[HIFU: Best Practices for Optimal Performance].
High-intensity focused ultrasound (HIFU) is a minimally invasive treatment option for selected patients with localized prostate cancer. This article is not intended as an original outcome study but as a practice-oriented expert review and institutional experience report on focal and hemiablative HIFU.
We describe patient selection, preoperative diagnostic assessment and biopsy mapping, intraoperative planning, safety margins, HIFU ablation using EDAP/Focal One(R), the double tap strategy, documentation and follow-up. Institutional practice is explicitly distinguished from evidence-based standards and consensus recommendations.
Reproducible outcomes require concordance between imaging and histological findings, an adequate safety margin around the index lesion, structured intraoperative documentation and a follow-up strategy including PSA kinetics, mpMRI and biopsy when indicated. The double tap strategy is presented as an institutionally established technical modification, with a brief summary of the available group data.
HIFU can be performed safely when carried out in a standardized manner. Treatment quality depends substantially on patient selection, treatment planning, technical execution, and post-treatment follow-up.
We describe patient selection, preoperative diagnostic assessment and biopsy mapping, intraoperative planning, safety margins, HIFU ablation using EDAP/Focal One(R), the double tap strategy, documentation and follow-up. Institutional practice is explicitly distinguished from evidence-based standards and consensus recommendations.
Reproducible outcomes require concordance between imaging and histological findings, an adequate safety margin around the index lesion, structured intraoperative documentation and a follow-up strategy including PSA kinetics, mpMRI and biopsy when indicated. The double tap strategy is presented as an institutionally established technical modification, with a brief summary of the available group data.
HIFU can be performed safely when carried out in a standardized manner. Treatment quality depends substantially on patient selection, treatment planning, technical execution, and post-treatment follow-up.
Authors
Salomon Salomon, Heckmann Heckmann, Hohenhorst Hohenhorst, Ekrutt Ekrutt, Palec Palec, Nagaraj Nagaraj
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