hifu technology history ablatherm ® device treatment ablatherm ablatherm ® integrated imaging the...

HIFU

Technology

History

ABLATHERM®

Device

Treatment AblathermAblatherm®

INTEGRATED IMAGING

The The HIFU Treatment

for Localized Prostate Cancer

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HIFU

Technology

History

ABLATHERM®

Device

Treatment

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HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The device

The probe

Robotized

Placement

Scanning

3D imaging

Planning

Firing phase

Ultrasound

Final aspect

End

Ablatherm® HIFU :Ablatherm® HIFU : step by step by stepstep

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Ultrasound Waves Ultrasound Waves GenerationGeneration

Plane transducerUltrasound waves emission

by transducer electro-mechanical vibrations

Tissue motionTissue

heating

Acoustical pressure

+ + +- - -

Physical PrinciplePhysical Principle Treatment Description

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Focused transducer

Emitting ultrasound waves

Tissue heatingOver 85°C

Acoustical pressure

Focused Ultrasound WavesFocused Ultrasound WavesPhysical PrinciplePhysical Principle Treatment Description

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Tissue Lesion FormationTissue Lesion Formation

Thermal effects

+ Cavitation effects

+ Time exposure

= Tissue lesion

Temperature Temperature SimulationSimulation INSERM U 557INSERM U 557

Thermal Dose Thermal Dose Simulation Simulation INSERM U 557INSERM U 557

HIC TechnologyHIC TechnologyHHIFUIFU I INDUCEDNDUCED C CAVITATIONAVITATION

Physical PrinciplePhysical Principle Treatment Description

HIFU

Technology

History

ABLATHERM®

Device

Treatment

HIFU HIFU HYPERTHERMIAHYPERTHERMIA

High Temperature (>85 °C) Short Time (< 5 Sec.)

Low Temperature (< 45 °C) Long Duration (>1 Hr)

TimeTime

Temp.Temp.

Two different approaches to reach the destruction Two different approaches to reach the destruction threshold :threshold :

Temp.Temp.

TimeTime

Local Increase of Tissue Local Increase of Tissue TemperatureTemperature

BPHBPHCANCERCANCER

Physical PrinciplePhysical Principle Treatment Description

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Transducer PositioningTransducer PositioningTreatment DescriptionTreatment DescriptionPhysical Principle

Precise lesion positioningwith dynamic focusing

Sparing ofsurrounding tissue

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Lesion Distribution within the Lesion Distribution within the ProstateProstate

• Each shot consists of a burst of ultrasound waves with a duration of 5 seconds

• The focal volume is very small: 19-24 mm in length by 1.7 mm in diameter

Treatment DescriptionTreatment DescriptionPhysical Principle

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Lesion Distribution within the Lesion Distribution within the ProstateProstateTreatment DescriptionTreatment DescriptionPhysical Principle

HIFU

Technology

History

ABLATHERM®

Device

Treatment

The firing head moves until the whole targeted volume is treated

Lesion Distribution within the Lesion Distribution within the ProstateProstateTreatment DescriptionTreatment DescriptionPhysical Principle

HIFU

Technology

History

ABLATHERM®

Device

Treatment

History of the History of the Ablatherm®Ablatherm® ProjectProject

• 1989: Preliminary experiments on rats kidneys

and technology development

• 1990: Cancer treatment - feasibility: Dunning tumors

• 1991: Endorectal approach - feasibility: canine prostate

• 1993: Treatment efficacy - evaluation: PCa

• 1995: Device safety improvements

• 1996: European Multicentric Study

• 2000: Mark Ablatherm® Maxis

• 2005: Mark Ablatherm® Integrated Imaging

HIFU

Technology

History

ABLATHERM®

Device

Treatment

CE Mark CE Mark Ablatherm®Ablatherm®

Marked January 2000Marked January 2000

HIFU

Technology

History

ABLATHERM®

Device

Treatment

In excess 9000 treatments in 100 sites in In excess 9000 treatments in 100 sites in EuropeEurope

Patients treated with Ablatherm every yearPatients treated with Ablatherm every year

10001000

20002000

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Ablatherm® HIFUAblatherm® HIFU

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Device DescriptionDevice Description

RF Power

Imagingand Firing

System

Electronics

and safeties

+ Disposable

Endorectal Probe

Cooling

Motors

User Interface

Command Command ModuleModule

Treatment Treatment ModuleModule

Probe Probe ModuleModule

Patient SupportComputer

ProbeGeneral DescriptionGeneral Description

HIFU

Technology

History

ABLATHERM®

Device

Treatment

2 functions, 2 transducers

integrated in ONE probe

Imaging

Treatment

Endorectal ProbeEndorectal Probe

Real-time ultrasound imaging.

7.5 MHz high-definition image.

Electronic array technology.

A 3 MHz transducer.

Dynamic positioning with respect to rectal

wall.

Wide opening.

ProbeProbeGeneral Description

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Integrated imagingIntegrated imaging

2 different transducers with anIntegrated imaging 7.5 MHz probe

High resolutionimaging system

ProbeProbeGeneral Description

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Imaging & Treating Imaging & Treating SimultaneouslySimultaneously

From a transversal real-time image,

the 7.5 MHz electronic ultrasound transducer

can provide

an accurate 3D reconstruction

of the treatment area.

Imaging

Firing

High-energy ultrasound waves are

focused through the rectal wall to

the targeted prostate area.

ProbeProbeGeneral Description

HIFU

Technology

History

ABLATHERM®

Device

Treatment

IndicationsIndicationsPositioning TreatmentSummarySummary

Candidate for RPP

EBRT failure

Recurrence after previous HIFU

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Main Steps of a Main Steps of a TreatmentTreatment

• Probe preparation (Ablapak® disposable)

• Patient installation (Immobilization)• Prostate localization (Apex identification)

- Longitudinal imaging

- Transversal imaging• Treatment (Safety controls)• Patient removal• Probe cleaning and disinfection

Positioning TreatmentSummarySummary

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Patient Installation Patient Installation (Immobilization)(Immobilization)

Patient positioned in right lateraldecubitus position

PositioningPositioning TreatmentSummary

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Patient Installation Patient Installation (Immobilization)(Immobilization)

Patientmovement detector

PositioningPositioning TreatmentSummary

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Probe insertion Intra-rectal positioning

Prostate localization (1)Prostate localization (1)PositioningPositioning TreatmentSummary

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Prostate localization (2)Prostate localization (2)

Probe insertion Robotized movements

PositioningPositioning TreatmentSummary

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HIFU

Technology

History

ABLATHERM®

Device

Treatment

Prostate localization (3)Prostate localization (3)

Automatic imaging phase 3D reconstruction

PositioningPositioning TreatmentSummary

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Prostate localization (4)Prostate localization (4)

Automatic imaging phase 3D reconstructionPositioningPositioning TreatmentSummary

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HIFU

Technology

History

ABLATHERM®

Device

Treatment

Treatment (planning)Treatment (planning)Positioning TreatmentTreatmentSummary

Treatment area programming Firing phase

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Treatment (planning)Treatment (planning)Positioning TreatmentTreatmentSummary

Treatment area programming Firing phase

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Treatment (planning)Treatment (planning)Positioning TreatmentTreatmentSummary

Treatment area programming Firing phase

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HIFU

Technology

History

ABLATHERM®

Device

Treatment

Treatment (planning)Treatment (planning)Positioning TreatmentTreatmentSummary

Treatment area programming Firing phase

If the video doesn’t start automatically click on the window

HIFU

Technology

History

ABLATHERM®

Device

Treatment

Treatment (Safety Treatment (Safety Controls)Controls)

Main safety features

• Power / Firing sequence• Probe position• Patient movement• Rectum position• Temperature

Positioning TreatmentTreatmentSummary

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