HIFU and its Role in Urology

High-Intensity Focused Ultrasound (HIFU) applies high-intensity focused ultrasound energy to locally heat and destroys diseased or damaged tissue through ablation. HIFU is a non-invasive approach that uses precisely delivered ultrasound energy to achieve tumor cell necrosis without radiation or surgical excision. In current urological oncology, HIFU is used clinically in the treatment of Prostate Cancer (PC). Clinical research on HIFU therapy for localized PC began in the 1990s, and most PC patients were treated with the Ablatherm device. HIFU treatment for localized PC can be considered as an alternative minimally invasive therapeutic modality for patients who are not candidates for radical prostatectomy. Patients with lower pre-HIFU PSA levels and favorable pathologic Gleason score seem to present better oncologic outcomes [1]. No prospective data exist evaluating Focal Therapy (FT) and Androgen Deprivation Therapy (ADT) combination in terms of cancer control for the treatment of localized PCa [2-5]. As it is well understood high-intensity focused ultrasound is a novel and noninvasive treatment for an increasing number of cancers and benign diseases. The principle is like focusing the sun's rays with a magnifying glass, causing a burn at the focal point!!! This can be done with ultrasound if the usual diagnostic energy is increased 10,000 times!!!. The ultrasound energy is generated under water and the energy is passed noninvasively into the body to a sharp focus where it destroys tissue. The technology is rapidly evolving. In urology, trials have been done in a number of areas but the two that are most promising at present are for the treatment of renal and prostate cancers. Treatment of renal cancer is currently limited by the position of the kidneys due to the ribs and the presence of perinephric fat, but treatment for prostate cancer is becoming more established [6].