Bioacoustics Research Lab
University of Illinois at Urbana-Champaign | Department of Electrical and Computer Engineering | The Department of Bioengineering  Monday, January 21st, 2019
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Radiation Oncology Seminar

Jean-Yves Chapelon, Ph.D
Directeur de Recherche
INSERM Unite 281
Lyon Cedex03 - France

Transrectal High-Intensity Focused Ultrasound: Minimally Invasive therapy of localiZed prostate cancer.

With the advent of the PSA test, an increasing number of prostate cancers are being detected at a local stage. Since 1989, our group has been developing a research project with the aim of establishing treatment of localized prostate cancer by means of High-Intensity Focused Ultrasound (HIFU). The treatment is administered transrectally, using ultrasound guidance only. The quality of HIFU treatment depends on four factors: the intensity of the wave emitted, the exposition-time, the signal frequency, and the time between two firing-bursts. The lesions are created by a thermal effect. Criteria for determining the durability of the response to transrectal HIFU ablation of prostate cancer have been recently established. A series of 82 patients (mean age 71 ± 5.7 years) with biopsy-proven localized (stage T1-T2) cancer who were not candidates for radical surgery underwent transrectal HIFU ablation with the Ablatherm™ machine. Progression was rigidly defined as any positive biopsy result, regardless of PSA levels, or 3 successive PSA increases for patients with a negative biopsy (PSA velocity ≥ 0.75). Times to specific events (positive biopsy and PSA elevation) were analyzed with Kaplan-Meier survival analysis. Overall, 62% of the patients exhibited no evidence of disease progression 60 months after transrectal HIFU ablation. In particular, the disease-free rate was 68% for the moderate risk group of 45 patients (PSA <15.0 ng/ml, Gleason sum < 8, prostate volume < 40 cm3 and number of positive biopsies < 5). For the low risk group of 27 patients (PSA < 10 ng/ml and Gleason sum < 7), the disease-free survival rate was 83%. These data indicate that transrectal HIFU prostate ablation is an effective therapeutic alternative for patients with localized prostatic adenocarcinoma.

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