Safety Study of MRI-guided Transurethral Ultrasound Ablation of Prostate Tissue to Treat Localized Prostate Cancer

Profound Medical Inc. has developed a novel technology called the MRI-guided transurethral
ultrasound therapy system. The technology is developed for patients with organ confined
prostate cancer. The therapeutic endpoint of this technology is thermal coagulation of
prostate tissue.

The treatment is conducted completely within an MRI suite, which enables real-time
temperature images of the heated region to be acquired as the ultrasonic treatment is
delivered. Using MRI thermometry during treatment, dynamic temperature feedback control over
the intensity of the ultrasound beams and rotation of the Ultrasound Applicator can shape the
pattern of thermal coagulation accurately and precisely in the prostate gland, thereby
reducing the risk of possible damage to important surrounding anatomy such as the rectum,
urinary sphincters, neurovascular bundles and pelvic bone. This coagulation method,
therefore, has the potential to have lower complication rates than conventional therapies.

Inclusion Criteria:

- Male, age ≥65

- Patient with low-risk, early-stage organ-confined prostate cancer (Stage T1c or T2a,
N0, M0).

- Gleason score 6 (3+3)

- Prostate-specific antigen (PSA) ≤ 10 ng/ml

- Eligible for MR imaging (DOC-10252)

- Meets the following criteria on pre-treatment transrectal ultrasound imaging:

1. No cysts or calcifications > 1.0 cm in size

2. No evidence of extraprostatic extension or seminal vesicle invasion

3. Overall prostate size less than 5 cm in sagittal length and less than 7 cm in
diameter

- Biopsy confirmed adenocarcinoma of the prostate, performed at least 6 weeks prior to
and no more than 6 months prior to the scheduled treatment.

- Eligible for General Anesthesia, as defined in American Society of Anesthesiologists
(ASA)

- Normal rectal anatomy and rectal mucosa on digital rectal examination

Exclusion Criteria:

- Bleeding disorder

- Abnormal coagulation and current anticoagulant therapy.

- Acute or chronic Urinary Tract Infection

- Interest in future fertility

- History of allergy relevant medication or other

- History of any other malignancy other than skin cancer

- Patients with peripheral arterial disease with intermittent claudication or Leriches
Syndrome

- Prior treatment of the prostate gland

- Prior treatment with 5 alpha reductase inhibitor allowed (not as prostate cancer
treatment or prevention) as long as drug has been stopped for minimum 3 months

- History of any major rectal or pelvic surgery

- History of ulcerative colitis or other chronic inflammatory conditions affecting
rectum

- History of documented clinical prostatitis requiring therapy within previous 6 months

- History of urethral and bladder outlet disorders, including urethral stricture
disease, urethral diverticulae, bladder neck contracture, urethral fistulae which had
required prior urethrotomy, urethral stenting, urethroplasty or chronic indwelling
urethral catheter

- Patients with artificial urinary sphincter or any penile implant (metallic or
non-metallic)

- Neurologic bladder disorders

- Untreated bladder stones

- History of acute urinary retention

- Confirmed or suspected bladder cancer

- Urinary sphincter abnormalities

- Active untreated gross hematuria for any cause

- Post Void Residual (PVR) bladder volume > 250 mL

- Obstructing median lobe enlarged out of proportion to the rest of the prostate and
protruding significantly into the bladder

Additional exclusion criteria on file....