Nature announces top ten scientific research achievements of 2024, AI-HIFU focal treatment of prostate cancer research is on the list

Recently, a follow-up study conducted by Dr. Sunao Shoji's team on the treatment of localized prostate cancer patients with AI-HIFU (artificial intelligence high-intensity focused ultrasound) - "Focal therapy using high-intensity focused ultrasound with intraoperative prostate compression for patients with localized prostate cancer: a multi-center prospective study with 7 year experience" was selected as "Top 10 Editor's Choice Top Studies in 2024" by Nature's Prostate Cancer and Prostatic Diseases (PCAN) journal for its excellent efficacy and safety. This 7-year study proved the excellent cancer treatment results, safety and function preservation effects of AI-HIFU, which not only demonstrated the breakthrough contribution of the study in the field of prostate cancer treatment, but also further affirmed the application prospects of high-intensity focused ultrasound (HIFU) technology in the treatment of prostate cancer.

Excellent research: 7-year follow-up data revealed

The study followed up 240 patients with localized prostate cancer who received focal treatment for up to 7 years, with a median age of 69 years. The results showed that the biochemical disease-free survival rate and pathological disease-free survival rate after a single AI-HIFU treatment for prostate cancer patients with low-risk (51 patients), intermediate-risk (107 patients) or high-risk (82 patients) reached remarkable levels. Specifically, the biochemical disease-free survival rate and pathological disease-free survival rate of low-risk patients were 93.7% and 92.2%, respectively; the intermediate-risk patients were 88.5% and 91.6%, and the high-risk patients were 84.8% and 86.6%. In addition, the probability that these patients did not need to undergo radical surgery or systemic treatment during the follow-up period was as high as 96.1%, 94.4% and 95.1%, respectively. This shows the effectiveness of AI-HIFU in treating prostate cancer of all risk levels.

In terms of safety, the incidence of side effects of this treatment method is extremely low. Among them, the incidence of grade 2 urethral stricture is 2.9%, the incidence of grade 2 urethral infection is 2.1%, the incidence of grade 1 urinary incontinence is 1.3%, and the incidence of rectal fistula is 0%. These data fully demonstrate the safety of AI-HIFU focal treatment of prostate cancer.

In terms of functional preservation, the researchers used the International Prostate Symptom Score (IPSS), quality of life (QOL), overactive bladder symptom score (OABSS), uroflowmetry, and the urine subscale score of the Expanded Prostate Cancer Composite Index (EPIC) to evaluate the patients' urinary function, and the International Index of Erectile Function (IIEF)-5 score and the EPIC sexual function score to evaluate erectile function. The study showed that the patients' urinary function and sexual function after AI-HIFU treatment returned to pre-treatment levels within 3-6 months. This is an important finding given the risk of functional impairment caused by traditional radical surgery to patients.

Innovative techniques: Prostate "squeezing techniques" during surgery to improve efficacy

In terms of surgical techniques, Dr. Shoji's team innovatively adopted the intraoperative prostate compression technique ("compression technique"). By adding water to the probe end sheath to compress the prostate, this technique significantly improves the accuracy and efficiency of HIFU treatment. Specifically, prostate compression has three major benefits: first, it reduces blood flow to the prostate during surgery, reduces heat deposition effects, shortens the HIFU energy transmission path, and improves the cavitation effect of treatment; second, it reduces swelling of the prostate during surgery and increases the accuracy of treatment; third, it reduces displacement of the prostate during surgery, which also improves the accuracy of treatment.

Top recognition: innovative research demonstrates value

"PCAN" is an academic journal under the journal "Nature" that focuses on the research of prostate cancer and prostate diseases. The editor-in-chief, Professor Cosimo De Nunzio, selected and released the "Editors Choice 2024" special issue in January 2025. This special issue only includes 10 research papers in the field in 2024.

The top research recommended by the editor-in-chief is not only an affirmation of the research results of Dr. Sunao Shoji's team, but also a recognition of the innovative method of HIFU combined with intraoperative prostate "squeezing" to treat localized prostate cancer. This study not only provides a new, safe and effective treatment method for patients with localized prostate cancer, but also brings new breakthroughs and hopes to the treatment of prostate cancer, bringing more good news to prostate cancer patients.

References:

Focal therapy using high-intensity focused ultrasound with intraoperative prostate compression for patients with localized prostate cancer: a multi-center prospective study with 7 year experience: https://www.nature.com/articles/s41391-024-00921-0

When precision meets prostate cancer: the rising role of HIFU focal therapy

https://www.nature.com/articles/s41391-025-00940-5