Focal Targeted Therapy Will Be a Future Treatment Modality for Early Stage Prostate Cancer  Jean J.M.C.H. de la Rosette, Vladimir Mouraviev, Thomas J. Polascik  European Urology Supplements  Volume 8, Issue 5, Pages 424-432 (April 2009) DOI: 10.1016/j.eursup.2009.01.005 Copyright © 2009 European Association of Urology Terms and Conditions

Fig. 1 Transrectal ultrasonography (TRUS) and macroscopic pathology of prostate cancer lesions; (A) gray-scale (B-mode) imaging; (B) contrast-enhanced TRUS; (C) gross pathology. Adapted from Wink et al [38]. European Urology Supplements 2009 8, 424-432DOI: (10.1016/j.eursup.2009.01.005) Copyright © 2009 European Association of Urology Terms and Conditions

Fig. 2 Transrectal ultrasonography: (A) gray-scale B-mode; (B) three-dimensional transrectal acoustic radiation force impulse imaging of cancer lesions; (C) matching pathology. Adapted from Zhai et al [39]. ARFI=acoustic radiation force impulse. European Urology Supplements 2009 8, 424-432DOI: (10.1016/j.eursup.2009.01.005) Copyright © 2009 European Association of Urology Terms and Conditions

Fig. 3 Conceptual schematic of treatment options for focal therapy: (A) true focal ablation; (B) hemiablation: the ablation zone is extended to include the ipsilateral neurovascular bundle and margin (treatment of possible extracapsular extension of disease); (C) 75% ablation: note that 25% of the gland (untreated area) will be on an active surveillance protocol; (D) near-total ablation: some undetermined amount of parenchyma will not be treated to maintain the neurovascular bundle on that side. Adapted from Polascik [53]. NVB=neurovascular bundle. European Urology Supplements 2009 8, 424-432DOI: (10.1016/j.eursup.2009.01.005) Copyright © 2009 European Association of Urology Terms and Conditions