EXHIBIT 4.1(b)

Amendment No. 1 to
the Distribution Agreement

Amendment
No. 1, dated as of December 23, 2004 (this Amendment), to the Distribution
Agreement (the Distribution Agreement), dated as of February 25, 2004, by
and between EDAP TMS S.A., EDAP S.A. and Technomed Medical Systems S.A. (collectively,
the EDAP Parties) and HT Prostate Therapy Management Company, LLC (HT Prostate).
Capitalized terms used but not otherwise defined herein shall have the
meanings ascribed to such terms in the Distribution Agreement.

W I T N E S S E T H:

WHEREAS,
the EDAP Parties and HT Prostate have entered into the Distribution Agreement; and

WHEREAS,
the EDAP Parties and HT Prostate desire to amend the Distribution Agreement, in
accordance  with Section 13.4 thereof.

NOW,
THEREFORE, in consideration of the mutual promises and covenants contained herein, and
other good and valuable consideration, the receipt and legal sufficiency of which are
hereby acknowledged, HT Prostate and the EDAP Parties, intending to be legally bound,
agree as follows:

| | 1)
Amendment to Section 8.1. The first two sentences of Section 8.1 of the
Distribution Agreement are hereby deleted and amended to read, in their entirety, as
follows:
| | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| | 8.1 | License.
HIFU Subsidiary hereby grants HT Prostate, and HT Prostate  hereby accepts, a
royalty-bearing, non-assignable, non-transferable, non-sublicensable  license to use the
trademarks, proprietary names and other marks set forth in Schedule A  (the Ablatherm
Related Marks ) in the Territory during the term of this  Agreement solely for
the purpose of marketing, distributing and providing services for the  Products and
Ablatherm Related Devices as permitted herein. Such license shall be  non-exclusive prior
to receipt of the PMA and shall be exclusive in the Territory  following receipt of the
PMA. In consideration for this license, HT Prostate agrees to pay  EDAP an amount equal
to 10% of the sales price of the Products sold to HT Prostate by  EDAP.
| | --- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| | 2)
Authorization. Each party hereto represents to the other that (a) such party has
all necessary corporate power and authority to enter into this Amendment; (b) the
execution and delivery by each party hereto of this Amendment have been duly authorized
by  all requisite corporate action on the part of such party; and (c) this Amendment has
been  duly executed and delivered by each party hereto.
| | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

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| | 3)
Distribution Agreement Remains in Effect. Except as expressly amended by this
Amendment, the Distribution Agreement remains in full force and effect and nothing in
this  Amendment shall otherwise affect any other provision of the Distribution Agreement
or the  rights and obligations of the parties thereunder, and the Distribution Agreement,
as  amended by this Amendment, shall together constitute a single agreement between the
parties.
| | ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| | 4)
Counterparts. This Amendment may be executed in one or more counterparts, each of
which when executed shall be deemed to be an original but all of which taken together
shall constitute one and the same instrument.
| | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| | 5)
Successors and Assigns. This Amendment and the rights, duties and obligations
arising hereunder shall be binding upon and inure to the benefit of the parties and to
their respective successors and permitted assigns. Neither HT Prostate nor any EDAP Party
may assign this Amendment or its rights, duties or obligations hereunder without the
prior  written consent of the EDAP Parties or HT Prostate, respectively, such consent not
to be  unreasonably withheld or delayed, and any prohibited assignment of this Amendment
shall be  null and void; provided, however that, except as otherwise provided
herein, any  party may assign its rights, duties or obligations under the Distribution
Agreement as  amended by this Amendment to the successor of its business in connection
with a merger,  acquisition or another event resulting in the sale of all, or
substantially all, of the  stock or assets of such party.
| | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

| | 6)
Governing Law. This Amendment will be construed and enforced in accordance with
the  laws of the State of Georgia.
| | ---------------------------------------------------------------------------------------------------------------------

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IN
WITNESS WHEREOF, the parties hereto have executed this Amendment, under seal, as of the
date first written above.

|HT PROSTATE THERAPY MANAGEMENT
COMPANY, LLC | EDAP TMS S.A.
|------------------------------------------- | -------------

|By: | /s/ Argil J. Wheelock | By: | /s/ Hugues de Bantel
|--- | --------------------- | --- | --------------------

| | Argil J. Wheelock, M.D., CEO |  | Hugues
de Bantel, CEO
| | ---------------------------- |  | ---------------------

|Address: | 1841 West Oak ParkwaySuite AMarietta, GA  30062 | Address: | 4-6 rue du Dauphiné
69120 Vaulx-en-VelinFrance
|-------- | ----------------------------------------------- | -------- | ----------------------------------------------

|Telephone No.: 770-419-0691Facsimile No.:  770-419-9490 | Telephone
No.: +33 4 72 15 31 50Facsimile No.:  +33 4 72 15 31 51
|------------------------------------------------------- | -----------------------------------------------------------------

| | EDAP
S.A.
| | ---------

| | By: | /s/ Hugues de Bantel
| | --- | --------------------

| |  | Hugues
de Bantel, President
| |  | ---------------------------

| | Address: | 4-6 rue du Dauphiné
69120 Vaulx-en-VelinFrance
| | -------- | ----------------------------------------------

| | Telephone
No.: +33 4 72 15 31 50Facsimile No.:  +33 4 72 15 31 51
| | -----------------------------------------------------------------

| | TECHNOMED MEDICAL SYSTEMS S.A.
| | ------------------------------

| | By: | /s/ Hugues de Bantel
| | --- | --------------------

| |  | Hugues
de Bantel, President
| |  | ---------------------------

| | Address: | 4-6 rue du Dauphiné
69120 Vaulx-en-VelinFrance
| | -------- | ----------------------------------------------

| | Telephone
No.: +33 4 72 15 31 50Facsimile No.:  +33 4 72 15 31 51
| | -----------------------------------------------------------------

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