Table 1.
Outcomes of key studies in focal high-intensity focussed ultrasound
| Reference | No. patients | Follow-up (years) | Gleason score | PSA (ng/ml) | Disease localisation | Ablation strategy | Continence | Potency | Adverse events | Oncological outcomes |
|---|---|---|---|---|---|---|---|---|---|---|
| Muto et al., 2008 [35] | 29 | 2.6 | 5–10 | 5.4 | MRI and TRUS biopsy | Posterior hockey stick ablation | 29/29 (100%) | NR | 1 year biopsy: 13/17 (77%) no cancer 2 years BDFS (ASTRO criteria): 83% in low-risk patients 54% in intermediate-risk patients 0% in high-risk patients |
|
| Ahmed et al., 2011 [74] | 20 | 1 | ≤4 + 3 | 7.3 | MP-MRI and TPM | Hemi-ablation | 18/20 (90%) | 19/20 (95%) | Urethral stricture 1/20 (5%) | 6 months biopsy: 17/19 (89%) no cancer 19/19 (100%) no significant cancer |
| El Fegoun et al., 2011 [75] | 12 | 10 | ≤3 + 4 | 7.3 | TRUS biopsy | Hemi-ablation | 12/12 (100%) | NR | Retention 1/12 (8%) UTI 2/12 (17%) |
1 year biopsy: 11/12 (92%) no cancer 5 years: Recurrence-free survival – 90% 10 years: Recurrence-free survival – 38% Cancer-specific survival 10/10 (100%) |
| Ahmed et al., 2012 [24] | 41 | 1 | ≤4 + 3 | 6.6 | MP-MRI and TPM | Lesion-targeted or Region-targeted | 38/38 (100%) | 31/35 (89%) | Retention 1/41 (2%) UTI 7/41 (17%) Urethral stricture 1/41 (2%) Diarrhoea and urine extravasation 1/41 (2%) |
6 months biopsy: 30/39 (77%) no cancer 36/39 (92%) no significant cancer |
| Barret et al., 2012 [25] | 21 | 0.75 | 6 | 6 | TPM | Hemi-ablation | 21/21 (100%) | IIEF-5 decrease from 20 to 14 | Retention 5/21 (24%) | NR |
PSA, mean/median pre-procedural prostate-specific antigen; TRUS, transrectal ultrasound guided; NR, not reported; BDFS, biochemical disease-free survival; ASTRO criteria, three successive increases in PSA; MP-MRI, multi-parametric magnetic resonance imaging; TPM, transperineal template mapping biopsy; UTI, irinary tract infection; IIEF-5 = International Index of Erectile Function.