High-intensity focused ultrasound as focal therapy of prostate cancer.

PURPOSE OF REVIEW: High-intensity focused ultrasound (HIFU) has been widely used for whole gland ablation with large series. HIFU induces immediate and irreversible coagulative necrosis with sharply delineated boundaries making HIFU an attractive treatment option for focal therapy of localized prostate. The treatment can be accurately targeted to a portion of the prostate gland. Unlike radiation, there is no lifetime dose limit, allowing HIFU to be repeated if necessary. Additional radical therapy can be performed involving radical surgery, external beam radiation therapy and cryotherapy. Moreover, HIFU is a minimally invasive therapy that can be performed under spinal anesthesia on an outpatient basis.

RECENT FINDINGS: Focal therapy is a new treatment modality for localized prostate cancer. Different energy can be employed to achieve focal therapy including HIFU. With a transrectal treatment, HIFU is one of the less invasive focal treatments. A systematic review of the literature has been performed to highlight the results of focal HIFU.

SUMMARY: The first published results of focal HIFU are promising. The patient's quality of life and potency are well preserved with good early oncological results.