The article by Gail ter Haar presents an excellent review of the history and current status of acoustic surgery, and describes the renewed interest and newest applications of high-intensity focused ultrasound (HIFU). Unfortunately, ter Haar neglects to mention outstanding contributions, dating back more than 30 years, from a group at the Indiana University School of Medicine in Indianapolis.
In 1970, researcher Frank Fry and neurosurgeon Robert Heimburger began treating terminally ill brain-cancer patients with Fry’s HIFU device, which was coupled with a highly accurate B-mode imaging system. 1 Fry and Heimburger continued to improve the HIFU technology. Then, in consultation with Indiana’s department of urology, Fry and I developed a prostate ablation device 2 that combined both imaging and HIFU treatment within a single ceramic crystal, thus eliminating transducer alignment complications. This device was approved in the US and Europe in 1992 for treatment of benign prostatic hyperplasia, 3 and has been used by my company to treat BPH patients for several years. Unlike the “disappointing” results ter Haar mentions, multisite phase-III clinical trials demonstrate that HIFU treatment is safe and effective, improves peak urinary flow, reduces symptom scores, and improves quality of life.
