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. Author manuscript; available in PMC: 2022 Dec 5.
Published in final edited form as: J Ultrasound Med. 2018 Aug 16;38(3):811–819. doi: 10.1002/jum.14765

Figure 2.

Figure 2.

Example of the post-HIFU appearance of the prostate on contrast-enhanced TRUS, with time-intensity curve and histologic correlates: 72-year-old man with prostate cancer (case 2 from Table 1). A, Pretreatment TRUS image shows a 1 × 0.8-cm hypoechoic lesion in the peripheral right mid lobe in the 7-o’clock position (arrow), which corresponded to Gleason 4 + 3 prostate cancer on biopsy. B, Transrectal US image 13 months after right hemigland HIFU ablation shows shrinkage of the ablated right lobe (arrow) versus the left lobe. The ablated right lobe is mildly hypoechoic diffusely relative to untreated left lobe. C, Contrast-enhanced TRUS image shows a clear and well-defined nonenhancing ablated right lobe (arrow) and a normally enhancing left lobe. Yellow and blue circles are manually selected ROIs placed for generation of time-intensity curves. D, Time-intensity curves generated from the ROIs placed in C. Time is on the x-axis (seconds), and peak intensity is on the y-axis (decibels). The untreated left lobe (blue ROI) shows gradual wash-in of contrast, peak enhancement at approximately 50 seconds, followed by gradual wash-out (blue curve). The treated right lobe (yellow ROI) shows a flat waveform (yellow curve), with no quantifiable enhancement. E, Histologic specimen (hematoxylin-eosin, original magnification × 10). Follow-up biopsy at 13 months confirmed necrosis in the ablated right lobe. F, Simultaneous biopsy of the untreated left lobe showed a normal prostate gland.