Sonablate vs. Ablatherm

Sonablate®
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Ablatherm®
Guadalajara 2-12
Larger piezo surface, less energy flow density on rectal wall ! !
Focal level
Rectal wall level
Piezo transducer level
Sonablate®
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Ablatherm®
Guadalajara 2-12
10
19/26 mm
40mm
10
30mm
3–8 mm
12..5 mm
Ablatherm®
R
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L
TURP
2
manuely & opticaly controled & adjusted
2 applicators intraoperatively to be exchanged
45 mm
1
robotic & optical controled, autofocus
1 applicator
Guadalajara 2-12
Sonablate®
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Ablatherm®
Guadalajara 2-12
Sonablate®: TRUS+HIFU at 4 MHz
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Ablatherm®: TRUS 7.5 HIFU at 3 MHz
Guadalajara 2-12
Ablatherm®
„right body position“
Sonablate®
„stone cut position“
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Guadalajara 2-12
Ablatherm®
Patient positioned
comfortably
in sleeping position
on the right side
Cavitation bubbles
can not disturb
therapy
Sonablate®
Patient positioned in
“stone cut”:
• risk of bubbles
• risk of thrombosis
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Cavitation bubbles
in the HIFU beam
might disturb therapy
!
Guadalajara 2-12
Sonablate® uses
Degassed water filled balloon
Ablatherm® uses
Ablapak® with Ablasonic®
PRO:
low costs !!
PRO:
Standardized,
caviation free liquid
Constant ballon pressure
CON:
Cavitation
CON:
High costs !!
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Guadalajara 2-12
Negative Biopsy Rate (%)
100
80
60
40
Study size:
20
20
100
Sonablate
200
Ablatherm
0
0
5
10
15
20
25
30
35
Median Follow-up (months)
1. Gelet et al, J Endourol. 2000;14(6):519-28; 2. Gelet et al, Eur Urol. 2001;40(2):124-9; 3. Poissonnier et al Prog Urol. 2003;13(1):60-72; 4. Poissonnier et al
Eur Urol. 2007;51(2):381-7; 5. Thuroff et al J Endourol. 2003;17(8):673-7; 6. Chaussy et al Curr Urol Rep. 2003;4(3):248-52; 7. Urology. 2004;63(2):297-300; 8.
Ficarra et al BJU Int. 2006;98(6):1193-8; 9. Prostate Cancer Prostatic Dis. 2006;9(4):439-43; 10. Uchida et al Urology. 2002 Mar;59(3):394-8; 11. Uchida et al
Hinyokika Kiyo. 2005 Oct;51(10):651-8; 12. Uchida et al Int J Urol. 2006 Mar;13(3):228-33; 13. Uchida et al BJU Int. 2006 Oct;98(4):770-2.
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Guadalajara 2-12
Ablatherm® is an intelligent robot*
* japanese association of robotics and automatisation
Planing:
endorectal applicator placement
according treatment plan
Sonablate® manual handling
Movements ?
non-stop, real time 3D
position measurement and
comparison to treatment plan
Correction !
automatic 3D repositioning
of endorectal applicatior position
(autofocus, +/- 1mm)
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Guadalajara 2-12
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Guadalajara 2-12