Dr. Scionti is the most experienced in America with both machines, he learned on the Ablatherm. He prefers the Sonablate, but works with both and teaches HIFU to the clinical trial doctors using both. He uses the Sonablate in P.V. and Nassau.
The difference is the french made Ablatherm is robotic, the doctor sets the machine and it does the ablation.
While the USA made Sonablate is manual. The doctor clamps down the probe so there's no movement, then he watches as he moves the beam of light and destroys the tissue. If cancer is outside the gland he can destroy that as well. Cancer shows up as bright specks on the computer screen. If the gland spasms during treatment & moves then he can treat it.
Good description of both is found here, it's a independent charity web site on prostate cancer: http://www.prostate-cancer.org/education/novelthr/Chinn_Tran
I could post many clinical trials, the doctors involved is the most important factor. The doctors in clinical trials don't have the experience that doctors do in the real world.
There are doctors in Japan who have done 1,000 HIFU treatments, they charge $13,000. and that includes two nights in the hospital (because of language barrier they want to keep an eye on you & teach you about the catheter). I've been to Japan, everyone speaks English. Dr. Toyoaki Uchida of Tokai University Hospital, Tokyo is the leading HIFU expert, he did a clinical trial using the Sonablate and he has results at 5 years of 97% clean from cancer.
The clinical trials in the USA have strict rules to enter the trials, but going to a doctor outside the US has lower restrictions.
This is from their web site:
Who is Eligible for HIFU Treatment? (outside USA)
1. Clinical stage T1-2N0M0
2. PSA less than 20 ng/ml
3. Any Gleason score
4. Prostate volumes of less than 40cc (patients with larger glands could consider neoadjuvant (pre HIFU) hormone therapy or transurethral resection of the prostate (TURP) prior to HIFU therapy to reduce the volume of the prostate.
5. Prostate glands without large calcifications of more than 1.0cm in diameter (TURP can be performed to remove these calcifications before HIFU).