Ablatherm® HIFU features, treatment procedure and safety features
Worldwide, Ablatherm® HIFU is the fastest growing minimally-invasive treatment for localized prostate cancer. HIFU is a precise local treatment that can be completed in one session and that can be repeated if necessary. It is a radiation-free treatment with a low complication rate and a short period of hospitalization.
Ablatherm® HIFU device
Ablatherm® HIFU has been designed and developed to treat patients with localized prostate cancer (T1-T2) and it is an effective and curative option for those localized prostate cancer patients who represent 70% of new prostate cancer diagnosed every year. Ablatherm® HIFU is also effective for patients who have local recurrence after external radiation therapy ("salvage" treatment).
Ablatherm® HIFU is approved in Europe, Canada, Russia, Australia and South Korea. Approval processes are ongoing in many other countries. The Ablatherm® Robotic HIFU® is not currently available in the US where an IDE clinical trial is ongoing (for more information on US clinical trial).
Ablatherm® HIFU technological features : take control of your new robotic assistant
Ablatherm® HIFU probe : real-time visualization
The Ablatherm® HIFU uses separate crystals for imaging (7.5 MHz) and treatment (3 MHz). The real time 7.5 MHz transducer of Ablatherm® HIFU offers a high quality image of the prostate and 3 MHz is the best operating frequency for prostate treatment with HIFU. This ensures that optimal values are used for real time monitoring during the procedure.
The Ablatherm® HIFU uses a single treatment probe that has a focal point 45 mm from the crystal. The 3 MHz probe creates an ablation volume which size is adjustable from to 19 mm x 1.7mm x 1.7 mm to 26 mm (anterior to posterior) x 1.7 mm x 1.7 mm
Ablatherm® HIFU probe support : fully robotic HIFU device
The unique design of the Ablatherm® HIFU probe coupled with 3D motorized movements enables the probe to be easily inserted into the rectum. Probe displacements are then controlled with high precision stepper motors and encoders. Many safety features pause the treatment when required.
Treatment module : ideal patient positioning
The Ablatherm® HIFU treatment module is unique in its design and enables the patient to be positioned in an optimal position(right lateral decubitus) to avoid interference of the ultrasound waves with gas bubbles. Furthermore, the treatment module includes the Ablatherm® HIFU probe support and controls to enable probe movements.
Control module : take control of your new robotic assistant
The physician controls the Ablatherm® HIFU treatment from the control module featuring the Ablaview software that enables to plan, perform and check the treatment procedure.
Ablapak® and Ablasonic® designed for optimizing treatment efficacy and safety
- Patented fluid for optimal ultrasound transmission
- Closed system without risk of contamination
- Rectal cooling system
- Reduce prostate movements
Customized treatment protocol for each patient
3 Treatment protocols : adapted treatment strategy
Ablatherm® HIFU treatment is the sum of a defined number of adjacent lesions programmed by the surgeon. This precise technique enables the surgeon to choose different treatment options such as :
1 - Complete treatment
2 - Partial treatment
3 - Nerve-sparing treatment to preserve sexual function
The ability to choose the mode of treatment - associated with a particular power algorithm developed by Inserm (French Institute of Medical Research) - is crucial as prostatic tissue does not have the same physical and physiological properties if it has not been treated before, or if it has previously been treated with HIFU or radiotherapy (EBRT).
When treating a gland that has been irradiated, care must be taken as the dissipation of energy will be lower, owing to decreased blood flow throughout the prostate. This is a result of radiation damage to the prostate's blood supply. The same will be true, although to a different extent, for a prostate that has already undergone a previous HIFU session. The reason this is important is that if not enough time is allowed for energy to dissipate a build up can occur which could lead to rectal injury and other complications.
Therefore, HIFU can be used in 3 different treatment options:
1 - HIFU as a first-line treatment
2 - HIFU retreatment
3 - Salvage treatment after EBRT failure
Automated safety features
Patient movements detector
An infrared sensor is placed on the patient hip during Ablatherm® HIFU treatment and the software analyses the patient’s position. If the patient moves during the procedure, the treatment will be automatically paused and a warning message will appear on the computer screen. In order to restart treatment, the patient position must be checked by the surgeon. This system removes human error from the equation.
Ablatherm® HIFU treatment is performed with the patient in a right lateral decubitus position (lying on their right side) to guarantee perfect ultrasound wave transmission during the whole treatment. The right lateral decubitus position enables fluid bubbles to rise up to the top of the balloon around the probe which suppresses the risk of ultrasound waves to be reflected by air bubbles. Treatment is therefore performed with the maximum safety and efficacy during both imaging and treatment phases.
Permanent rectal wall cooling
During Ablatherm® HIFU treatment, the tissue temperature increases not only at the focal point but also throughout and adjacent to the prostate due to thermal conduction. The rectal wall is sensitive to temperature changes, justifying the need for precise rectal monitoring. To maintain acceptable temperatures throughout the rectal wall, Ablatherm® HIFU uses the following strategy:
- Active cooling of the rectal wall during treatment,
- Continuous monitoring of the temperature of the rectal wall.
Automated treatment : autofocus of the targeted area
Interoperative automated treatment
1 - Automated and precise treatment of the targeted volume
2 - Dynamic adjustment of the focal point following the rectal wall positon
3 - Real-time visualization
Altogether, these measures have reduced the occurrence of urethra-rectal fistulas with the Ablatherm® HIFU to almost nil.