HIFU, which stands for high intensity focused ultrasound, is a recently approved, new technology for prostate tissue ablation. Many urologists have worked with HIFU for several years in order to offer their patients a minimally invasive, treatment option for prostate cancer; either as a part of a clinical trial or at international treatment centers outside the United States.
There are currently two different medical devices that use HIFU energy to heat and destroy tissue in the prostate. The most technologically advanced HIFU device for prostate cancer is called the Sonablate. The Sonablate is a software directed device that includes a computer console, a transrectal probe and a chilling unit. The Sonablate software that physicians use to plan and execute Sonablate HIFU treatment has state-of-the-art features that make it the safest and most precise HIFU device for prostate disease available.
Using the Sonablate state-of-the-art software physicians obtain real-time images of the prostate that are used to map out and target exactly where HIFU should be delivered. Once treatment plan is mapped, HIFU energy is delivered to those areas.
One of the unique, key features that the Sonablate has is called Tissue Change Monitoring, or more simply, TCM.
What is TCM?
The most simple way to explain it is that TCM allows the treating HIFU doctor to monitor changes that happen to the tissue in the prostate after the HIFU energy has been delivered. This monitoring of tissue is important because the doctor will immediately know if enough energy has been delivered to effectively destroy the tissue.
While HIFU is being delivered, heating and destroying tissue in the prostate, physicians have the ability to monitor how the tissue is changing and reacting. The Sonablate gives unique feedback on changes to the tissue so the doctor can monitor exactly what is happening and make adjustments as needed for the best outcomes.
The more technical explanation of TCM is that it is a comparison of pre-HIFU and post-HIFU radio-frequency (RF) measurements that is used by a HIFU physician to optimize the delivery of HIFU during the prostate cancer treatment.
Since the doctor has the ability to adjust how much HIFU is delivered at anytime with the Sonablate, they can optimize treatment and maintain safety throughout the entire HIFU treatment.
TCM identifies and grades those measured changes and puts them into one of four categories. The Sonablate software then overlays the reading onto the 2D and 3D ultrasound images by displaying 4 different colors: orange, yellow, green or gray.
These colors represent the amount of tissue change that occurs.
- Green: Not enough tissue changes pre-HIFU vs Post-HIFU; the physician can treat this tissue again
- Yellow: Moderate tissue change, this site is appropriately ablated
- Orange: Large tissue change, this site is appropriately ablated
- Grey: No TCM calculation
This feedback is delivered in real-time to the HIFU physician and assists them in making better treatment decisions.
Why is TCM important?
- It is real-time feedback to the HIFU physician of how effectively the tissue in the prostate is being destroyed.
- It reduces the learning curve for HIFU physicians by giving them immediate feedback.
- It assists the HIFU physician in better customization of the HIFU procedure.
- The data shows that the TCM software increases the effectiveness of HIFU by approximately 20%.
 Toyoaki Uchida, *. T. (2015). Improved Outcomes with Advancements in High Intensity Focused Ultrasound Devices for the Treatment of Localized Prostate Cancer. THE JOURNAL OF UROLOGY®, 103-110.