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Ultrasound-Guided Treatment of Prostate Cancer: High-Intensity Focused Ultrasound

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Atlas of Ultrasonography in Urology, Andrology, and Nephrology

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Abstract

Prostate cancer (PC) shows a large prognostic spectrum, which ranges from the indolent to the lethal form and can be cured by two extreme therapies: “doing nothing” (“active surveillance”) or “destroying the prostate” (“radical surgical or radiotherapeutic treatment”). The gulf between these two extremes has been covered by the concept of focal therapy (FT), which is aimed at treating only the affected part of the prostate.

For more than 18 years, “prostatic transrectal thermo-ablation” (PTTA) with high-intensity focused ultrasound (HIFU) has been added to the therapeutic arsenal for treating PC. HIFU therapy requires the prostate tissue to increase in temperature to obtain coagulative necrosis.

This treatment, with the same aim of therapeutic efficacy as traditional therapy (consisting of surgery and radiotherapy), has different features: minimally invasive, reduced side effects (in terms of urinary incontinence and sexual impotence), adaptability to the concept of FT, and short hospitalisation.

The instruments available for the implementation of PTTA/HIFU are Ablatherm (EDAP-TMS, Lyon, France), Sonablate (FOCUS Surgery, Indianapolis, IN, USA), and Focal One (EDAP-TMS).

In 1996, the first treatments with the Ablatherm were carried out in patients with both localised PC and local recurrence after radiotherapy. The use of PTTA/HIFU has been recently proposed as a focal therapy at the initial stage of PC and as salvage therapy in the case of local recurrence after radical prostatectomy.

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Authors and Affiliations

  1. Ospedale S. Anna –Como, Via Ravona, 20, San Fermo della Battaglia, 22020, Como, Italy

    Giario Natale Conti, Antonello Paulesu & Carmen Maccagnano

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  1. Giario Natale Conti
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  2. Antonello Paulesu
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  3. Carmen Maccagnano
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Correspondence to Giario Natale Conti .

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Editors and Affiliations

  1. Department of Emergency and Organ Transplantation Urology Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy

    Pasquale Martino

  2. Division of Urology, Polytechnic University of Marche, Ancona, Italy

    Andrea B. Galosi

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Conti, G.N., Paulesu, A., Maccagnano, C. (2017). Ultrasound-Guided Treatment of Prostate Cancer: High-Intensity Focused Ultrasound. In: Martino, P., Galosi, A. (eds) Atlas of Ultrasonography in Urology, Andrology, and Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-319-40782-1_32

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  • DOI: https://doi.org/10.1007/978-3-319-40782-1_32

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40780-7

  • Online ISBN: 978-3-319-40782-1

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