The SONA FUSION Registry is an observational study designed to evaluate the long-term effectiveness and safety of the Sonablate High-Intensity Focused Ultrasound (HIFU) system. This study focuses on adult men who have been treated for localized prostate cancer, benign prostatic hyperplasia (BPH) with urinary symptoms, or a combination of both conditions. The registry collects real-world medical data from multiple clinics globally to better understand how well the HIFU treatment controls disease and affects urinary and sexual function over a 10- to 20-year period. The study includes two groups of participants: a retrospective group of patients who previously received treatment, and a prospective group of newly treated patients receiving standard clinical care. No experimental interventions are assigned for the purpose of this study. To protect participant privacy, all medical data is completely de-identified and stripped of direct identifiers before being securely transferred to the central coordinating center at Indiana University. The ultimate goal of this research is to improve patient care protocols, advance men's health knowledge, and establish evidence-based guidelines for minimally invasive prostate treatments.
Traditional surgical interventions for prostate cancer and benign prostatic hyperplasia (BPH) are often associated with significant morbidity. While high-intensity focused ultrasound (HIFU) has emerged as a recognized, minimally invasive alternative, existing clinical evidence often lacks prospective, long-term follow-up and standardized, validated outcome assessments. To systematically track and evaluate these standard-of-care interventions, the SONA FUSION Registry serves as a central repository for the consolidation of real-world clinical data from leading academic and clinical centers globally. The registry is designed to refine HIFU treatment protocols, improve patient counseling practices, and establish evidence-based scientific foundations for the standardized adoption of robotic HIFU technology. The central repository at Indiana University receives and maintains exclusively de-identified research data. The protocol structurally prevents re-identification by mandating the permanent removal of all direct identifiers at the local site level prior to transmission. Furthermore, clinical dates are strictly protected via temporal masking, converting all temporal data to relative study days-and a non-negotiable 180-day post-procedure delay is enforced before any prospective data is authorized for abstraction. To continuously validate these safeguards, an independent Honest Broker conducts an annual audit of a 20 percent sample of the database, ensuring the central research team remains definitively blinded to all patient identifiers.
Study Type
OBSERVATIONAL
Enrollment
10,000
Use of high intensity focused utrasound and sonatripsy for thermal and mechanical tissue ablation
Indiana University Medical Center
Indianapolis, Indiana, United States
RECRUITINGBiochemical and Histological Recurrence-Free Survival Rate
Proportion of patients remaining free of clinically significant prostate cancer recurrence in the treated area, evaluated via standard-of-care Prostate Specific Antigen (PSA) testing, multiparametric MRI, and/or follow-up prostate biopsy.
Time frame: Baseline, and annually up to 10 years
Change in International Prostate Symptom Score (IPSS) / AUA Symptom Score
Assessment of lower urinary tract symptoms (LUTS) for both prostate cancer and BPH patients. The IPSS/AUASS consists of 7 questions regarding urinary symptoms. Total scores range from 0 to 35. A score of 0-7 indicates mild symptoms, 8-19 moderate symptoms, and 20-35 severe symptoms. Higher scores indicate worse urinary outcomes.
Time frame: Baseline, 3, 6, 12 months, and annually up to 10 years
Change in Erectile Function (SHIM / IIEF-5 Score)
Erectile function and ability to maintain an erection satisfactory for penetration assessed via the Sexual Health Inventory for Men (SHIM), also known as the IIEF-5. Total scores range from 1 to 25. A score of 22-25 indicates normal erectile function, while scores of 21 or below indicate varying degrees of erectile dysfunction. Lower scores indicate worse sexual function outcomes.
Time frame: Baseline, 3, 6, 12 months, and annually up to 10 years
Pad-Free Urinary Continence Rate
Proportion of patients achieving complete pad-free urinary continence following HIFU treatment, clinically defined as the use of zero absorbent pads per day for urinary leakage.
Time frame: 3, 6, 12 months, and annually up to 10 years
Intraoperative Tissue Change Monitoring (TCM) Correlation
Correlation of intraoperative Tissue Change Monitoring (TCM) data with post-operative IPSS relief and PSA nadir to identify predictors of treatment success.
Time frame: Up to 10 years
Salvage-Free Survival
Time from the primary Sonablate HIFU procedure (index date) to the initiation of any post-ablation salvage treatment (e.g., radical prostatectomy, radiation therapy, systemic therapy, or repeat HIFU ablation), evaluated via time-to-event longitudinal survival analysis.
Time frame: Up to 10 years
Number of Participants with Procedure-Related Adverse Events
Number of participants experiencing urological, functional, or rectal complications post-HIFU, extracted from de-identified medical records following a mandatory 180-day abstraction delay. Severity is graded via the Clavien-Dindo system (Grade I \[minor\] to Grade V \[death\]), where higher grades indicate greater severity.
Time frame: Up to 10 years
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