently available are highly directed energies - focused ultrasound (HIFU), cryotherapy, and laser - all offering the hope of curing prostate cancer with few side effects. RECENT FINDINGS: MRI now enables visualization of many prostate cancers...
December 11, 2017: Current Opinion in Urology
Paolo Capogrosso, Eric Barret, Rafael Sanchez-Salas, Igor Nunes-Silva, François Rozet, Marc Galiano, Eugenio Ventimiglia, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Xavier Cathelineau
AIM: To assess outcomes of whole gland high-intensity focused ultrasound (HIFU) as compared with minimally-invasive radical prostatectomy (MIRP) in elderly patients. MATERIALS & METHODS: Patients aged ≥70 years with, cT1-cT2 disease, biopsy Gleason score (GS) 3 + 3 or 3 + 4 and preoperative PSA ≤10 ng/mL were submitted to either whole-gland HIFU or MIRP. Propensity-score matching analysis was performed to ensure the baseline equivalence of groups. Follow-up visits were routinely performed assessing PSA and urinary function according to the International Continence Score (ICS) and the International Prostatic Symptoms Score (IPSS) questionnaires...
January 2018: European Journal of Surgical Oncology
Shawn Dason, Nathan C Wong, Christopher B Allard, Jen Hoogenes, William Orovan, Bobby Shayegan
BACKGROUND: Some men with localized radio-recurrent prostate cancer may benefit from salvage high-intensity focused ultrasound (HIFU). Herein, we describe oncologic outcomes and predictors of disease response after salvage whole gland HIFU from our prospective cohort. MATERIALS AND METHODS: Patients with localized radio-recurrent prostate cancer were prospectively enrolled from January 2005 to December 2014. Participants had to meet both biochemical and histological definitions of recurrence...
December 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Walter Artibani, Antonio Benito Porcaro, Vincenzo De Marco, Maria A Cerruto, Salvatore Siracusano
How to manage patients with prostate cancer (PCa) with biochemical recurrence (BCR) following primary curative treatment is a controversial issue. Importantly, this prostate-specific antigen (PSA)-only recurrence is a surrogate neither of PCa-specific survival nor of overall survival. Physicians are therefore challenged with preventing or delaying the onset of clinical progression in those deemed at risk, while avoiding over-treating patients whose disease may never progress beyond PSA-only recurrence. Adjuvant therapy for radical prostatectomy (RP) or local radiotherapy (RT) has a role in certain at-risk patients, although it is not recommended in low-risk PCa owing to the significant side-effects associated with RT and androgen deprivation therapy (ADT)...
November 21, 2017: Urologia Internationalis
J-M Cosset, G Créhange
Salvage brachytherapy after a first prostate radiation therapy is an emerging technique, which has to be considered in the therapeutic armamentarium in the clinically challenging context of patients with isolated local failure from prostate cancer who may still be considered for cure. These occult failures are more and more frequently diagnosed at an early stage, thanks to targeted biopsies and advances in imaging modalities, such as multiparametric MRI and PET-CT. Salvage brachytherapy benefits from the implantation accuracy of brachytherapy procedures using 3D dosimetry and has resulted in more than 50% tumour control rates with long-term...
December 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Tomasz Łoziński, Justyna Filipowska, Grzegorz Gurynowicz, Iwona Gabriel, Artur Czekierdowski
Benign uterine fibroids are common female genital tract tumors and if symptomatic often require extensive surgery. When tumors are multiple and large or unusually located, the operative treatment may lead to significant morbidity and compromise quality of life. Recovery period after surgical treatment may be complicated by patient's medical condition and wound healing problems. Currently used other non-surgical treatment modalities usually provide only a temporal symptoms relief and may not be efficient in all affected women...
2017: Ginekologia Polska
Max Peters, Abi Kanthabalan, Taimur T Shah, Neil McCartan, Caroline M Moore, Manit Arya, Jochem R van der Voort van Zyp, Marinus A Moerland, Richard G Hindley, Mark Emberton, Hashim U Ahmed
PURPOSE: Patient selection for focal salvage remains difficult. Therefore, we developed and internally validated prediction models for biochemical failure (BF) and a composite endpoint (CE) following focal salvage high intensity focused ultrasound (HIFU) for radiorecurrent prostate cancer. MATERIALS AND METHODS: A prospective HIFU registry identified 150 cases (November 2006-August 2015). Recurrence was assessed with multiparametric magnetic resonance imaging (MRI) combined with template prostate mapping biopsies, targeted biopsies, or systematic transrectal ultrasound-guided biopsies...
January 2018: Urologic Oncology
Narendra T Sanghvi, Wo-Hsing Chen, Roy Carlson, Clint Weis, Ralf Seip, Toyoaki Uchida, Michael Marberger
BACKGROUND: The purpose of these clinical studies was to validate a Tissue Change Monitoring (TCM) algorithm in vivo. TCM is a quantitative tool for the real-time assessment of HIFU dose. TCM provides quantitative analysis of the backscatter pulse echo signals (pre and immediately post HIFU) for each individual ablative site, using ultrasonic tissue characterization as a surrogate for monitoring tissue temperature. Real-time analysis generates an energy difference parameter (ΔE in dB) that is proportional to tissue temperature...
2017: Journal of Therapeutic Ultrasound
C Hennequin, J-M Hannoun-Lévi, F Rozet
Isolated local relapse after prostate cancer radiotherapy corresponds to 40% of biochemical failure. The management of these relapses is not well defined. Several strategies are available including surgery, high-intensity focused ultrasounds (HIFU), cryotherapy and reirradiation. Radical prostatectomy is the historical approach; biochemical control is obtained in 50 to 80% at 5 year. However, morbidity is higher after irradiation than as a first line treatment. Some limited series of HIFU and cryotherapy have been published with interesting results, but again the risk of urinary and rectal toxicity is high...
October 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
F Donis Canet, M D Sánchez Gallego, F Arias Fúnez, G Duque Ruíz, I Laso, J Brasero Burgos, J Lorca Álvaro, V Gómez Dos Santos, R Rodríguez Patrón, F J Burgos Revilla
CONTEXT AND OBJECTIVE: The increasingly early diagnosis of prostate cancer requires a search for therapeutic alternatives with good oncological results that in turn facilitate a good long-term quality of life. This review analyses 2 minimally invasive therapies for treating localised prostate cancer in terms of oncological and functional results, as well as the complications resulting from the therapies. ACQUISITION OF EVIDENCE: A systematic literature review was conducted of the treatment of localised prostate cancer with 2 ablative techniques as the primary therapy: cryosurgery or cryotherapy and high intensity focused ultrasound (HIFU)...
August 14, 2017: Actas Urologicas Españolas
Helen L Nicholson, Yasser Al-Hakeem, Javier J Maldonado, Vincent Tse
The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment...
July 2017: Translational Andrology and Urology
Nicole M Golbari, Aaron E Katz
PURPOSE OF REVIEW: While recurrence after primary treatment of prostate cancer (PCa) is not uncommon, there is currently no consensus on the most appropriate management after radiation treatment failure. This article seeks to explore the currently utilized modalities for salvage treatment for radiorecurrent PCa. We focused our review on the oncologic outcomes and reported toxicity rates in the latest studies examining salvage radical prostatectomy (SRP), salvage cryotherapy (SCT), salvage high-intensity focused ultrasound (HIFU) and re-irradiation...
August 2017: Current Urology Reports
Tonye A Jones, Joseph Chin, David Mcleod, Jack Barkin, Allan Pantuck, Leonard S Marks
PURPOSE: We determined the safety and efficacy of whole gland high intensity focused ultrasound in men with radio-recurrent prostate cancer. MATERIALS AND METHODS: A total of 100 men with clinically localized recurrent prostate cancer at least 2 years after external beam radiation therapy underwent whole gland. high intensity focused ultrasound in an open label trial from 2009 to 2012. Treatments were performed at 16 sites, including 14 in the United States and 2 in Canada...
June 23, 2017: Journal of Urology
Karthik M Sundaram, Sam S Chang, David F Penson, Sandeep Arora
Therapeutic ultrasound approaches including high-intensity focused ultrasound (HIFU) are emerging as popular minimally invasive alternative treatments for localized, low-to-intermediate risk prostate cancer. FDA approval was recently granted for two ultrasound-guided HIFU devices. Clinical trials for devices using MRI guidance are ongoing. The current level of evidence for whole-gland ultrasound ablation suggests that its clinical efficacy and adverse event rates including erectile dysfunction and urinary incontinence are similar to current definitive therapies such as radical prostatectomy and external-beam radiotherapy...
June 2017: Seminars in Interventional Radiology
Simon Gauvin, Yannick Cerantola, Eléonore Haberer, Vincent Pelsser, Stephan Probst, Franck Bladou, Maurice Anidjar
INTRODUCTION: We sought to determine predictive factors (patient and prostate-specific antigen [PSA] characteristics) for 18F-fluoromethylcholine positron emission tomography-computed tomography (18F-FCH PET/CT) positivity in the context of biochemical recurrence after local treatment of prostate cancer (PCa) with curative intent. METHODS: This is a retrospective study including 60 18F-FCH PET/CT scans of patients with biochemical recurrence after initial radical prostatectomy (RP), external beam radiation therapy (EBRT), or focal high-intensity focused ultrasound (HIFU) with curative intent...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
R Ganzer
BACKGROUND: High intensity focused ultrasound (HIFU) has been used since the beginning of the 1990s as an alternative treatment for prostate cancer. OBJECTIVE: Overview of the current status and critical review of the different indications for HIFU in the treatment of prostate cancer. MATERIAL AND METHODS: Review of the current literature on the indications, side effects, oncologic results and current guideline recommendations. RESULTS: The principle of HIFU is based on high energy sound waves, which lead to coagulation necrosis at the focal point...
August 2017: Der Radiologe
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