TULSA – Urological HIFU

TULSA Research Group

The TULSA Research Group at Turku University Hospital and the University of Turku investigates MRI-guided transurethral ultrasound ablation (TULSA) for prostate diseases, including localized prostate cancer, radiorecurrent prostate cancer, and benign prostatic enlargement. Our work combines advanced MRI guidance, real-time thermometry, and detailed assessment of tissue response with computational and data-driven modelling to enhance the precision, safety, and effectiveness of thermal ablation. Our mission is to develop less invasive, image-guided therapeutic options supported by robust clinical and translational research.

Urologists:

Adjunct prof. Mikael Anttinen, MD, PhD, FEBU

  • Department of Urology, Turku University Hospital and University of Turku, FICAN West Cancer Centre
    • mikael [dot] anttinen [at] varha [dot] fi

Prof. Peter J. Boström, MD, PhD, FEBU

  • Department of Urology, Turku University Hospital and University of Turku, FICAN West Cancer Centre
  • peter [dot] bostrom [at] varha [dot] fi

Adjunct professor Heikki Seikkula, MD, PhD, FEBU

  • Head of the department of Urology, Turku University Hospital and University of Turku, FICAN West Cancer Centre
  • heikki [dot] seikkula [at] varha [dot] fi

Dr. Pertti Nurminen, MD, PhD, FEBU

  • Department of Urology, Turku University Hospital and University of Turku, FICAN West Cancer Centre
  • pertti [dot] nurminen [at] varha [dot] fi

Dr. Elja Heiskanen, MD, PhD candidate

  • Department of Urology, Turku University Hospital and University of Turku, FICAN West Cancer Centre
  • elja[dot] heiskanen [at] varha [dot] fi

Adjunct professor Otto Ettala, MD, PhD, FEBU

  • Department of Urology, Turku University Hospital and University of Turku, FICAN West Cancer Centre
  • otto [dot] ettala [at] varha [dot] fi

Radiologists:

Prof. Roberto Blanco Sequeiros, MD, PhD

  • Department of Diagnostic Radiology, Turku University Hospital and University of Turku
  • reberto [dot] blanco [at] varha [dot] fi

Dr. Pietari Mäkelä, MD, PhD

  • Department of Diagnostic Radiology, Turku University Hospital and University of Turku
  • pietari [dot] makela [at] varha [dot] fi

Dr. Heikki Pärssinen, MD, PhD candidate

  • Department of Diagnostic Radiology, Turku University Hospital and University of Turku
  • heikki [dot] parssinen [at] varha [dot] fi

Medical Physicists:

Dr. Teija Sainio, M.Sc., PhD

  • Department of Medical Physics, Turku University Hospital and University of Turku
  • teija [dot] sainio[at] varha [dot] fi

Dr. Kalle Koskensalo, M.Sc., PhD

  • Department of Medical Physics, Turku University Hospital and University of Turku
  • kalle [dot] koskensalo [at] varha [dot] fi

Patologists:

Professor Pekka Taimen, MD, PhD

  • Institute of Biomedicine, University of Turku and Department of Pathology, Turku University Hospital, FICAN West Cancer Centre
  • pekka [dot] taimen [at] varha [dot] fi

PhD Researchers:

Dr. Ilari Virtanen, MD, PhD candidate

  • Department of Urology, Turku University Hospital and University of Turku
  • ilari [dot] a [dot] virtanen [at] utu [dot] fi

Dr. Eemil Yli-Pietilä, MD, PhD candidate

  • Department of Urology, Turku University Hospital and University of Turku
  • ehmyli [at] utu [dot] fi

Dr. Antti Viitala, MD, M.Sc. (Tech.), PhD candidate

  • Department of Urology and Radiology, Turku University Hospital and University of Turku
  • antti [dot] j [dot] viitala [at] gmail [dot] com

Dr. Samu Heino, MD, PhD candidate

  • Department of Urology, Turku University Hospital and University of Turku
  • samu [dot] k [dot] heino [at] utu [dot] fi

Medical thesis on MRI-guided transurethral ultrasound ablation

Anttinen, Mikael. NOVEL IMAGING AND IMAGE-GUIDED THERAPY OF PROSTATE CANCER. https://www.utupub.fi/bitstream/handle/10024/152415/AnnalesD1555Anttinen.pdf?sequence=1

Mäkelä, Pietari. MRI FINDINGS AFTER TRANSURETHRAL ULTRASOUND ABLATION OF PROSTATE

https://www.utupub.fi/bitstream/handle/10024/179117/AnnalesD1814Mäkelä.pdf?sequence=1&isAllowed=y

Wright, Cameron. OPTIMIZING MRI-GUIDED PROSTATE ULTRASOUND ABLATION THERAPY USING RETROSPECTIVE ANALYSES AND ARTIFICIAL INTELLIGENCE

https://www.utupub.fi/bitstream/handle/10024/174315/AnnalesD1693%20Wright.pdf?sequence=5&isAllowed=y

Full Publication List:

Suomi, V., Treeby, B., Jaros, J., Makela, P., Anttinen, M., Saunavaara, J., … & Blanco, R. (2018). Transurethral ultrasound therapy of the prostate in the presence of calcifications: a simulation study. Medical physics45(11), 4793-4805. https://doi.org/10.1002/mp.13183

Anttinen, M., Yli-Pietilä, E., Suomi, V., Mäkelä, P., Sainio, T., Saunavaara, J., … & Boström, P. J. (2019). Histopathological evaluation of prostate specimens after thermal ablation may be confounded by the presence of thermally-fixed cells. International Journal of Hyperthermia36(1), 914-924. https://doi.org/10.1080/02656736.2019.1652773

Anttinen, M., Mäkelä, P., Suomi, V., Kiviniemi, A., Saunavaara, J., Sainio, T., et al. (2019). Feasibility of MRI-guided transurethral ultrasound for lesion-targeted ablation of prostate cancer. Scandinavian journal of urology53(5), 295-302. https://doi.org/10.1080/21681805.2019.1660707

Anttinen, M., Mäkelä, P., Nurminen, P., Yli-Pietilä, E., Suomi, V., Sainio, T., et al. (2020). Palliative MRI-guided transurethral ultrasound ablation for symptomatic locally advanced prostate cancer. Scandinavian Journal of Urology54(6), 481-486. https://doi.org/10.1080/21681805.2020.1814857

Anttinen, M., Mäkelä, P., Viitala, A., Nurminen, P., Suomi, V., Sainio, T., et al. (2020). Salvage magnetic resonance imaging–guided transurethral ultrasound ablation for localized radiorecurrent prostate cancer: 12-month functional and oncological results. European Urology Open Science22, 79-87. https://doi.org/10.1016/j.euros.2020.10.007

Mäkelä, P., Anttinen, M., Suomi, V., Steiner, A., Saunavaara, J., Sainio, T., et al. (2021). Acute and subacute prostate MRI findings after MRI-guided transurethral ultrasound ablation of prostate cancer. Acta Radiologica62(12), 1687-1695. https://doi.org/10.1177/0284185120976931

Viitala, A., Anttinen, M., Wright, C., Virtanen, I., Mäkelä, P., Hovinen, T., … & Boström, P. J. (2022). Magnetic resonance imaging‐guided transurethral ultrasound ablation for benign prostatic hyperplasia: 12‐month clinical outcomes of a phase I study. BJU international129(2), 208-216. https://doi.org/10.1111/bju.15523

Mäkelä, P., Wright, C., Anttinen, M., Boström, P. J., & Blanco Sequeiros, R. (2022). Safety and efficacy of MRI-guided transurethral ultrasound ablation for radiorecurrent prostate cancer in the presence of gold fiducial markers. Acta Radiologica, 02841851221108292. https://doi.org/10.1177/02841851221108292

Wright, C., Mäkelä, P., Anttinen, M., Sainio, T., Boström, P. J., & Blanco Sequeiros, R. (2021). Fiducial markers and their impact on ablation outcome for patients treated with MR-guided transurethral ablation (TULSA): a retrospective technical analysis. International Journal of Hyperthermia38(1), 1677-1684. https://doi.org/10.1080/02656736.2021.2008519

Anttinen, M., Syvänen, K., Minn, H., & Boström, P. J. (2022). Ablaatiohoidot – sädehoidon jälkeen paikallisesti uusiutuneen eturauhassyövän hoitovaihtoehto. Duodecim; Lääketieteellinen Aikakauskirja138(10), 911-9. https://www.duodecimlehti.fi/duo16843

Anttinen, M., Blanco Sequeiros, R., Boström, P. J., & Taimen, P. (2022). Evolving imaging methods of prostate cancer and the emergence of magnetic resonance imaging guided ablation techniques. Frontiers in Oncology, 6246. 10.3389/fonc.2022.1043688

Wright, C., Mäkelä, P., Bigot, A., Anttinen, M., Boström, P. J., & Blanco Sequeiros, R. (2022). Deep learning prediction of non-perfused volume without contrast agents during prostate ablation therapy. Biomedical Engineering Letters, 1-10. https://doi.org/10.1007/s13534-022-00250-y

Mäkelä, P., Anttinen, M., Wright, C., Sainio, T., Boström, P., Blanco, R. Evolution of Non-perfused Volume after Ultrasound Ablation of Prostate: A Retrospective 12-month Analysis. (2023). European Journal of Radiology Open. https://doi.org/10.1016/j.ejro.2023.100506

Seikkula, H., Mäkelä, L., Visapää, H., Anttinen, M. (2023). Optimal strategies for managing prostate-specific antigen recurrence after primary radiotherapy in prostate cancer: the Finnish perspective. European Urology Focus, 9(5), 698-700. 10.1016/j.euf.2023.11.008

Anttinen, M., Mäkelä, P., Nurminen, P., Pärssinen, H., Malaspina, S., Sainio, T., Högerman, M., Taimen, P., Blanco Sequeiros, R., Boström, P.J. (2025). Salvage MRI-guided transurethral ultrasound ablation for localized radio-recurrent prostate cancer. European Urology Open Science, 71, 69-77. https://doi.org/10.1016/j.euros.2024.11.001

Viitala, A., Anttinen, M., Mäkelä, P., Pärssinen, H., Nurminen, P., Sainio, T., Saunavaara, J., Taimen, P., Blanco Sequeiros, R., Boström, P.J. (2025). Magnetic resonance imaging-guided transurethral ultrasound ablation for benign prostatic obstruction: 1-year clinical outcomes of a phase II study. BJU International. https://doi.org/10.1111/bju.16795

International conference abstracts:

Suomi, Visa. 2018, May. Transurethral Ultrasound Treatment of the Prostate in the Presence of Calcifications and Cysts. In 2018 19th International Symposium on Therapeutic Ultrasound (ISTU). ISTU.

Anttinen, Mikael. 2019, June. Early experience of palliative MRI-guided transurethral ultrasound ablation for symptomatic locally advanced prostate cancer. 5th European Focused Ultrasound Symposium (EUFUS).

Anttinen, Mikael. 2019, June. Early experience of salvage MRI-guided transurethral ultrasound ablation for locally radiorecurrent prostate cancer. 5th European Focused Ultrasound Symposium (EUFUS).

Anttinen, Mikael. Early experience of salvage MRI guided transurethral ultrasound ablation for local prostate cancer recurrence after radiotherapy. European Association of Urology, Annual meeting, 20.-24.3.2020, Amsterdam

Anttinen, Mikael. Transurethral ultrasound ablation for benign prostatic hyperplasia: Three-month clinical outcomes of a phase 1-2 study. American Urological Association, Annual Meeting, 13.-16.5.2022, New Orleans, USA

Anttinen, Mikael. Transurethral ultrasound ablation (TULSA) for benign prostatic hyperplasia: three-month clinical outcomes. European Association of Urology, Annual Congress, Amsterdam, Netherlands, 1.-4.7.2022

Doerwald, Pouya. 12-month functional and oncological outcomes of salvage TULSA for localized radio-recurrent prostate cancer. UAA 2022, 19th Urological Association of Asia congress, Sydney, Australia, 5.10.-8.10.2022

Anttinen, Mikael. 12-month safety and oncological outcomes of salvage TULSA for localized radio-recurrent prostate cancer. European Association of Urology, Annual Congress, Milan, Italy,10.-13.3.2023

Anttinen, Mikael. 12 months clinical outcomes of transurethral ultrasound ablation (TULSA) for benign prostatic hyperplasia. European Association of Urology, Annual Congress, Milan, Italy,10.-13.3.2023

Anttinen, Mikael. Transurethral ultrasound ablation (TULSA) for benign prostatic obstruction: 12 months clinical outcomes. American Urological Association, Annual Meeting, 28.4.-1.5.2023, Chicago, USA

Doerwald, Pouya. Salvage transurethral ultrasound ablation (TULSA) for localized radio-recurrent prostate cancer: 12-month safety and oncological outcomes. Urological Association of Asia Congress, 28.9.-1.10.2023, Dubai, UAE

Doerwald, Pouya. Transurethral ultrasound ablation (TULSA) for benign prostatic hyperplasia: 12 months clinical outcomes. Urological Association of Asia Congress, 28.9.-1.10.2023, Dubai, UAE

Anttinen, Mikael. MRI-guided transurethral ultrasound ablation (tulsa) for the treatment of benign prostatic hyperplasia: 12-month outcomes of a phase 1-2 study. European Association of Urology, Annual Congress, 5.4.-8.4.2024, Paris, France

Anttinen, Mikael. Safety, Efficacy and Quality of Life Outcomes of MRI-guided Transurethral Ultrasound Ablation for Localized Prostate Cancer: 12-Month Outcomes. American Urological Association, Annual Meeting, 3.5.-6.5.2024, San Antonio, USA

Anttinen, Mikael. 12-month clinical outcomes of MRI-guided Transurethral ultrasound ablation (TULSA) in men with benign prostatic hyperplasia (BPH). American Urological Association, Annual Meeting, 3.5.-6.5.2024, San Antonio, USA

Anttinen, Mikael. CAPTAIN Randomized Controlled Trial Of TULSA Against Radical Prostatectomy For Intermediate-Risk Prostate Cancer: Design, Enrollment Update And Best Practices For Successful Recruitment. European Association of Urology, Annual Congress, 21.3.-24.3.2025, Madrid, Spain

Anttinen, Mikael. Effect of Neoadjuvant Degarelix on MRI-Guided Transurethral Ultrasound Ablation in Intermediate-Risk Prostate Cancer: A Pilot Study in Progress. Nordisk Urologisk Forening (NUF) biennial meeting, 4.6.-7.6.2025, Gothenburg, Sweden

Anttinen, Mikael. Impact of Neoadjuvant Degarelix on MRI Characteristics in MRI-Guided
Transurethral Ultrasound Ablation: Early Results from a Pilot Study. Nordisk Urologisk Forening (NUF) biennial meeting, 4.6.-7.6.2025, Gothenburg, Sweden

Anttinen, Mikael. CAPTAIN randomized controlled trial of TULSA against radical prostatectomy for intermediate-risk prostate cancer: Design and best practices for successful recruitment. Nordisk Urologisk Forening (NUF) biennial meeting, 4.6.-7.6.2025, Gothenburg, Sweden

Virtanen, Ilari. Short-term androgen deprivation therapy (nADT) optimizes prostate anatomy for MRI-guided transurethral ultrasound ablation (TULSA). BALTIC25, 10th Baltic Meeting in conjunction with the EAU, 30.5.-31.5.2025, Vilnius, Lithuania

Ongoing and Completed Research Projects:

Current projects (Active, Not Recruiting; Follow-up Phase):

1. Neoadjuvant ADT with TULSA in the Treatment of Intermediate Risk Prostate Cancer (NeoADT-TULSA)

NCT05917860
EUCT2022-502067-38-00
VARHA Research Permission: T1338/2023
Status: All participants have completed treatment; scheduled follow-up ongoing.
Objective: To evaluate whether short-course androgen deprivation enhances MRI-guided transurethral ultrasound ablation efficacy.

2. A Comparison of TULSA Procedure vs. Radical Prostatectomy in Participants With Localized Prostate Cancer (CAPTAIN)

NCT05027477
International multicenter randomized controlled trial.
Turku serves as the only European study site.

Status: Enrollment and interventions completed at our site; follow-up phase ongoing.

Objective: To compare oncological and functional outcomes of TULSA versus radical prostatectomy for localized prostate cancer.

Completed projects (Long-term Follow-up Ongoing):

1. MRI-Guided Transurethral HIFU for Various Prostate Diseases (HIFU-PRO)

NCT03335029
Ethics approval: 152/1801/2016, 13 January 2017

Status: Treatment phase completed; long-term follow-up ongoing.

Objective: To evaluate the feasibility, safety, and early clinical efficacy of MRI-guided transurethral ultrasound ablation across different prostate disease indications.

2. Prospective Clinical Safety and Efficacy Study of MRI-TULSA for Localized Prostate Cancer (PRO-TULSA-PCa)

NCT03814252
Ethics approval: 103/1801/2018, 26 October 2018

Status: Treatment completed; structured long-term follow-up ongoing.

Objective: To assess the safety, functional preservation, and oncological effectiveness of lesion-targeted MRI-guided transurethral ultrasound ablation in localized prostate cancer.