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Clinical Information of HIFU
Indications for Ablatherm® HIFU
Clinically Localized Prostate Cancer:
- First choice therapy (T-1, T-2)
- Curative Salvage therapy for local recurrence after EBRT
Ablatherm® HIFU remains the only HIFU system approved in
Canada and has undergone the most extensive research, development
and testing. Ablatherm® HIFU is presently being used in England,
Belgium, France, Italy, Germany, Russia, South Korea, and other
Asian countries.
Histology
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48 hours: Complete destruction
of the glandular tissue due to coagulation necrosis which
reaches the capsule and the periprostatic fat. |
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3 months: The necrotic prostatic tissue
is replaced by a fibrotic tissue (including the capsule). |
Immediately after the Ablatherm® HIFU treatment, biopsies
show a complete coagulation necrosis in the treated area (capsule
and periprostatic fat included). After 3 months, fibrosis replaces
the necrotic tissue.
MRI Post-Treatment
MRI of the prostate after an Ablatherm® HIFU session (the
whole prostate volume is treated)
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| Transversal plane |
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Longitudinal plane |
MRI examinations performed early after the HIFU treatment of
prostate cancer cannot give a qualitative assessment of the necrosis.
It does however, allow a precise evaluation of the treated volume
as demonstrated in a clinical trial. After gadolinium injection,
the treated area appeared as a hypo-intense area and a surrounding
6-8 mm ring of contrast enhancement. Biopsies were taken in the
ring, and these also demonstrated complete necrosis in this ring.
PSA Post-Treatment
Typical PSA evolution after a single treatment session
(complete treatment of the gland)
- Elevated PSA level before the treatment of prostate cancer
- Peak in PSA immediately after the session
- Nadir PSA obtained 3 months after the treatment
- Low and stable follow-up PSA level at 0.2 ng/ml
PSA evolution after the first nerve sparing treatment
(need for a second session)
- Elevated PSA level before the treatment of prostate cancer
- Peak in PSA immediately after the first session
- Nadir PSA obtained within 3 months after the 1st session
and showing a residual PSA level
- Rising PSA level following the Nadir with residual positive
biopsies; indication for a 2nd treatment session
- Then, low and stable follow-up PSA level
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