Abstract
Introduction
Prostate cancer (PCa) management poses challenges due to treatment-related morbidities associated with conventional therapies. Focal therapy (FT) is emerging as a promising alternative for intermediate-risk PCa, aiming to selectively target localized cancerous lesions while preserving healthy tissue. This review explores emerging FT modalities for PCa treatment, focusing on transrectal MRI-guided focused ultrasound surgery (MRgFUS), transurethral ultrasound ablation (TULSA), focal laser ablation (FLA), and histotripsy.
Methods
A comprehensive literature search was conducted to identify studies and clinical trials related to FT. Relevant articles were selected and data were synthesized to provide insights into the efficacy and feasibility of MRgFUS, TULSA, FLA, and histotripsy for FT.
Results
MRgFUS utilizes transrectal high-intensity focused ultrasound under MRI guidance to selectively ablate cancerous tissue, demonstrating positive outcomes in oncologic control and preservation of urinary and sexual function. TULSA employs transurethral delivery of high-intensity ultrasound energy under MRI guidance, showing promising results for whole gland treatment. FLA benefits from precise ablation, indicating effectiveness in tumor destruction while preserving quality-of-life. Histotripsy, a mechanical ablation method, exhibits promise by inducing tissue fractionation through bubble activity, offering advantages such as tissue selectivity and real-time treatment monitoring.
Conclusion
Emerging FT modalities present promising alternatives for the management of localized PCa, offering personalized treatment. Further research and clinical trials are warranted to establish the long-term efficacy of these techniques in PCa management.
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Fig. 1: Imaging findings of a 67-year-old patient with biopsy-proven Gleason 7 (3 + 4) prostate cancer treated by transrectal MRgFUS.
Fig. 2: A 69 year-old man with PSA 6.4 ng/ml and biopsy-proven GG2 prostate cancer in a PIRADS 4 lesion at the left mid-gland and GG1 cancer bilaterally was treated with whole gland TULSA.
Fig. 3: Imaging findings of a 59-year-old patient with biopsy-proven Gleason 7 (3 + 4) prostate cancer treated by transperineal MRgFLA.
Fig. 4: Ex vivo human prostate cancer tissue treated with boiling histotripsy.
References
Hopstaken JS, Bomers JGR, Sedelaar MJP, Valerio M, Fütterer JJ, Rovers MM. An Updated Systematic Review on Focal Therapy in Localized Prostate Cancer: What Has Changed over the Past 5 Years? Eur Urol. 2022;81:5–33.
PubMedGoogle Scholar
Sekhoacha M, Riet K, Motloung P, Gumenku L, Adegoke A, Mashele S. Prostate Cancer Review: Genetics, Diagnosis, Treatment Options, and Alternative Approaches. Molecules. 2022;27:5730.
CASPubMedPubMed CentralGoogle Scholar
Baboudjian M, Breda A, Rajwa P, Gallioli A, Gondran-Tellier B, Sanguedolce F, et al. Active Surveillance for Intermediate-risk Prostate Cancer: A Systematic Review, Meta-analysis, and Metaregression. Eur Urol Oncol. 2022;5:617–27.
PubMedGoogle Scholar
Li P, You S, Nguyen C, Wang Y, Kim J, Sirohi D, et al. Genes involved in prostate cancer progression determine MRI visibility. Theranostics. 2018;8:1752–65.
CASPubMedPubMed CentralGoogle Scholar
Wibmer AG, Lefkowitz RA, Lakhman Y, Chaim J, Nikolovski I, Sala E, et al. MRI-Detectability of Clinically Significant Prostate Cancer Relates to Oncologic Outcomes After Prostatectomy. Clin Genitourin Cancer. 2022;20:319–25.
PubMedPubMed CentralGoogle Scholar
Alabousi M, Ghai S, Haider MA. MRI-guided Minimally Invasive Focal Therapies for Prostate Cancer. Radiology. 2023;309:e230431.
PubMedGoogle Scholar
Ghai S, Perlis N. Beyond the AJR: MRI-Guided Focused Ultrasound Focal Therapy for Intermediate-Risk Prostate Cancer. Am J Roentgenol. 2023;220:610–610.
Google Scholar
Tay KJ, Scheltema MJ, Ahmed HU, Barret E, Coleman JA, Dominguez-Escrig J, et al. Patient selection for prostate focal therapy in the era of active surveillance: an International Delphi Consensus Project. Prostate Cancer Prostatic Dis. 2017;20:294–9.
CASPubMedGoogle Scholar
Jaipuria J, Ahmed HU. Clinical and pathologic characteristics to select patients for focal therapy or partial gland ablation of nonmetastatic prostate cancer. Curr Opin Urol. 2022;32:224–30.
PubMedGoogle Scholar
Eastham JA, Boorjian SA, Kirkby E. Clinically Localized Prostate Cancer: AUA/ASTRO Guideline. J Urol. 2022;208:505–7.
PubMedGoogle Scholar
Bomers JGR, Sedelaar JPM, Barentsz JO, Fütterer JJ. MRI-Guided Interventions for the Treatment of Prostate Cancer. Am J Roentgenol. 2012;199:714–20.
Google Scholar
Le Nobin J, Rosenkrantz AB, Villers A, Orczyk C, Deng F-M, Melamed J, et al. Image Guided Focal Therapy for Magnetic Resonance Imaging Visible Prostate Cancer: Defining a 3-Dimensional Treatment Margin Based on Magnetic Resonance Imaging Histology Co-Registration Analysis. J Urol. 2015;194:364–70.
PubMedPubMed CentralGoogle Scholar
Pooli A, Johnson DC, Shirk J, Markovic D, Sadun TY, Sisk AE, et al. Predicting Pathological Tumor Size in Prostate Cancer Based on Multiparametric Prostate Magnetic Resonance Imaging and Preoperative Findings. J Urol. 2021;205:444–51.
PubMedGoogle Scholar
Khokhlova VA, Fowlkes JB, Roberts WW, Schade GR, Xu Z, Khokhlova TD, et al. Histotripsy methods in mechanical disintegration of tissue: towards clinical applications. Int J Hyperthermia. 2015;31:145–62.
PubMedPubMed CentralGoogle Scholar
Rosnitskiy PB, Tsysar SA, Karzova MM, Buravkov SV, Malkov PG, Danilova NV, et al. Pilot ex vivo study on non-thermal ablation of human prostate adenocarcinoma tissue using boiling histotripsy. Ultrasonics. 2023;133:107029.
CASPubMedPubMed CentralGoogle Scholar
Schade GR, Keller J, Ives K, Cheng X, Rosol TJ, Keller E, et al. Histotripsy focal ablation of implanted prostate tumor in an ACE-1 canine cancer model. J Urol. 2012;188:1957–64.
PubMedPubMed CentralGoogle Scholar
Napoli A, Anzidei M, Ciolina F, Marotta E, Cavallo Marincola B, Brachetti G, et al. MR-guided high-intensity focused ultrasound: current status of an emerging technology. Cardiovasc Intervent Radiol. 2013;36:1190–203.
PubMedGoogle Scholar
Ghai S, Perlis N, Lindner U, Hlasny E, Haider MA, Finelli A, et al. Magnetic resonance guided focused high frequency ultrasound ablation for focal therapy in prostate cancer - phase 1 trial. Eur Radiol. 2018;28:4281–7.
PubMedGoogle Scholar
Ghai S, Louis AS, Van Vliet M, Lindner U, Haider MA, Hlasny E, et al. Real-Time MRI-Guided Focused Ultrasound for Focal Therapy of Locally Confined Low-Risk Prostate Cancer: Feasibility and Preliminary Outcomes. AJR Am J Roentgenol. 2015;205:W177–184.
PubMedGoogle Scholar
Orihuela E, Pow-Sang M, Motamedi M, Cowan DF, Warren MM. Mechanism of healing of the human prostatic urethra following thermal injury. Urology. 1996;48:600–8.
CASPubMedGoogle Scholar
Tay KJ, Cheng CWS, Lau WKO, Khoo J, Thng CH, Kwek JW. Focal Therapy for Prostate Cancer with In-Bore MR-guided Focused Ultrasound: Two-Year Follow-up of a Phase I Trial-Complications and Functional Outcomes. Radiology. 2017;285:620–8.
PubMedGoogle Scholar
Ehdaie B, Tempany CM, Holland F, Sjoberg DD, Kibel AS, Trinh Q-D, et al. MRI-Guided Focused Ultrasound (MRgFUS) Focal Therapy for Intermediate-Risk Prostate Cancer: A Phase 2b Multicenter Study. Lancet Oncol. 2022;23:910–8.
CASPubMedPubMed CentralGoogle Scholar
Ghai S, Finelli A, Corr K, Chan R, Jokhu S, Li X, et al. MRI-guided Focused Ultrasound Ablation for Localized Intermediate-Risk Prostate Cancer: Early Results of a Phase II Trial. Radiology. 2021;298:695–703.
PubMedGoogle Scholar
Ghai S, Finelli A, Corr K, Lajkosz K, McCluskey S, Chan R, et al. MRI-guided Focused Ultrasound Focal Therapy for Intermediate-Risk Prostate Cancer: Final Results from a 2-year Phase II Clinical Trial. Radiology. 2024;310:e231473.
PubMedGoogle Scholar
Napoli A, Alfieri G, Scipione R, Leonardi A, Fierro D, Panebianco V, et al. High-intensity focused ultrasound for prostate cancer. Expert Rev Med Devices. 2020;17:427–33.
CASPubMedGoogle Scholar
Ahmed HU, Dickinson L, Charman S, Weir S, McCartan N, Hindley RG, et al. Focal Ablation Targeted to the Index Lesion in Multifocal Localised Prostate Cancer: a Prospective Development Study. Eur Urol. 2015;68:927–36.
PubMedGoogle Scholar
Feijoo ERC, Sivaraman A, Barret E, Sanchez-Salas R, Galiano M, Rozet F, et al. Focal High-intensity Focused Ultrasound Targeted Hemiablation for Unilateral Prostate Cancer: A Prospective Evaluation of Oncologic and Functional Outcomes. Eur Urol. 2016;69:214–20.
PubMedGoogle Scholar
Huber PM, Afzal N, Arya M, Boxler S, Dudderidge T, Emberton M, et al. Focal HIFU therapy for anterior compared to posterior prostate cancer lesions. World J Urol. 2021;39:1115–9.
PubMedGoogle Scholar
Chin JL, Billia M, Relle J, Roethke MC, Popeneciu IV, Kuru TH, et al. Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Tissue in Patients with Localized Prostate Cancer: A Prospective Phase 1 Clinical Trial. Eur Urol. 2016;70:447–55.
PubMedGoogle Scholar
Chopra R, Colquhoun A, Burtnyk M, N’djin WA, Kobelevskiy I, Boyes A, et al. MR imaging-controlled transurethral ultrasound therapy for conformal treatment of prostate tissue: initial feasibility in humans. Radiology. 2012;265:303–13.
PubMedGoogle Scholar
Nair SM, Hatiboglu G, Relle J, Hetou K, Hafron J, Harle C, et al. Magnetic resonance imaging-guided transurethral ultrasound ablation in patients with localised prostate cancer: 3-year outcomes of a prospective Phase I study. BJU Int. 2021;127:544–52.
CASPubMedGoogle Scholar
Klotz L, Pavlovich CP, Chin J, Hatiboglu G, Koch M, Penson D, et al. Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer. J Urol. 2021;205:769–79.
PubMedGoogle Scholar
Ramsay E, Mougenot C, Staruch R, Boyes A, Kazem M, Bronskill M, et al. Evaluation of focal ablation of MRI-defined prostate cancer using MRI-controlled transurethral ultrasound therapy with prostatectomy as the reference standard. J Urol. 2017;197:255–61.
PubMedGoogle Scholar
Anttinen M, Mäkelä P, Suomi V, Kiviniemi A, Saunavaara J, Sainio T, et al. Feasibility of MRI-guided transurethral ultrasound for lesion-targeted ablation of prostate cancer. Scand J Urol. 2019;53:295–302.
CASPubMedGoogle Scholar
Anttinen M, Mäkelä P, Viitala A, Nurminen P, Suomi V, Sainio T, et al. Salvage Magnetic Resonance Imaging–guided Transurethral Ultrasound Ablation for Localized Radiorecurrent Prostate Cancer: 12-Month Functional and Oncological Results. Eur Urol Open Sci. 2020;22:79–87.
PubMedPubMed CentralGoogle Scholar
Lee T, Mendhiratta N, Sperling D, Lepor H. Focal Laser Ablation for Localized Prostate Cancer: Principles, Clinical Trials, and Our Initial Experience. Rev Urol. 2014;16:55–66.
PubMedPubMed CentralGoogle Scholar
Oto A, Sethi I, Karczmar G, McNichols R, Ivancevic MK, Stadler WM, et al. MR imaging-guided focal laser ablation for prostate cancer: phase I trial. Radiology. 2013;267:932–40.
PubMedGoogle Scholar
Lindner U, Lawrentschuk N, Trachtenberg J. Focal laser ablation for localized prostate cancer. J Endourol. 2010;24:791–7.
PubMedGoogle Scholar
Lindner U, Lawrentschuk N, Weersink RA, Davidson SRH, Raz O, Hlasny E, et al. Focal laser ablation for prostate cancer followed by radical prostatectomy: validation of focal therapy and imaging accuracy. Eur Urol. 2010;57:1111–4.
PubMedGoogle Scholar
Lindner U, Weersink RA, Haider MA, Gertner MR, Davidson SRH, Atri M, et al. Image guided photothermal focal therapy for localized prostate cancer: phase I trial. J Urol. 2009;182:1371–7.
CASPubMedGoogle Scholar
Raz O, Haider MA, Davidson SRH, Lindner U, Hlasny E, Weersink R, et al. Real-time magnetic resonance imaging-guided focal laser therapy in patients with low-risk prostate cancer. Eur Urol. 2010;58:173–7.
PubMedGoogle Scholar
Eggener SE, Yousuf A, Watson S, Wang S, Oto A. Phase II Evaluation of Magnetic Resonance Imaging Guided Focal Laser Ablation of Prostate Cancer. J Urol. 2016;196:1670–5.
PubMedGoogle Scholar
Lepor H, Llukani E, Sperling D, Fütterer JJ. Complications, Recovery, and Early Functional Outcomes and Oncologic Control Following In-bore Focal Laser Ablation of Prostate Cancer. Eur Urol. 2015;68:924–6.
PubMedGoogle Scholar
Al-Hakeem Y, Raz O, Gacs Z, Maclean F, Varol C. Magnetic resonance image-guided focal laser ablation in clinically localized prostate cancer: safety and efficacy. ANZ J Surg. 2019;89:1610–4.
PubMedGoogle Scholar
Walser E, Nance A, Ynalvez L, Yong S, Aoughsten JS, Eyzaguirre EJ, et al. Focal Laser Ablation of Prostate Cancer: Results in 120 Patients with Low to Intermediate Risk Disease. J Vasc Interv Radiol. 2019;30:401–9.e2.
PubMedPubMed CentralGoogle Scholar
Chao B, Lepor H. 5-Year Outcomes Following Focal Laser Ablation of Prostate Cancer. Urology. 2021;155:124–9.
PubMedGoogle Scholar
Mehralivand S, George AK, Hoang AN, Rais-Bahrami S, Rastinehad AR, Lebastchi AH, et al. MRI-guided focal laser ablation of prostate cancer: a prospective single-arm, single-center trial with 3 years of follow-up. Diagn Interv Radiol. 2021;27:394–400.
PubMedPubMed CentralGoogle Scholar
Magee D, Perlis N, Corr K, Chan R, Gertner M, Zisman A, et al. Salvage interstitial laser thermal therapy under MRI guidance (MRgFLA) for high-intensity focal ultrasound (HIFU) recurrences: feasibility study. Clin Imaging. 2021;76:217–21.
PubMedGoogle Scholar
Natarajan S, Jones TA, Priester AM, Geoghegan R, Lieu P, Delfin M, et al. Focal Laser Ablation of Prostate Cancer: Feasibility of Magnetic Resonance Imaging-Ultrasound Fusion for Guidance. J Urol. 2017;198:839–47.
PubMedGoogle Scholar
van Riel LAMJG, van Kollenburg RAA, Vis AN, van Leeuwen PJ, de Reijke TM, de Bruin DM, et al. Safety and Feasibility of Soractelite Transperineal Focal Laser Ablation for Prostate Cancer and Short-term Quality of Life Analysis from a Multicenter Pilot Study. Eur Urol Open Sci. 2022;39:48–54.
PubMedPubMed CentralGoogle Scholar
Genesis Research LLC. Investigator Initiated Trial to Further Evaluate the Safety and Efficacy of Trans-perineal Focal Laser Ablation of Localized Prostate Cancer Using High Frequency Micro-ultrasound Imaging. 2023. https://clinicaltrials.gov/study/NCT05826470. Accessed 31 Dec 2023.
Ghai S, Perlis N, Atallah C, Jokhu S, Corr K, Lajkosz K, et al. Comparison of Micro-US and Multiparametric MRI for Prostate Cancer Detection in Biopsy-Naive Men. Radiology. 2022;305:390–8.
PubMedGoogle Scholar
Cornud F, Lefevre A, Flam T, Dumonceau O, Galiano M, Soyer P, et al. MRI-directed high-frequency (29MhZ) TRUS-guided biopsies: initial results of a single-center study. Eur Radiol. 2020;30:4838.
CASPubMedGoogle Scholar
Wenger H, Yousuf A, Oto A, Eggener S. Laser Ablation as Focal Therapy for Prostate Cancer. Curr Opin Urol. 2014;24:236–40.
PubMedPubMed CentralGoogle Scholar
van Luijtelaar A, Greenwood BM, Ahmed HU, Barqawi AB, Barret E, Bomers JGR, et al. Focal laser ablation as clinical treatment of prostate cancer: report from a Delphi consensus project. World J Urol. 2019;37:2147–53.
PubMedPubMed CentralGoogle Scholar
University Health Network, Toronto. MRI Guided Focal Laser Ablation of Prostate Cancer. 2020. https://clinicaltrials.gov/study/NCT03650595. Accessed 31 Dec 2023.
Radboud University Medical Center. Magnetic Resonance Imaging-guided Focal Laser Ablation of Prostate Cancer. 2022. https://clinicaltrials.gov/study/NCT05370482. Accessed 31 Dec 2023.
Woodrum DA. A Pilot Study to Evaluate Magnetic Resonance Thermal Image-Guided Focal Laser Ablation of Prostate Cancer Tumors. 2023. https://clinicaltrials.gov/study/NCT02600156. Accessed 31 Dec 2023.
Dubinsky TJ, Khokhlova TD, Khokhlova V, Schade GR. Histotripsy: The Next Generation of High-Intensity Focused Ultrasound for Focal Prostate Cancer Therapy. J Ultrasound Med. 2020;39:1057–67.
PubMedGoogle Scholar
Parsons JE, Cain CA, Abrams GD, Fowlkes JB. Pulsed cavitational ultrasound therapy for controlled tissue homogenization. Ultrasound Med Biol. 2006;32:115–29.
PubMedGoogle Scholar
Khokhlova TD, Canney MS, Khokhlova VA, Sapozhnikov OA, Crum LA, Bailey MR. Controlled tissue emulsification produced by high intensity focused ultrasound shock waves and millisecond boiling. J Acoust Soc Am. 2011;130:3498–510.
CASPubMedPubMed CentralGoogle Scholar
Bader KB, Vlaisavljevich E, Maxwell AD. For Whom the Bubble Grows: Physical Principles of Bubble Nucleation and Dynamics in Histotripsy Ultrasound Therapy. Ultrasound Med Biol. 2019;45:1056–80.
PubMedPubMed CentralGoogle Scholar
Simon JC, Sapozhnikov OA, Khokhlova VA, Wang Y-N, Crum LA, Bailey MR. Ultrasonic atomization of tissue and its role in tissue fractionation by high intensity focused ultrasound. Phys Med Biol. 2012;57:8061–78.
PubMedPubMed CentralGoogle Scholar
Luo J, Ren X, Yu T. Efficacy of extracorporeal ultrasound-guided high intensity focused ultrasound: An evaluation based on controlled trials in China. Int J Radiat Biol. 2015;91:480–5.
CASPubMedGoogle Scholar
Khokhlova TD, Wang Y-N, Simon JC, Cunitz BW, Starr F, Paun M, et al. Ultrasound-guided tissue fractionation by high intensity focused ultrasound in an in vivo porcine liver model. Proc Natl Acad Sci USA. 2014;111:8161–6.
CASPubMedPubMed CentralGoogle Scholar
Lafond M, Asquier N, Mestas J-LA, Carpentier A, Umemura S-I, Lafon C. Evaluation of a Three-Hydrophone Method for 2-D Cavitation Localization. IEEE Trans Ultrason Ferroelectr Freq Control. 2018;65:1093–101.
PubMedGoogle Scholar
Hall TL, Hempel CR, Wojno K, Xu Z, Cain CA, Roberts WW. Histotripsy of the prostate: dose effects in a chronic canine model. Urology. 2009;74:932–7.
PubMedGoogle Scholar
Lake AM, Hall TL, Kieran K, Fowlkes JB, Cain CA, Roberts WW. Histotripsy: minimally invasive technology for prostatic tissue ablation in an in vivo canine model. Urology. 2008;72:682–6.
PubMedGoogle Scholar
Wheat JC, Hall TL, Hempel CR, Cain CA, Xu Z, Roberts WW. Prostate histotripsy in an anticoagulated model. Urology. 2010;75:207–11.
PubMedGoogle Scholar
Hempel CR, Hall TL, Cain CA, Fowlkes JB, Xu Z, Roberts WW. Histotripsy fractionation of prostate tissue: local effects and systemic response in a canine model. J Urol. 2011;185:1484–9.
PubMedPubMed CentralGoogle Scholar
Schade GR, Styn NR, Hall TL, Roberts WW. Endoscopic assessment and prediction of prostate urethral disintegration after histotripsy treatment in a canine model. J Endourol. 2012;26:183–9.
PubMedPubMed CentralGoogle Scholar
Schade GR, Hall TL, Roberts WW. Urethral-sparing histotripsy of the prostate in a canine model. Urology. 2012;80:730–5.
PubMedGoogle Scholar
Radboud University Medical Center. Effectiveness of Focal Therapy in Men With Prostate Cancer. 2024. https://clinicaltrials.gov/study/NCT06223295. Accessed 31 Dec 2023.
Baco E. A Randomized Control Trial of Focal Prostate Ablation Versus Radical Prostatectomy. 2021. https://clinicaltrials.gov/study/NCT03668652. Accessed 31 Dec 2023.
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Author notes
These authors contributed equally: Sangeet Ghai, Tiffany T. Ni
Authors and Affiliations
Joint Department of Medical Imaging, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
Sangeet Ghai & Tiffany T. Ni
James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Christian P. Pavlovich
Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
Jurgen J. Futterer
Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
George R. Schade
Department of Surgery, Division of Urology, McGill University, Montreal, QC, Canada
Rafael Sanchez-Salas
Department of Radiology, Clinique de l’Alma, 75007, Paris, France
Francois Cornud
Department of Surgery, Section of Urology, University of Chicago, Chicago, IL, USA
Scott Eggener
Halo Diagnostics, Indian Wells, CA, USA
John F. Feller
Department of Urology, University of Michigan, Ann Arbor, MI, USA
Arvin K. George
Department of Urology, University Hospital, Lille, France
Arnauld Villers
Department of Urology, Istanbul Medipol University, Istanbul, Turkey
Jean de la Rosette
Bashkir State Medical University, Ufa, Russia
Jean de la Rosette
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Sangeet Ghai
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Contributions
SG conceived the study, and TN and SG wrote the initial manuscript draft and prepared the manuscript revisions. CP, JF, GS, RS, FC, SE, JF, AG, AV, and JR provided expert feedback and revisions on the manuscript content.
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Correspondence to Sangeet Ghai.
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SG served as Principal Investigator for Phase I and Phase II studies assessing MRgFUS sponsored by Insightec Ltd. GS currently serves as a consultant to EDAP Technomed Inc., an advisor to Immunity Bio, owns intellectual property licensed to Petal Surgical, and his work has been funded by the NIH (NIH R01DK119310 and R01CA258581) and American Cancer Society (RSG2117101). SE previously served as a member of the medical advisory board for Profound Medical approximately from the years 2016-2020. All other co-authors declare no potential competing interests.
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Ghai, S., Ni, T.T., Pavlovich, C.P. et al. New kids on the block: MRI guided transrectal focused US, TULSA, focal laser ablation, histotripsy – a comprehensive review. Prostate Cancer Prostatic Dis (2025). https://doi.org/10.1038/s41391-025-00956-x
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Received:14 May 2024
Revised:07 February 2025
Accepted:24 February 2025
Published:27 March 2025
DOI:https://doi.org/10.1038/s41391-025-00956-x
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