High-intensity focused ultrasound (HIFU) followed after one to two weeks by radical retropubic prostatectomy: Results of a prospective study

BACKGROUND. High-intensity focused ultrasound (HIFU) consists of focused ul trasound waves emitted from a transducer that are capable of inducing tissu e damage. Experimental studies have shown clear damage of malignant tissue exposed to HIFU, but knowledge of in vivo effects is limited. We studied th e safety and efficacy of HIFU in patients with a T1-2 N-0 M-0 prostate carc inoma. METHODS. HIFU treatment was performed under general anesthesia with the Abl atherm(TM) device (Technomed Medical Systems, Lyon, France), 7-12 days prio r to radical prostatectomy. Only the lobe in which carcinoma was confirmed was treated. The radical prostatectomy specimen was examined histopathologi cally, and the changes were compared with treatment goals. RESULTS. So far, 9 patients have been treated. On histology, a sharp deline ation was noted between areas treated with HIFU and untreated areas. On the dorsal border, however, incomplete destruction of tissue was noted, and in 2 cases a small residual tumor was seen in this region. In all cases compl ete necrosis was seen in the treated region. CONCLUSIONS. Histology reports of radical prostatectomy specimens of patien ts operated 7-12 days after HIFU treatment showed marked and complete necro sis in the treated area. Due to incomplete tissue destruction at the dorsal side, however, a small focus of residual vital tumor was found in 2 of 9 p atients. (C) 1999 Wiley-Liss, Inc.