The clinical applications of high intensity focused ultrasound in the prostate.

PURPOSE: To review the current status of high intensity focused ultrasound (HIFU) therapy in the prostate, in particular the treatment of prostate cancer.

MATERIALS AND METHODS: Two trans-rectal devices are currently in clinical use; the SonablateR500 and AblathermR. These devices are compared and similarities and differences highlighted.

RESULTS: Outcomes from the primary treatment of prostate cancer, and HIFU as a salvage therapy are discussed. The rate of adverse events are described after each of these, and the role and safety of other therapies after primary HIFU failure are outlined. Factors which may influence outcome such as use of neo-adjuvant androgen suppression are discussed.

CONCLUSIONS: Trans-rectal HIFU for prostate cancer is a promising technique with medium-term oncological results broadly comparable to standard therapies. It is the only form of therapy which is non-invasive and does not utilise ionising radiation. This is an exiciting field undergoing rapid developments, both in the technology and the way in which prostate cancer as a disease is managed.