Transrectal high-intensity focused ultrasound devices: a critical appraisal of the available evidence

Developments in the technology applied to the field of minimally invasive surgery have led to the exploration of high-intensity focused ultrasound (HIFU) for the treatment of localized prostate cancer. Extensive research and continuous evolution have resulted in two commercially available HIFU devices: the Ablatherm and the Sonablate500. These devices are conceptually the same; however, specific technical differences exist. This paper reviews the clinical outcomes obtained with these devices, evaluates the quality of the evidence from the individual trials, and provides the results of a head-to-head comparison in terms of oncologic outcomes and complication rates.