Sonablate vs. Ablatherm
Transcription
Sonablate vs. Ablatherm
Sonablate® [email protected] Ablatherm® Guadalajara 2-12 Larger piezo surface, less energy flow density on rectal wall ! ! Focal level Rectal wall level Piezo transducer level Sonablate® [email protected] Ablatherm® Guadalajara 2-12 10 19/26 mm 40mm 10 30mm 3–8 mm 12..5 mm Ablatherm® R [email protected] 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® [email protected] Ablatherm® Guadalajara 2-12 Sonablate®: TRUS+HIFU at 4 MHz [email protected] Ablatherm®: TRUS 7.5 HIFU at 3 MHz Guadalajara 2-12 Ablatherm® „right body position“ Sonablate® „stone cut position“ [email protected] 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 [email protected] 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 !! [email protected] 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. [email protected] 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) [email protected] Guadalajara 2-12 [email protected] Guadalajara 2-12