Early experience in MRI-guided therapies of prostate cancer: HIFU, laser and photodynamic treatment

Prostate cancer screening has resulted in earlier diagnosis with lower-grade disease, leading to over-detection and overtreatment in a significant number of patients. Current whole-gland radical treatments are associated with significant rates of morbidity. The high prevalence of low-risk disease together with an inability to accurately identify those men harboring more aggressive cancers has led to tremendous research in low-morbidity focal therapies for prostate cancer. This review summarizes the early experiences with focal therapy with emphasis on early applications of laser, high-intensity focuses ultrasound, and photodynamic approaches.