HIFU Treatment does not involve surgery but instead uses a High Intensity Focused Ultrasound (HIFU) beam which safely and effectively destroys the prostate tissue with minimal side effects. 

After reviewing the information on this website, you and your family will have a better understanding of prostate cancer treatment options and whether Ablatherm HIFU may be the right prostate cancer treatment for you.In November 2015, the FDA granted full approval to EDAP Ablatherm HIFU.... MORE BELOW

Prostate Cancer Treatment



Eliminating Prostate Cancer

 HiFU, which is short for high intensity focused ultrasound, is the focusing of high intensity sound waves to create heat at a specific point, called the focal point. With state-of-the-art technology, HiFU can be used to destroy targeted tissue during a procedure that is individually customized for each patient's prostate cancer treatment. When HiFU energy is delivered to a specific location within the body, the tissue temperature at the focal point is elevated to nearly 195 degrees Fahrenheit in a matter of seconds, resulting in tissue destruction, while the tissue outside the focal point remains unharmed. 



Robatic HIFU


 HIFU is a revolutionary form of treatment for organ-confined disease that allows treatment of prostate cancer without radiation and without having to make a surgical incision in the body.The technology, High Intensity Focused Ultrasound (HIFU), helped over 40,000 patients in 22 years. 


American HIFU is the leading provider for HIFU in the United States


 HIFU Treatment does not involve surgery but instead uses a High Intensity Focused Ultrasound (HIFU) beam which safely and effectively destroys the prostate tissue with minimal side effects. 

 After reviewing the information on this website, you and your family will have a better understanding of prostate cancer treatment options and whether Ablatherm HIFU may be the right prostate cancer treatment for you.In November 2015, the FDA granted full approval to EDAP Ablatherm HIFU to carry out prostate ablation treatment in the USA. Learn more about the FDA Approval

What is it?




What is HIFU?

 The HIFU therapy allows the clinician to get a live image of the prostate and cancerous tumor, then target and kill the tumor with a beam of clean ultrasound energy, which effectively destroys the cancerous tissue without affecting the surrounding healthy tissue. HIFU energy works like a magnifying glass and sunlight. Using a magnifying glass, you can focus energy of the sun and concentrate it over a focus point while allowing safe and harmless energy transfer over the entire course of that beam until it reaches the point of concentration.   HIFU, which stand for high intensity focused ultrasound, is the focusing of sound waves to create heat at a specific point; this is called the focal point.  HIFU is used to heat and destroy targeted tissue during an outpatient procedure; individually customized for each patient’s prostate cancer treatment.

The most advanced and state-of-the-art medical device, 


Why Choose HIFU?

 HIFU is a relatively new option for the treatment of prostate cancer and finally available in the United States as of November 2015. In most cases, HIFU is a 1-3 hour, one-time procedure performed on an out-patient basis under anesthesia. Unlike radiation, HIFU is non-ionizing; this means that HIFU may also be used as a salvage technique if other prostate cancer treatments fail. With HIFU, there is no blood loss and minimal recovery time. In addition, HIFU can be used in focal therapy, like in radiation or surgery. Focal therapy allows the HIFU physician to treat just the small area in the prostate containing cancer while leaving the rest of the prostate unharmed, in men with low volume disease. Focal therapy further reduces the side effect risks of the procedure and makes HIFU the least invasive procedure offered for prostate cancer. 

 When HIFU is being performed, the treatment can be monitored using real time imaging captured by the treatment delivery device. A technology called TCM/tissue change monitoring confirms the heat generated from the ultrasound energy is raising the target temperature and destroying the cancer tissue while leaving the surrounding tissue unharmed. This provides pinpoint accuracy throughout the procedure, making HIFU highly effective when compared to other, more invasive procedures. Another reason why HIFU preserves erectile function at a better rate than radiation therapy is the steep temperature gradient created using the ultrasound energy of HIFU. When HIFU targets a lesion, only that lesion is affected while tissue 1 cm away remains unheated. This is unique to ultrasound energy heat as radiation energy does not create that gradient and although the radiation energy is aimed at a specific lesion, the surrounding tissue does get heated up and affected as well. 


About HIFU

 Since many men are diagnosed with early-stage prostate cancer, often, they must choose between a risky surgical intervention, no treatment at all, or simply monitoring the disease.   HIFU, which stands for high intensity focused ultrasound, offers a less invasive, lower risk method of eliminating the prostate in the body with fewer complications.Physicians can target and treat small amounts of tissue, minimizing damage to nerves around the prostate responsible for preserving potency.  

ewer complications. Physicians can target and treat small amounts of tissue, minimizing damage to nerves around the prostat



What does it do?

 Think about how a magnifying glass focuses light rays from the sun to a particular point and can burn a hole in a leaf.HIFU works the same way; there is a transducer, which focuses sound waves to a particular point, creates heat and destroys tissue at that point; nothing outside of the focal point is damaged. 


What to Expect?

If you decide to choose Sonablate HIFU you will receive pre-operative instructions from Dr. Raj.The HIFU procedure typically lasts between 1-4 hours, depending on the size of the prostate, and is either done under general anesthesia or an epidural and IV sedation. During the procedure a suprapubic catheter will be put into place to help with urination, and will typically stay in place for 1-3 weeks.After the HIFU treatment, patients will be in recovery for about 2-4 hours. Once released from the treatment center, patients return home or to a hotel to recover more comfortably.Though, it is recommended that patients take things easy, most patients feel well enough to go out for dinner and maybe even a walk, the night after of the procedure.For more information read our BROCHURE. 


How does HIFU treat prostate disease?

Using intersecting precision focused ultrasound waves, the device destroys tissue and leaves healthy cells surrounding the prostate unharmed. Unlike radiation, HIFU energy is “clean” energy. This means it can be applied repeatedly (if needed) without causing damage to tissue between the transducer and the prostate. 

What are the outcomes of the HIFU treatment?

 An international study published by Toyaki Uchida, MD (Japan) reported that 94% of patients (low risk) were disease-free after four years. Additionally, 92% of men treated with HIFU had a PSA of .2ng/ML or lower 3 months after HIFU as reported in a study by Dr. Mark Emberton of London. 


How do I know if I qualify for HIFU? ?

While only a physician can determine if you qualify for HIFU or not, typically men with a prostate gland of less than 40 grams with localized prostate cancer (tumor has not spread outside of the prostate gland) may be candidates for HIFU. The other information that physicians usually look at to determine if you qualify for HIFU is a PSA of 20 or less and a Gleason score of 7 or less. It is best to talk with a HIFU nurse or doctor to determine if you might qualify for HIFU. 


Can I still be treated if I have a large prostate?

Your physician will need to know the exact dimensions of your prostate to know whether or not you are a candidate for HIFU. If your prostate is too large, there may be ways you can work with your doctor to shrink or reduce the size of the gland prior to scheduling a HIFU procedure. 


Should I have total gland HIFU or Focal HIFU ?

 In order to know if you are a candidate for focal HIFU or whole gland ablation, a physician would need to thoroughly review your pathology report as well as ideally have advanced MRI imaging done to determine the exact size and location of your prostate cancer. 


Is there a greater chance the cancer will come back if I choose to have a focal treatment versus full gland treatment? ?

With focal therapy, the physician only treats the area of the prostate that contains the tumor. This is determined after multiple types of diagnostic imaging as well as biopsy reports to confirm the staging of the disease. The procedure is shorter, recovery time is faster and time wearing a catheter is greatly reduced. This means that if after focal HIFU there is an elevation in PSA, and evidence that the cancer has appeared in a different location, the physician can easily go back and deliver HIFU in the new location. Additionally, the patient may choose to have any other type of therapy at that time. This is a much less radical approach to locating the cancer and eliminating it. Prior to having focal HIFU, your physician should thoroughly explain to you the risk of the cancer returning based on your diagnostic reports. 

How does HIFU compare to traditional treatments for prostate cancer, including surgery and radiation?

Studies show that HIFU has rates of efficacy similar to other treatments for prostate cancer but with less risk for side effects such as incontinence and erectile dysfunction. HIFU also does not exclude you from having any other treatments, should you have a recurrence of prostate cancer, as other treatments such as surgery and radiation will. 


Is HIFU a type of radiation, like brachytherapy?

No, HIFU is completely radiation free. Unlike radiation, HIFU is a clean, or non-ionizing, energy source. This means that it can be repeated as necessary, and will not prevent a patient from pursuing any other treatment options after HIFU. During brachytherapy, radioactive seeds are placed inside the prostate and remain in the prostate after the procedure is complete. Often times, these seeds will migrate to other organs, which can cause additional issues for patients. 


What will I need to do to prepare for the HIFU procedure ?

 Prior to HIFU, patients should have the usual lab work (CBC, Complete Medical Panel, Urinary Analysis with culture, if indicated by your physician) and an EKG in preparation for undergoing anesthesia. If the patient has any significant medical history, he should see his cardiologist or primary physician for clearance for the anesthesia. The HIFU procedure itself causes no significant bleeding or swings in blood pressure, etc. A nurse will send detailed information after the procedure has been scheduled regarding diet, medications and any additional lab work or tests that may be required. 


What happens to the urethra during HIFU? Since it runs through the center of the prostate, is it destroyed during the procedure?

During HIFU, the entire prostate is ablated, including the prostatic urethra. However, the urethra is derived from a different type of tissue (bladder squamous-type epithelium) rather than prostatic tissue (glandular, fibrotic and muscular). While the urethra is an important anatomical structure, the sphincter and bladder neck are more important to maintaining the urinary function. 


Is there pain with HIFU? What should I expect ?

 During HIFU, patients are given anesthesia to minimize any movement during the procedure and to make the patient as comfortable as possible. There should be no pain associated with the procedure although patients may experience various levels of discomfort afterwards. 


What type of follow-up is there after HIFU?

Follow up after HIFU with your physician will be similar to any other treatment for prostate cancer. A HIFU nurse will call you after your procedure to see how you are recovering and ask if you have any questions and concerns. Additionally, you will need to make an appointment several weeks after your procedure to have your catheter removed and then return for visits at 3 months, 6 months, 9 months, and 12 months to have your PSA tested.

When can I go back to work/normal activities? 

Men may return to office-based work and drive the following day. More intense physical activity resumes in 3-5 days, though no activity should be started that dislodges the catheter or stirs up bleeding from the catheter insertion site. The treated prostate tissue does not bleed, as the blood vessels are sealed by the HIFU energy. If a TURP was done prior to HIFU, no physical exertion should be done until at least one month following the TURP. The TURP exposes blood vessels at the bladder neck that are not exposed to the sealing HIFU energy, and therefore could bleed. Always seek the advice of your HIFU physician before resuming any physical activity after HIFU. 


When can I resume sexual intercourse ?

Usually, patients can have sex after their catheter has been removed. You should speak with a physician if you have any questions or concerns about resuming sexual activities. 

How does it Work?

Detail your services



How HIFU Works?

High Intensity Focused Ultrasound, or HIFU, utilizes highly energized, high frequency sound waves that are focused on a single spot. The accompanying pressure waves collide with one another, releasing a tremendous amount of energy instantaneously. This released energy is converted into heat causing the temperature to immediately rise. For prostate cancer, the temperature is allowed to rise to 100 degrees Centigrade (boiling!), which leads to death of the cancer. Furthermore, the oscillating nature of the waves produces rapid fluctuations between high pressures and low pressures within the cancerous tissue itself. This leads to a process known as cavitation, a process that is lethal to cancer cells. By combining these two unique properties and focusing them onto the cancerous tissue, effective eradication of the cancer can be instantaneously achieved. One of the most important aspects of HIFU, is that being treated with it does not preclude patients from being treated with surgery or radiation, should they require further treatment. 

Acceptance of a Medicare

Medicare patients


 CMS recently announced the acceptance of a Medicare C-code application for HIFU prostate tissue ablation, which will go into effect on July 1st, 2017. This code may be applied to any procedure performed with Ablatherm, including focal, hemi-gland, whole-gland, primary or salvage HIFU prostate ablations. Hospitals offering these HIFU procedures to Medicare patients will be eligible for reimbursement. 


Prostate cancer is the leading cancer among men in the U.S.A. It is estimated that 38.7 million men world wide have prostate cancer . Treatment Options and alternative prostate cancer treatment options include surgery, External Beam Radiotherapy (EBRT), Brachytherapy, Cryotherapy and non-invasive, High Intensity Focused Ultrasound therapy (HIFU) including focal therapy . 


Insurance, Government and Medicare Reimbursement.


Reimbursement usually means receiving money in repayment for money you have already spent, or an expense you have already incurred. It is a term used in a wide variety of ways in business and personal life, but it has a different meaning in healthcare.Healthcare providers are paid by insurance or government payers, such as Medicare through a system of reimbursement.

  • They provide medical services to a patient and then file for reimbursement for those services with the insurance company or government agency. It’s not the patient who is paying out of pocket and getting reimbursed, it is the doctor providing the service and awaiting reimbursement.
  • Whenever you have a medical procedure performed or health care service provided, it is coded in your medical record for tracking and billing. CPT codes and HCPCS codes are related systems of medical coding required for providers and insurers to send information electronically.
  • You can look up a procedure by code to see how much Medicare reimburses your doctor or hospital to perform it.
  • A private insurance company negotiates their own reimbursement schedules with providers and hospitals.

Even with health insurance, patients may have to pay a co-pay for a medical procedure, or may have to pay out of pocket for procedures not covered by insurance or Medicare.

Reimbursement for HIFU under Medicare

  • In July 2017, a reimbursement code went into effect for HIFU ablation of the prostate.
  • This code, called a c-code, is specifically for patients covered under Medicare and only applies to a hospital outpatient facility or ambulatory surgery center (ASC).
  • At this time, it does not apply to commercial insurers.
  • It does not apply to procedures performed in a physician’s office or to a physician’s services.
  • The c-code is C9747, Ablation of prostate, transrectal, high intensity focused ultrasound (HIFU), including image guidance.

What does this mean for you and the HIFU procedure?When a man undergoes HIFU, much like other medical procedures, there are a variety of healthcare providers providing services in order to carry out the treatment. When you choose HIFU with HIFU Prostate Services, this includes:

  • The facility (hospital, outpatient facility etc.) where the procedure takes place.
  • The physician who performs the HIFU procedure.
  • The anesthesiologist who administers anesthesia
  • Concierge Patient Support Services.


HIFU Broschure

ablatherm-brochure-usa (pdf)



 Prostate Cancer Animation


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FOX News: Is HIFU a Safe Prostate Cancer Treatment Option?


 3D Animation of HIFU Procedure


 HIFU: State of the Art Prostate Cancer Treatment