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