To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound (HIFU) in the treatment of benign prostatic hyperplasia (BPH), serial studies were conducted in 150 BPH patients before and 30 min, 1, 2, 6 and 12 month(s) after Sonablate-500 HIFU treatment. A silicon-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score (IPSS), quality of life (QOL), uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month(s) (P<0.01). Maximum urine flow rate (6.0 to 17.2 mL/s, P<0.01), PVR (75.0 to 30.3, P<0.01) and prostatic volume (65.0 to 38.1 mL, P<0.05) were significantly improved 12 months after the operation. Recurrent urinary retention (n=2) and urethrorectal fistula (n=1) occurred at the 15(th) postoperative day. The duration of the HIFU prostate ablation was 25-90 min. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonablate-500 HIFU is safe and effective.
Prostatic Hyperplasia/diagnosis ; Prostatic Hyperplasia/*therapy ; Ultrasound, High-Intensity Focused, Transrectal/adverse effects ; Ultrasound, High-Intensity Focused, Transrectal/instrumentation ; Ultrasound, High-Intensity Focused, Transrectal/*methods

It has been a long time since ultrasound hyperthermia began to be used in the clinical management of cancers and benign diseases. Numerous biological and clinical investigations have demonstrated that: hyperthermia in the range of 41-45 degrees C can significantly enhance clinical response to radiation therapy and chemotherapy, and high-temperature hyperthermia (greater than 65 degrees C) alone is now being used as an alternative to conventional invasive surgery for selective tissue destruction, causing tumor coagulation and necrosis. As a promising noninvasive and effective local therapy, HIFU has attracted great attention. China is advanced in the clinical applications of HIFU. This article gives an introduction of the development and applications of ultrasound hyperthermia technology, and also provides a general review of a selection of ultrasound hyperthermia systems both in clinical use and under development.
Equipment Design ; Humans ; Hyperthermia, Induced ; instrumentation ; methods ; Neoplasms ; therapy ; Ultrasonics ; Ultrasound, High-Intensity Focused, Transrectal

According to the hardware characters of the high intensive focused ultrasound (HIFU) serial-parallel robots, this paper presents an algorithm of 2-grade interpolation scheme which includes the rough and fine interpolations. Both pre-acceleration and post-acceleration are employed to meet the restrictive requirements of coordinated dynamic performance and the detailed procedure of the interpolation algorithm is given too.
Algorithms ; Artificial Intelligence ; Computer Simulation ; Equipment Design ; Humans ; Robotics ; Ultrasound, High-Intensity Focused, Transrectal ; instrumentation ; methods

High intensity focused ultrasound (HIFU) has become a new developed micro-invasive surgical treatment of tumor, which is a hot topic in basic and applied research field. HIFU has shown its unique advantages including micro-invasion and curative effect during the treatment of several kinds of superficial tumor, e. g. mammary cancer. Based on the cellular thermo-necrotic theory, the expression of omega value was introduced to establish the mathematic model of the necrosed field formed in HIFU treatment progress. A non-interferential and self-focused system with multi-transducer was used to verify the theoretical model. Results of this study proved that the necrosed field mathematic model can simulate the actual heating progress. The model of this study may predict the practical value of the necrosed field as well as the time needed to take shape.
Breast Neoplasms ; pathology ; therapy ; Humans ; Models, Biological ; Necrosis ; Neoplasms ; pathology ; therapy ; Ultrasonic Therapy ; methods ; Ultrasound, High-Intensity Focused, Transrectal ; methods

HIFU technique has been applied in clinic tumor therapy for over ten years. It is the important indication of a new development stage of the ultrasound in medicine. In the paper, the present status of HIFU for tumor treatment is introduced and its future development is discussed too.
Equipment Design ; Humans ; Magnetic Resonance Imaging ; Neoplasms ; therapy ; Tomography, X-Ray Computed ; Transducers ; Ultrasound, High-Intensity Focused, Transrectal ; instrumentation ; methods

OBJECTIVETo evaluate the effect of high intensity focused ultrasound (HIFU) for liver cancer.

METHODSHIFU treatment was performed in 44 liver cancer patients under general anesthesia and ultrasound positioning. Before and after HIFU treatment, the clinical symptoms, liver functional tests, AFP and MRI were evaluated.

RESULTSAfter HIFU treatment, the remission rate of clinical symptoms was 87.5% (28/32), with the scanty ascites in 3 patients disappeared. ALT (79.73 +/- 12.31 U/L) and AST (103.47 +/- 24.55 U/L) before HIFU were reduced to normal in 84.6% (22/26) and 73.5% (25/34) patients. AFP in 64.3% (18/28) patients decreased > or = 50% of the original value. After HIFU, MRI showed coagulative necrosis and blood supply reduction or disappearance of tumor in the target region.

CONCLUSIONHIFU treatment pocesses good effect on liver cancer, which will offer a considerable weight in noninvasive local treatment of hepatic tumor.

Adult ; Aged ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Ultrasonic Therapy ; Ultrasound, High-Intensity Focused, Transrectal

OBJECTIVETo investigate the efficacy and side-effects of high intensity focused ultrasound (HIFU) in the treatment of malignant solid tumors.

METHODSThirty such patients who refused surgery and or refractory to chemotherapy, were treated by HIFU alone, with the efficacy and side effects monitored in terms of vital organ signs observation, functional assay of important organs, imaging examinations: digital subtraction angiography (DSA), CT, MRI, single photoemission computed tomography (SPECT), large core needle biopsy, complications or metastasis.

RESULTSAfter HIFU therapy, the vital signs remained stable and the function of heart, lung, kidney and liver was also normal. DSA images showed that small or larger arteries were not damaged. After a follow-up of 10 - 38 months (23.1 months), 26 patients (87%) have been alive. The volume of the tumor underwent complete regression in 10 patients. Shrinkage of tumor volume >/= 50% was observed in 13. Eight of 13 patients were examined by large core needle biopsy, all showing necrosis and/or fibrosis though 3 patients (10%) had local recurrence. Two of these were retreated again by HIFU and the locally recurrent tumor became well controlled. New metastases developed in 5 patients after HIFU therapy. Two patients suffered from peripheral nerve injuries, most of which have recovered during the follow-up. However, one patient developed skin injury.

CONCLUSIONHigh intensity focused ultrasound alone is effective and safe in the treatment of malignant solid tumors.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasms ; therapy ; Treatment Outcome ; Ultrasound, High-Intensity Focused, Transrectal

OBJECTIVETo evaluate the clinical effect of transrectal high-intensity focused ultrasound (HIFU) in the treatment of prostate cancer (PCa).

METHODSA total of 57 PCa patients, 27 localized and 30 advanced, underwent transrectal HIFU with the Sonab- late 500, the localized group treated by transrectal HIFU only, while the advanced group by transrectal HIFU combined with androgen ablation.

RESULTSFor the HIFU treatment, the mean operating time, hospital stay and follow-up were 111 mm (ranging from 86 to 153 mm), 3.2 days (ranging from 2 to 18 days) and 18 months (ranging from 6 to 30 months), respectively. The biochemical disease-free rates at 1, 2 and 3 years in the localized group were 86%, 81% and 79%, respectively. While in the advanced group, the serum prostate specific antigen (PSA) was < 4.0 microg/L in 26 cases ( < 0.51 microg/L in 20) and the prostate volume decreased more than 50% in 21 cases after treated for an average of 8 months (ranging from 3 to 24 months). After transrectal HIFU prostate ablation, the prostate volume reduced, serum PSA lowered, Qmax raised and IPSS improved significantly (P < 0.05). No serious complications occurred including severe urethrorectal fistula and incontinence.

CONCLUSIONTransrectal HIFU is a safe, effective and minimally invasive therapy for patients with prostate cancer.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; pathology ; therapy ; Treatment Outcome ; Ultrasound, High-Intensity Focused, Transrectal

Early prostate cancers are best detected with transrectal ultrasound (TRUS)-guided core biopsy of the prostate. Due to increased longevity and improved prostate cancer screening, more men are now subjected to TRUS-guided biopsy. To improve the detection rate of early prostate cancer, the current trend is to increase the number of cores obtained. The significant pain associated with the biopsy procedure is usually neglected in clinical practice. Although it is currently underutilized, the periprostatic nerve block is an effective technique to mitigate pain associated with prostate biopsy. This article reviews contemporary issues pertaining to pain during prostate biopsy and discusses the practical aspects of periprostatic nerve block.
*Biopsy, Needle ; Humans ; Lidocaine ; Male ; *Nerve Block ; Pain Measurement ; Prostate/anatomy & histology/*surgery/ultrasonography ; Prostatic Neoplasms/*pathology/ultrasonography ; Ultrasound, High-Intensity Focused, Transrectal

OBJECTIVESTo study the etiology of persistent hematospermia and to evaluate the efficacy of transrectal ultrasonography (TRUS)-guided transperineal needle aspiration and irrigation for diagnosis and treatment of persistent hematospermia.

METHODSTwelve patients were included in the study, with a mean age of (36.4 +/- 10.8) years old, and a mean duration of the disease of (13.9 +/- 6.4) months. After the expressed prostatic secretion (EPS) by prostatic massage was cultured, patients with recurrent hematospermia received TRUS-guided transperineal needle aspiration for seminal vesicle fluid (SVF), which was sent for bacteriological and cytological examination. If the EPS culture were positive, certain antibiotics according to the drug sensitivity assay were injected into the abnormal seminal vesicle(s) via TRUS-guided transperineal needle puncture. The treatment would be repeated one month later if the patients still had hematospermia. The patients were followed up every three months.

RESULTSAbnormal images were found in left seminal vesicle (SV) in 4 cases, right in 3 cases, bilateral in 2 cases, and no abnormal findings in 3 cases. The abnormal findings included: 7 cases of SV and/or ejaculatory duct dilation, 3 cases of thickening SV wall, 3 cases of calcification or calculi of SV, and 1 case of Müllerian duct cyst. SVF cultures were positive in 7 cases: methicillin-resistant Staphylococcus aureus (MRSA) 4 cases, methicillin-resistant coagulase-negative Staphylococcus (MRCNS), E. Coli, Proteus mirabilis 1 case, respectively. In five of these 7 cases, bacteriological cultures of SVF and EPS showed the same results. All patients were treated by TRUS-guided transperineal injection of certain antibiotics into SV. Seven cases were injected once, 5 cases twice. The mean follow-up period of 10 patients was (16.7 +/- 5.9) months. Hematospermia disappeared in 6 cases.

CONCLUSIONSSV infection of bacteria, especially infection of the drug resistant strains was one of the main causes of persistent hematospermia. The difficulties in treatment of persistent hematospermia were due to infection of drug resistant bacteria, calcification or calculi of SV, obstruction of ejaculatory duct. TRUS-guided transperineal aspiration of SVF was helpful to the etiologic diagnosis of persistent hematospermia.

Adult ; Drug Resistance, Bacterial ; Genital Diseases, Male ; etiology ; microbiology ; Humans ; Male ; Middle Aged ; Pilot Projects ; Seminal Vesicles ; microbiology ; Ultrasound, High-Intensity Focused, Transrectal