The use of high intensity focused ultrasound for various therapeutic applications has continued to grow since lynn et al first proposed it in 1942. Find out more about it including how you have it and when you might have it for different types of cancer. A new therapeutic option for solid tumors franco orsi 1, paolo arnone 1, wenzhi chen 2, lian zhang 2 1 interventional radiology unit, division of senology, european institute of oncology, 435 via ripamonti, 20141 milan, italy 2 clinical center for tumor therapy of 2nd hospital of chongqing university of medical sciences, chongqing 400010, china. Advantages over conventional local tumor control such as surgery, radiation, or radiofrequency are that mrhifu is completely noninvasive, nonionizing, and enables ablation of large tumor. Applying 25 high power sonications under mr imaging guidance, partial tumor ablation could be achieved without provoking neurological deficits or other adverse effects in the patient. Clinical application of highintensity focused ultrasound in. Currently, the evidence on the use of magnetic resonanceguided high intensity focused ultrasound mrgfus ablation for the treatment of other tumors breast cancer, brain cancer, prostate cancer and desmoid tumors consists of small case series, which is insufficiently robust to. Stent insertion with highintensity focused ultrasound.
A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success. Mrguided high intensity focused ultrasound, which offers precision of anatomy and temperature mapping for ablation of a target tissue without causing skin or subcutaneous tissue disruption in the path of focused ultrasound beam, is completely noninvasive for breast cancer therapy. The goal of this study was to investigate the feasibility of performing wide local ablation using ultrasound. Review of ten years of clinical experience lian zhang1, md, zhibiao wang 1,2,3, md, phd 1 clinical center for tumor therapy of 2nd hospital of chongqing university of medical sciences, chongqing 400010, china. This energy delivery system originally used to treat the whole prostate is used nowadays to treat a part of the gland. However, skin burn, long treatment time and incomplete ablation. In their prospective study, kovatcheva et al found that usguided high intensity focused us ablation is an effective and safe noninvasive treatment for benign solid thyroid nodules. Overview highintensity focused ultrasound for atrial.
A randomised clinical trial of highintensity focused. High intensity focused ultrasound in clinical tumor ablation abstract june 12, 2011 yufeng zhou, division of engineering mechanics, school of mechanical and aerospace engineering, nanyang technological university, 50 nanyang avenue, singapore 639798, singapore. Tissue damage can be accurately controlled using a range of focused ultrasound transducers with different sonication sizes. It is only in the past 10 to 15 years that technological advances in both the delivery system and the monitoring systems have allowed us to begin to truly explore this potential clinically. Review of ten years of clinical experience highintensity focused ultrasound hifu is a technique to destroy tissue at depth. It does not cover whether or not the nhs should fund a procedure. In current clinical practice, breastconserving therapy is the standard of care for patients with localized breast cancer. Prostate cancer treatment options information for patients. High intensity focused ultrasound is a rapidly developing technology for the ablation of tumors. Hifu for palliative treatment of pancreatic cancer springer. Highintensity focused ultrasound for prostate cancer. Hifu can be used to increase the flow of blood or lymph, or to destroy tissue, such as tumors, through a number of mechanisms.
Case report a fiftyoneyearold male patient with inoperable metastatic pancreatic cancer and low response to chemotherapy with gemcitabine as single therapy underwent palliative high intensity focused ultrasound hifu ablation. Highintensity focused ultrasound use widens in research. The use of highintensity focused ultrasound as a novel treatment for painful. Focused ultrasound ablation and pd1 antibody blockade in. Pdf high intensity focused ultrasound in clinical tumor ablation. The main mechanisms of hifu ablation involve mechanical and thermal effects. Ultrasound therapy, thermal ablation, cancer, heating, high intensity focused ultrasound hifu introduction the aim of most ablative therapies, whether for the treatment of cancer or of benign conditions, is the selective destruction of a targeted tissue volume, leaving surrounding tissues intact. Mr imaging guided high intensity focused ultrasound hifu. Damage effect of highintensity focused ultrasound on breast. High intensity focused ultrasound hifu is a treatment that aims to kill cancer cells with high frequency sound waves. It is also known as mrgfus mriguided focused ultrasound and fus focused ultrasound surgery. High intensity focused ultrasound hifu cancer research uk. Patients with residual cancer lesion by biopsy, psa greater than 0.
Hifu is capable of concentrating ultrasonic pressure waves to a specified region without any physical penetration of the body. Hifu is an attractive option for treatment of breast tumors. Diagnostic ultrasound is the first imaging modality used for guiding hifu ablation. Liu f, hu z, qiu l, hui c, li c, zhong p, zhang j 2010 boosting high intensity focused ultrasound induced anti tumor immunity using a sparsescan strategy that can more effectively promote dendritic cell maturation. A beam of ultrasound energy travels into the prostate from a probe put into the back passage rectum. Wide local ablation of localized breast cancer using. Apr 10, 2017 mri guided high intensity focused ultrasound hifu is a completely noninvasive technology for thermal ablation. High intensity focused ultrasound hifu has the potential to be such a treatment, as it can noninvasively ablate a targeted tumor below the skin surface, and may subsequently augment host antitumor immunity. High intensity focused ultrasound in clinical tumor. Highintensity focused ultrasound for therapeutic tissue. Hifu from its recommendations due to lack of randomized controlled clinical trials and. High intensity focused ultrasound hifu prostate cancer uk. Jan 10, 2011 recent advances in high intensity focused ultrasound hifu, which was developed in the 1940s as a viable thermal tissue ablation approach, have increased its popularity.
Liver cancer is one of the most common malignancies worldwide. Day 30 pain visual analogue scale experienced by patients during the sedation procedure, until surgery. Magnetic resonance mrguided high intensity focused ultrasound hifu is an innovative technique that allows for noninvasive thermal ablation of tissue. Highintensity focused ultrasound hifu is a noninvasive technique for the thermal ablation of solid tumours. The possibility of inducing precise coagulative necrosis of the tumor with sharp boundaries makes hifu one of the best options for focal therapy.
Our clinic treats hundreds of patients from around the world every year. Magnetic resonanceguided highintensity focused ultrasound mrhifu is a completely noninvasive ablation. High intensity focused ultrasound hifu energy using the sonablate system is delivered to the prostate tissue over approximately 2 hours. Mrg hifu bone and soft tissue tumor ablation, author ghanouni, p. Clinical use of ultrasound in cancer is not only for the diagnosis but also for the treatment. By using the combination of intensity high focused ultrasound hifu and imaging method, fus has the potential to ablate tumor lesions precisely. Multimodality treatment by folfox plus hifu in a case of. Mrhifu magnetic resonance high intensity focused ultrasound ablation was performed using proton resonance frequency shift mr thermometry and an mrhifu system specifically designed for breast tumor ablation.
Recent advances in hifu have increased its popularity. Currently, the evidence on the use of magnetic resonanceguided high intensity focused ultrasound mrgfus ablation for the treatment of other tumors breast cancer, brain cancer, prostate cancer and desmoid tumors consists of small case series, which is insufficiently robust to draw conclusions about efficacy. Focal high intensity focused ultrasound for prostate cancer. Local recurrence andor failure occurred in 42% of patients at high risk for recurrence. Hifu is an innovative, noninvasive treatment for a wide range of tumors and diseases. High intensity focused ultrasound hifu is a novel noninvasive.
This metaanalysis aims to evaluate the role of hifu in pain palliation of advanced unresectable pancreatic adenocarcinoma. The content of the monograph is the research of the physical and technical basis of the application of high intensity focused ultrasound in medicine in russian, 656 pages. To evaluate the clinical outcomes of high intensity focused ultrasound hifu and surgery in treating uterine fibroids, and prepare for a definitive randomised trial. In particular high intensity ultrasound and ultrasound visualization was accomplished stereotaxically with a cincinnati precision milling machine to perform accurate ablation of brain tumors. Until recently, clinical trials of hifu for ablation were few although significant work in hyperthermia was performed with ultrasonic heating, perhaps due to the complexity of the treatments and the difficulty of targeting the. Clinical application of highintensity focused ultrasound in cancer.
Jan 03, 2016 clinical use of ultrasound in cancer is not only for the diagnosis but also for the treatment. Focused ultrasound ablation and pd1 antibody blockade in advanced solid tumors am003 the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. You may hear your doctor call it noninvasive, which means a. Focused ultrasound at ucsf technical developments temperature mapping robust to motion real time integration rthawk with insightec system temperature mapping in bone and fat basic and clinical research cardiac ablation with high intensity ultrasound prostate hyperthermia pre clinical studies. Focused ultrasound surgery fus is a noninvasive technique.
A highintensity focused ultrasound hifu procedure is a technique approved by the fda to remove prostate tissue. We determined the clinical effectiveness and longterm outcomes in patients with distal biliary obstruction dbo secondary to pancreatic carcinoma pc who were treated by selfexpanded metallic stent sems insertion with or without high intensity focused ultrasound hifu ablation. Context pancreatic cancer is one of the most aggressive malignant diseases in which the survival rate has not improved in the past 40 years. Focused ultrasound fus, also called high intensity focused ultrasound hifu, has gained a lot of interest in recent years as noninvasive cancer therapy that does not require radiation, chemotherapy, or surgery, resulting is less collateral damage to the patient. Food and drug administration fda has approved 2 types of minimally invasive, high intensity focused ultrasound hifu therapy for treating prostate cancer. There is a new treatment option for patients with prostate cancer that is confined to the organ, and not spread to other areas of the body. The principle, mechanism, and clinical outcome of hifu were introduced. Highintensity focused ultrasound hifu ucsf radiology. Jul 26, 2006 the national institute for health and clinical excellence nice issued full guidance to the nhs in england, wales, scotland and northern ireland on high intensity focused ultrasound ablation of atrial tissue for atrial fibrillation as an associated procedure with other cardiac surgery in july 2006. Review clinical application of highintensity focused. This proves, for the first time, the feasibility of using transcranial mrguided focused ultrasound to safely ablate substantial volumes of brain tumor tissue. In this book experts will deal with two main topics. A highintensity focused ultrasound hifu procedure is one of the newest ways to treat prostate cancer. Clinical application of highintensity focused ultrasound.
Patients with earlystage invasive breast cancer underwent partial tumor ablation prior to surgical resection. Other applications include brain tumor ablation and disruption of the bloodbrain barrier. High intensity focused ultrasound hifu, thermal ablation. Effective and safe therapy for solid tumors in difficult locations franco orsi 1, lian zhang 2, paolo arnone 3, gianluigi orgera 1, guido bonomo 1, paolo della vigna 1, lorenzo monfardini 1, kun zhou 2, wenzhi chen 2. High intensity focused ultrasound hifu high intensity focused ultrasound hifu is a minimallyinvasive surgical technique for the thermal ablation of both malignant and benign tumors and cessation of internal bleeding in injured vessels and organs with little damage to the surrounding tissue. Magnetic resonanceguided focused ultrasound surgery mrgfus allows for precise thermal ablation of target tissues. Highintensity focused ultrasound in treating patients. High intensity focused ultrasound hifu is becoming an emerging approach of noninvasively ablating solid tumor in clinics. Hifu is a noninvasive, focal treatment for prostate cancer that allows precise application of heat to destroy cancer tissue. High intensity focused ultrasound as a trackless, noninvasive method of ablating tissue has been a concept with potential for more than 60 years. High intensity focused ultrasound hifu is a method of thermal ablation that is gaining popularity as an acceptable alternative to radical therapy in patients with localized prostate cancer pca. Although unique technical challenges remain to be overcome. In clinics, hifu has been applied to treat a variety of solid malignant tumors in a welldefined volume. Several clinical highintensity focused ultrasound projects have been conducted by various research groups, and re sults have shown the technique is safe, effective, and feasible in clinical application 1215.
The high intensity ultrasound beam is focused directly onto the cancer which heats the cells up and kills them. A chinese study found that ultrasonographyguided high intensity focused ultrasound ablation of bone tumors was both feasible and effective, and could be part of a limbsparing regimen. Purpose to assess the shortterm efficacy and safety of ultrasonographically usguided high intensity focused ultrasound hifu ablation for treatment of benign. To understand the basic principle of high intensity focused ultrasound as an. Fus is performed as an outpatient procedure, so it can eliminate the usual two weeks of recovery needed from most types of surgery. Robotassisted laparoscopic highintensity focused ultrasound and radical cystectomy for thermal ablation of muscle invasive cells in patients with bladder tumors the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. High intensity focused ultrasound hifu is a noninvasive therapeutic technique that uses nonionizing ultrasonic waves to heat tissue. Thermal ablation, the most clinically advanced bioeffect of focused ultrasound, produces cell death in a targeted area with minimal damage to the surrounding tissue. Evaluation of highintensity focused ultrasound ablation.
Highintensity focused ultrasound ablation around the tubing plos. Aug 10, 2010 high intensity focused ultrasound hifu is a technique to destroy tissue at depth within the body, selectively and without harming overlying and adjacent structures within the path of the beam because the ultrasonic intensity at the beam focus is much higher than that outside of the focus. Effective and safe therapy for solid tumors in difficult. It cant be used to treat tumours that are more widespread. Mrguided highintensity focused ultrasound ablation of. High intensity focused ultrasound hifu is being promoted as the only completely noninvasive and extracorporeal method to treat primary solid tumors and metastatic disease. Nov 17, 2017 feasibility of noninvasive presurgical identification of the tumor area to be resected palpation by the surgeon of the focused ultrasound ablation zone time frame. Highintensity focused ultrasound treatment for advanced. High intensity focused ultrasound in clinical tumor ablation ncbi. Request pdf highintensity focused ultrasound tumor ablation.
Partial gland ablation with high intensity focused ultrasound therapy was safe and it had a minimal impact on functional outcomes. Highintensity focused ultrasound hifu for treatment of. High intensity focused ultrasound hifu is a novel noninvasive technique that is capable of producing coagulative necrosis at a precise focal point within the body, without harming overlying and adjacent structures even within the path of the beam. Highintensity focused ultrasound hifu is an effective noninvasive procedure for the focal treatment of prostate cancer pca. Pdf high intensity focused ultrasound in clinical tumor. Highintensity focused ultrasound hifu is a technique to destroy tissue at depth within the body, selectively and without harming overlying and adjacent structures within the path of the beam because the ultrasonic intensity at the beam focus is much higher than that outside of the focus. We aim at b riefly outlining the clinical utility of fus as a noninvasive technique for a variety of types of cancer treatment. High intensity focused ultrasound treatment of breast tumors.
High intensity focused ultrasound hifu is a noninvasive thermal ablation technique that has been used to treat pancreatic cancer. Using noninvasive focused ultrasound in the treatment of brain tumors with minimal side effects or down time seems like science fiction. Highintensity focused ultrasound hifu uses high frequency ultrasound energy to heat and destroy cancer cells in the prostate. High instensity focused ultrasound hifu is a minimally invasive technique which decreases the risk of posttreatment complications and allows shorter hospitalization times. First noninvasive thermal ablation of a brain tumor with. Onehalf of participants will be randomized to receive the first dose of pembrolizumab. Since liver has a large number of blood vessels, blood flow cooling can reduce the necrosed volume and may cause regeneration of the tumor to occur. Optimizing the treatment of breast cancer remains a major topic of interest. Bone regeneration after fus effect of sonication duration on ablation depth facet joint ablation. Though it hasnt been approved for the treatment of prostate cancer in the u. Highintensity focused ultrasound maimonides medical. Hifumediumterm oncological outcomes prostate cancer. Multiphysics modeling of liver tumor ablation by high. The aim of this study was to evaluate the safety and efficacy of ultrasound guided high intensity focused ultrasound therapeutic ablation of solid tumors in difficult locations.
In clinics, hifu has been applied to treat a variety of solid malignant tumors in. In the book the tumor, john grisham describes this highly innovative clinical process, which consists of applying sound waves at a frequency past the hearing capability of a human ear. While this emerging modality is increasingly used for the treatment of various types of extracranial soft tissue tumors, it has only recently been acknowledged as a modality for noninvasive neurosurgery. For breast tumors, ultrasound and mr guided hifu therapy have been used. Highintensity focused ultrasound hifu has been emerging as an effective and noninvasive modality in cancer treatment with very promising clinical. A metaanalysis of palliative treatment of pancreatic. High intensity focused ultrasound hifu is a technique to destroy tissue at depth within the body, selectively and without harming overlying and adjacent structures within the path of the beam because the ultrasonic intensity at the beam focus is much higher than that outside of the focus. May 26, 2016 highintensity focused ultrasound hifu is a noninvasive therapy that makes entire coagulative necrosis of a tumor in deep tissue through the intact skin. See a list of clinical trials assessing focused ultrasound for treatment of breast cancer a trial at the university of virginia is evaluating the use of high intensity focused ultrasound combined with pembrolizumab in patients with metastatic breast cancer. We aim at briefly outlining the clinical utility of fus as a. Medical image computing and computerassisted intervention. Ge hy, miao ly, wang jr, xiong ll, yan f, zheng cs, jia jw, cui lg, chen w 20 correlation between ultrasound reflection intensity and tumor ablation ratio of latestage pancreatic carcinoma in hifu therapy. Caution urged with high intensity focused ultrasound. High intensity focused ultrasound hifu is a new technique that can cause cell death and tissue necrosis by focusing high energy ultrasonic waves on a single location, and it has attracted recent interest as a noninvasive therapy particularly for cancer treatment.
A probe is placed in the rectum for treatment, and high energy ultrasound waves are focused on the prostate, which is 14 centimeters away. Review high intensity focused ultrasound tumor ablation. First clinical experience with a dedicated mriguided high intensity focused ultrasound system for breast cancer ablation. High intensity focused ultrasound offers new tumor treatment. High intensity focused ultrasound hifu is a form of ablation that uses energy from high frequency sound waves to destroy cancer cells. Highintensity focused ultrasound hifu uses ultrasonic energy in the frequency range of 20 khz200 mhz to create focused thermal ablation lesions by molecular vibration and friction, without affecting intervening structures fig. There are many reports about the hifus efficacy in the treatment of patients with breast cancer, but randomized clinical trials are rare which emphasize on the systematic assessment of histological changes in the ablated tumor.
Day 2, 8 immediate complications of focused ultrasound time frame. Mriguided highintensity focused ultrasound mrgfus ablation. Pancreatic cancer is under high mortality but has few effective treatment modalities. High intensity focused ultrasound ablation subject areas on research ablation of the locally advanced pancreatic cancer. This chapter is to introduce the history and principles of hifu tumor ablation, and its biological effects on the tumor microenvironment.
High intensity focused ultrasound treatment of breast. Technological developments have fueled interest in less invasive breast cancer treatment. Early treatment of her2amplified brain tumors with targeted nk92 cells and focused ultrasound improves survival. The treatment is very precise, zeroing in on just the cancerous tumor. High intensity focused ultrasound in clinical tumor ablation. Among these therapies, high intensity focused ultrasound hifu emerged as a valid mini invasive therapy for localised prostate cancer, using focused ultrasound to generate areas of intense heat to induce tissue necrosis. Our website is designed to provide information on prostate cancer treatment options, particularly high intensity focused ultrasound hifu treatments, for patients and physicians. Hifu energy delivered circumferentially via a balloon at the pv ostium was developed for pv isolation. Listing a study does not mean it has been evaluated by the u. A novel high intensity focused ultrasound robotic system for. Prospective multicentre patient choice cohort study ideal exploratory study of hifu, myomectomy or hysterectomy for treating symptomatic uterine fibroids. Mrguided high intensity focused ultrasound hifu on.
What are the principles of the various ablation modalities, and ii. Hifu as a treatment for cancer hifu is only useful to treat a single tumour or part of a large tumour. Our team of board certified urologists has the most experience with the hifu procedure in the area, and with the treatment of prostate cancer in general. By using the combination of high intensity focused ultrasound hifu and imaging method, fus has the potential to ablate tumor lesions precisely. Tumor ablation methods using chemicals, radiation, photodynamic therapy, cryoablation, high temperature, radiofrequency, high intensity focused ultrasound, and electricbased ablation have been developed for focal tumors. World journal of clinical oncology, 2011 january 10. The application of ultrasound in clinics is no longer limited to diagnosis. By using the combination of highintensity focused ultrasound hifu and imaging method, fus has the potential to ablate tumor lesions precisely. Recent advances in high intensity focused ultrasound hifu, which was developed in the 1940s as a viable thermal tissue ablation approach, have increased its popularity. High intensity focused ultrasound hifu is a promising technique for cancer treatment owing.
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