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. 2022 Jun;25(2):225-232.
doi: 10.1007/s40477-021-00594-8. Epub 2021 May 24.

The real-time intraoperative guidance of the new HIFU Focal-One® platform allows to minimize the perioperative adverse events in salvage setting

Enrico Checcucci  1   2   3 , Stefano De Luca  4 , Federico Piramide  4 , Diletta Garrou  5   4 , Alessandra Mosca  6 , Andrea Galla  7 , Gaetano Belli  7 , Filippo Russo  8 , Pasquale Rescigno  9 , Carlo Poti  10 , Daniele Amparore  4 , Paolo Verri  4 , Gabriele Volpi  4 , Matteo Manfredi  4 , Cristian Fiori #  4 , Francesco Porpiglia #  4
Affiliations

The real-time intraoperative guidance of the new HIFU Focal-One® platform allows to minimize the perioperative adverse events in salvage setting

Enrico Checcucci et al. J Ultrasound. 2022 Jun.

Abstract

Purpose: To assess the use of the new Focal-One® HIFU platform in salvage setting to evaluate the occurrence of postoperative complications.

Methods: Patients who underwent salvage HIFU (sHIFU) with Focal-One® platform were enrolled prospectively (Candiolo cancer institute-FPO IRCCS; registry number: 258/2018). Perioperative and postoperative outcomes (in terms of oncological and functional ones) were recorded during the first year of follow-up. In particular postoperative complications were classified according to Clavien-Dindo system.

Results: 20 patients were enrolled. No grade 3 complications were recorded. Referring to grade 2 complications, eight patients reported urgency after 3 months of follow-up, and in 4 cases, a low urinary tract infection occurred. Evaluating the impact of sHIFU on patients' sexual potency, micturition and quality of life, no significant deterioration was recorded during the follow-up as proven using the ANOVA analysis for repeated measurements. Only two patient had a biochemical failure after 12 months of follow-up.

Conclusions: The real-time intraoperative guidance with Focal-One® platform, allows a continuous monitoring and tailoring of the treatment, with a minimization of the adverse events even in a salvage setting.

Keywords: HIFU; Magnetic resonance imaging; PSMA-PET/CT; Prostate cancer; Salvage therapy.

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Conflict of interest statement

All authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Graphical representation of ANOVA trend analysis for International Prostatic Symptoms Score (IPSS), Quality of Life (QoL), International Index of Erectile Function (IIEF-5) scores and PSA values
Fig. 2
Fig. 2
Patient #3 pre-sHIFU mp-MRI revealed a suspicious area (PI-RR 4) of 8 mms at the level of prostate apex, posteriorly located, right sided that was confirmed by PSMA-PET/CT scan. After 12 months of follow-up both mp-MRI and PSMA-PET/CT scan were negative
Fig. 3
Fig. 3
a During treatment planning the contouring was done with no more than 2 foci over the prostate capsule; b during the active phase of the treatment a mismatch between the contouring and the prostate bounder was detected by the operator; therefore (c) the surgeon had the possibility to stop the treatment. Then, the surgeon can modulate the planning again (d) in order to perform an adequate treatment (e, f)
See this image and copyright information in PMC

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