Journal articles on the topic 'HIFU therapy'
To see the other types of publications on this topic, follow the link: HIFU therapy.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'HIFU therapy.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Bespalov, Vladimir, Grigoriy Tochilnikov, Konstantin Senchik, Yelena Yermakova, Yelizaveta Kovalevskaya, Georgiy Gafton, and A. Berkovich. "HIGH-INTENSITY FOCUSED ULTRASOUND IN THE TREATMENT OF MALIGNANT AND BENIGN TUMORS." Problems in oncology 66, no. 1 (January 1, 2020): 29–35. http://dx.doi.org/10.37469/0507-3758-2020-66-1-29-35.
Abstract:
The review article discusses the possibilities of using high-intensity focused ultrasound (HIFU) in oncology. The technical principles and features of HIFU ablation, a brief history of the development of HIFU therapy, the principles of HIFU therapy, the physical basis of the HIFU ablation method, and the mechanisms of antitumor action of HIFU therapy are presented. The results and benefits of HIFU therapy for various malignant and benign tumors are discussed.
2
Gunderman, Anthony, Rudy Montayre, Ashish Ranjan, and Yue Chen. "Review of Robot-Assisted HIFU Therapy." Sensors 23, no. 7 (April 3, 2023): 3707. http://dx.doi.org/10.3390/s23073707.
Abstract:
This paper provides an overview of current robot-assisted high-intensity focused ultrasound (HIFU) systems for image-guided therapies. HIFU is a minimally invasive technique that relies on the thermo-mechanical effects of focused ultrasound waves to perform clinical treatments, such as tumor ablation, mild hyperthermia adjuvant to radiation or chemotherapy, vein occlusion, and many others. HIFU is typically performed under ultrasound (USgHIFU) or magnetic resonance imaging guidance (MRgHIFU), which provide intra-operative monitoring of treatment outcomes. Robot-assisted HIFU probe manipulation provides precise HIFU focal control to avoid damage to surrounding sensitive anatomy, such as blood vessels, nerve bundles, or adjacent organs. These clinical and technical benefits have promoted the rapid adoption of robot-assisted HIFU in the past several decades. This paper aims to present the recent developments of robot-assisted HIFU by summarizing the key features and clinical applications of each system. The paper concludes with a comparison and discussion of future perspectives on robot-assisted HIFU.
3
Sofuni, Atsushi, Yasutsugu Asai, Takayoshi Tsuchiya, Kentaro Ishii, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, et al. "Novel Therapeutic Method for Unresectable Pancreatic Cancer—The Impact of the Long-Term Research in Therapeutic Effect of High-Intensity Focused Ultrasound (HIFU) Therapy." Current Oncology 28, no. 6 (November 20, 2021): 4845–61. http://dx.doi.org/10.3390/curroncol28060409.
Abstract:
High-intensity focused ultrasound (HIFU) is a novel advanced therapy for unresectable pancreatic cancer (PC). HIFU therapy with chemotherapy is being promoted as a novel method to control local advancement by tumor ablation. We evaluated the therapeutic effects of HIFU therapy in locally advanced and metastatic PC. PC patients were treated with HIFU as an optional local therapy and systemic chemotherapy. The FEP-BY02 (Yuande Bio-Medical Engineering) HIFU device was used under ultrasound guidance. Of 176 PC patients, 89 cases were Stage III and 87 were Stage IV. The rate of complete tumor ablation was 90.3%, while that of symptom relief was 66.7%. The effectiveness on the primary lesions were as follows: complete response (CR): n = 0, partial response (PR): n = 21, stable disease (SD): n = 106, and progressive disease (PD): n = 49; the primary disease control rate was 72.2%. Eight patients underwent surgery. The median survival time (MST) after diagnosis for HIFU with chemotherapy compared to chemotherapy alone (100 patients in our hospital) was 648 vs. 288 days (p < 0.001). Compared with chemotherapy alone, the combination of HIFU therapy and chemotherapy demonstrated significant prolongation of prognosis. This study suggests that HIFU therapy has the potential to be a novel combination therapy for unresectable PC.
4
Ge, Hui-Yu, Li-Ying Miao, Jin-Rui Wang, Liu-Lin Xiong, Fang Yan, Cui-Shan Zheng, Jian-Wen Jia, Li-Gang Cui, and Wen Chen. "Correlation between Ultrasound Reflection Intensity and Tumor Ablation Ratio of Late-Stage Pancreatic Carcinoma in HIFU Therapy: Dynamic Observation on Ultrasound Reflection Intensity." Scientific World Journal 2013 (2013): 1–10. http://dx.doi.org/10.1155/2013/852874.
Abstract:
The minimally invasive high-intensity focused ultrasound (HIFU) therapy is thermal ablation treatment for late-stage pancreatic carcinoma with widely recognized safety and effectiveness, but there are currently no instant assessment methods for its ablation effect. It is vital to find a real-time high-sensitive assessment method. This research aims to dynamically observe the variation rules of ultrasound reflection intensity, analyze the correlation between ultrasound reflection intensity and tumor ablation ratio, and find out the value of ultrasound reflection intensity in prognosis of HIFU ablation effect. HIFU intermittent therapies were retrospectively analyzed for 31 subjects with late-stage pancreatic carcinoma from March 2007 to December 2009 in the study. The variation rules of the ultrasound reflection intensity during HIFU therapy were summarized and the correlation between ultrasound reflection intensity and tumor ablation ratio was analyzed based on the tumor ablation ratio indicated by CT scanning. The conclusion is that variation of ultrasound reflection intensity can be used for initial assessment of tumor ablation in HIFU therapy and early prognosis of overall HIFU ablation, providing important clinical basis for improving safety and effectiveness of HIFU therapy. Ultrasound can work as a real-time imaging instrument for observation of HIFU ablation effect in treating late-stage pancreatic carcinoma.
5
Liu, Li, and Jian Sun. "A Study of Temperature Measurement Technique of High Intensity Focusing Ultrasonic Therapy." Applied Mechanics and Materials 201-202 (October 2012): 521–24. http://dx.doi.org/10.4028/www.scientific.net/amm.201-202.521.
Abstract:
High intensity focused ultrasound (HIFU) is the fourth brand-new and efficient means to cure tumour acknowledged by the medical field. China is one of countries applying HIFU to clinical oncotherapy earliest in the world. However, a considerable part of HIFU equipments which have been put on the market leave unused because accidental injuries such as ambustion to the body surface, tumour tissue residues in the target section or damages to normal tissues are often caused in HIFU clinical treatment. In the thesis, temperature measurement technique of high-intensity focusing ultrasonic therapy is introduced; features and existing problems of two methods (ultrasound and MRI) which are usually used at home and abroad to guide and monitor HIFU treatment are focally analyzed and illustrated.
6
Yu, Tinghe, and Xiao Fu. "Extracorporeal Ultrasound-Guided High Intensity Focused Ultrasound: Implications from the Present Clinical Trials." Scientific World Journal 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/537260.
Abstract:
Extracorporeal ultrasound-guided high intensity focused ultrasound (HIFU) has been clinically used for 15 years, and over 36000 cases have been reported. However, there yet lacked a consensus in the clinical values, suggesting the necessity of checking clinical findings. Clinical trials were searched and data reevaluated. HIFU was hardly performed alone; almost all present anticancer means have been applied during an HIFU treatment, and a specific regimen varied between trials; there were heterogeneity and disagreement between trials. The complexity made it difficult to distinguish the effect of HIFU. Based upon evaluable data, the efficacy of HIFU was similar to that of radio frequency, chemoembolization, chemotherapy, radiotherapy, or hormone therapy; a combined therapy did not improve the efficacy. The survival rate of HIFU plus radiotherapy was lower than that of radical surgery in liver cancers. Adverse events had no downtrend in the past years. HIFU was not a standardized procedure where the intensity and insonation mode were modified constantly throughout a treatment, limiting an evaluation from the perspective of ultrasonics. These implied that HIFU should be applied as an alternative at most occasions. The present clinical trials had defects making against the understating of HIFU.
7
Vargas-Olivares, A., O. Navarro-Hinojosa, M. Maqueo-Vicencio, L. Curiel, M. Alencastre-Miranda, and J. E. Chong-Quero. "Segmentation Method for Magnetic Resonance-Guided High-Intensity Focused Ultrasound Therapy Planning." Journal of Healthcare Engineering 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/5703216.
Abstract:
High-intensity focused ultrasound (HIFU) is a minimally invasive therapy modality in which ultrasound beams are concentrated at a focal region, producing a rise of temperature and selective ablation within the focal volume and leaving surrounding tissues intact. HIFU has been proposed for the safe ablation of both malignant and benign tissues and as an agent for drug delivery. Magnetic resonance imaging (MRI) has been proposed as guidance and monitoring method for the therapy. The identification of regions of interest is a crucial procedure in HIFU therapy planning. This procedure is performed in the MR images. The purpose of the present research work is to implement a time-efficient and functional segmentation scheme, based on the watershed segmentation algorithm, for the MR images used for the HIFU therapy planning. The achievement of a segmentation process with functional results is feasible, but preliminary image processing steps are required in order to define the markers for the segmentation algorithm. Moreover, the segmentation scheme is applied in parallel to an MR image data set through the use of a thread pool, achieving a near real-time execution and making a contribution to solve the time-consuming problem of the HIFU therapy planning.
8
Pasticier, Gilles, Ji-Wann Lee, Sebastien Crouzet, J. Soria, Christelle Medollima, Florence Mege-Lechevallier, Jean-Yves Chapelon, Olivier Rouviere, and Albert Gelet. "Localized prostate cancer and salvage treatment: EBRT first + salvage HIFU or HIFU first + salvage EBRT? A single-institution matched pair analysis over a 20-year period." Journal of Clinical Oncology 35, no. 6_suppl (February 20, 2017): 77. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.77.
Abstract:
77 Background: In the field of curative treatment for localized prostate cancer, HIFU (High Intensity Focused ultrasound) is one of salvage option after EBRT(external beam radiation therapy) failure and EBRT is the standard salvage option for local relapse after HIFU.Our aim was to compare and evaluate the oncologic outcomes between HIFU first + salvage EBRT versus EBRT first +salvage HIFU. Methods: Using a matched pair analysis, 342 Patients (171 in each group) treated between 1994 and 2014 in the same institution were prospectively followed and matched to a 1:1 basis. Outcome measurements: Overall Survival Rate(OSR), cancer specific(CSSR) and metastasis free (MFSR) survival rates were the primary endpoints. Secondary endpoints were survival rate free of hormone therapy (HTFR) and the rate of side effects Clavien score ≥ 3. Results: Mean follow-up were 114 and 124 months for HIFU+ S-EBRT and EBRT + S-HIFU respectively. At 7 years from the primary treatment , the MFSR were significantly better after HIFU first +S- EBRT than after EBRT first+S- HIFU: 96% vs 91%% (p:0.011). The OSR and the CSSR were not significantly different in the two arms (97% and 99% after HIFU+S- EBRT versus 96% and 98% after EBRT+S- HIFU). The HTFR at 7 years was significantly different (p <0.001) after HIFU+ S-EBRT than after EBRT+ S-HIFU 90% versus 69%. In multivariable Cox regression, the initial Gleason sum ≥ 8 and the treatment strategy were predictors of MFSR (risk ratio 3.2 for treatment modality). The rate of side effect Clavien score≥ 3 was significantly higher (p:0.01) in the EBRT+ S-HIFU arm than in the HIFU+ S-EBRT arm. The rate of urinary toxicity (severe incontinence and bladder outlet obstruction) were worse in the EBRT+ S-HIFU arm than in HIFU+S-EBRT arm: 9.4% and 15.2% vs 1.2% and 7.6% (p:0.01 and 0.078). Conclusions: In this single-institution Matched Pair comparison, the MFSR and HTFR were significantly better in the HIFU+S-EBRT arm than in the EBRT+S-HIFU arm. The rate of urinairy toxicity and Clavien≥3 side-effects were Higher in the EBRT + S-HIFU arm than in the HIFU + S-EBRT arm.
9
He, G.-B., W. Luo, X.-D. Zhou, L.-W. Liu, M. Yu, and X.-D. Ma. "A preliminary clinical study on high-intensity focused ultrasound therapy for tubal pregnancy." Scottish Medical Journal 56, no. 4 (November 2011): 214–19. http://dx.doi.org/10.1258/smj.2011.011161.
Abstract:
Our aim was to explore the clinical application value of high-intensity focused ultrasound (HIFU) therapy for tubal pregnancy. Forty hospitalized patients with tubal pregnancies (28 cases of non-ruptured tubal pregnancy and 12 cases of ruptured tubal pregnancy) were selected to receive HIFU therapy. Serum human chorionic gonadotropin (β-HCG) concentrations were compared before and after treatment. Serum β-HCG was measured weekly and patients received observation only if the concentration decreased by 15% or more, compared with the previous value. Patients were given supplement HIFU therapy if the decrease in the serum β-HCG was <15% within two weeks. Ultrasound was used to detect the volume changes in the ectopic lesions before and after treatment, and changes in vital signs and complications were recorded. Contrast-enhanced ultrasonography was used to assess fallopian tube patency after treatment. HIFU treatment was successful in 33 of the 40 patients (82%). Seven patients failed HIFU treatment and received surgical therapy (18%). Before and after treatment, serum β-HCG concentrations and lesion volume were significantly different ( P < 0.05, P < 0.01, respectively). Post-treatment tubal contrast-enhanced ultrasonography showed tubal patency on the affected side in 21 cases (64%) at six months and in 27 cases (82%) at 12 months. In conclusion, HIFU is safe and effective, and can be a treatment option for tubal pregnancy.
10
Feng, Sui, Yingjie Qu, Yuquan Meng, and Jinjin Zheng. "Use thermophysical property to quantify state of HIFU treatment for VLS." E3S Web of Conferences 185 (2020): 03045. http://dx.doi.org/10.1051/e3sconf/202018503045.
Abstract:
The aim of this study is to evaluate the performance of ADT methods in grading the effectiveness of HIFU treatment for VLS. High-intensity focused ultrasound has been identified as a promising treatment modality for vulvar lichen sclerosus, a common inflammatory disorder associated with an increased risk of developing vulvar carcinoma. With small probe on extensive VLS parts, the therapy was sometimes uneven, thus the total doses of HIFU machine couldn’t indicate the curative effect at each part. The current therapeutic effect was based on symptoms and skin appearance after 3 months, which was time-consuming. Until now, there has been no immediate quantitative assessment method of HIFU therapeutic response for VLS. In our study, active dynamic IR thermal (ADT) was scheduled to undergo HIFU therapy before and after treatment. The thermal time constant was calculated based on ADT images measured both before and after HIFU treatment. In the result of pig phantom measurements, with each part approximately the same thermal time constant before HIFU treatment, the change of thermal time constant was strictly positively associated with HIFU dose onto each part. This study demonstrates the clinical potential of ADT in fast and effective quantify state of HIFU treatment for VLS.
11
Vespasiani, G., A. D. Asimakopoulos, E. Finazzi Agrò, and G. Virgili. "High-intensity focused ultrasound and prostate cancer: technology, state of the art and future." Urologia Journal 75, no. 4 (October 2008): 199–206. http://dx.doi.org/10.1177/039156030807500401.
Abstract:
Background. The potential applications of the high-intensity focused ultrasound (HIFU) as a minimally invasive therapy of the localized prostate cancer explain the growing interest of the urologic community towards this technique. HIFU has been assessed for its role in the treatment of localized prostate cancer in patients who otherwise would not have benefited from surgery, and in local recurrences after radiation failure. Methods. Relevant information on HIFU treatment was identified through a literature search of published studies. Results. High biochemical efficacy, excellent tumor local control and favorable mid- and long-term oncological data with a low morbidity rate have been shown in many series of patients. Conclusions. Although HIFU is a recent and emerging technology, it has been well studied and developed to a point that HIFU will undoubtedly be an effective alternative to radiation therapy.
12
Rittberg, Rebekah, Tadeusz Kroczak, Neil Fleshner, and Darrel Drachenberg. "Salvage HIFU for biopsy confirmed local prostate cancer recurrence after radical prostatectomy and radiation therapy: Case report and literature review." Canadian Urological Association Journal 9, no. 9-10 (September 9, 2015): 671. http://dx.doi.org/10.5489/cuaj.2888.
Abstract:
High-intensity focused ultrasound (HIFU) is a treatment option for low- and intermediate-risk prostate cancer and more recently has been used as salvage therapy after failed radiation therapy. We present a case of local recurrence with biochemical failure after radical prostatectomy and salvage external beam radiation therapy with salvage HIFU without biochemical recurrence at 20 months.
13
Siedek, Florian, Sin Yuin Yeo, Edwin Heijman, Olga Grinstein, Grischa Bratke, Carola Heneweer, Michael Puesken, Thorsten Persigehl, David Maintz, and Holger Grüll. "Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU): Technical Background and Overview of Current Clinical Applications (Part 1)." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 191, no. 06 (January 10, 2019): 522–30. http://dx.doi.org/10.1055/a-0817-5645.
Abstract:
Background Extracorporeal high-intensity focused ultrasound (HIFU) is a promising method for the noninvasive thermal ablation of benign and malignant tissue. Current HIFU treatments are performed under ultrasound (US-HIFU) or magnetic resonance (MR-HIFU) image guidance offering integrated therapy planning, real-time control (spatial and temperature guidance) and evaluation. Methods This review is based on publications in peer-reviewed journals addressing thermal ablation using HIFU and includes our own clinical results as well. The technical background of HIFU is explained with an emphasis on MR-HIFU applications. A brief overview of the most commonly performed CE-approved clinical applications for MR-HIFU is given. Results Over the last decade, several HIFU-based applications have received clinical approval in various countries. In particular, MR-HIFU is now approved for the clinical treatment of uterine fibroids, palliation of bone pain, ablation of the prostate and treatment of essential tremor as a first neurological application. Conclusion MR-HIFU is a patient-friendly noninvasive method for thermal ablation which has received clinical approval for several applications. Overall, clinical data demonstrate treatment efficacy, safety and cost efficiency. Key Points: Citation Format
14
Guillaumier, Stephanie, Neil McCartan, Louise Dickinson, Yomi Fatola, Alex Freeman, Richard Hindley, Mark Emberton, and Hashim Uddin Ahmed. "Does focal high-intensity focused ultrasound have a role in treating localized prostate cancer in the elderly?" Journal of Clinical Oncology 33, no. 7_suppl (March 1, 2015): 133. http://dx.doi.org/10.1200/jco.2015.33.7_suppl.133.
Abstract:
133 Background: There is an increase in the ageing population leading a significant proportion of men diagnosed with prostate cancer being over 75 years of age. Misconceptions regarding treating the elderly are still rife. The body of evidence that has recently emerged shows that this cohort of patients should be offered the same curative therapies as their counterparts. This study looks at the feasibility of focal HIFU in treating localised prostate cancer in those aged over 75 years of age. Methods: Our independent academic HIFU registry incorporates a total of 60 patients who were diagnosed with low, intermediate and high risk localized adenocarcinoma of the prostate, stage T2a-T3aN0M0 and treated with focal HIFU using Sonablate500, between 2004 and 2014. We divided the patient cohort into those that were treated within the remit of a trial protocol, and those that were not. Results: As biochemical failure is difficult to define, we looked at the medium-term transition rates to redo HIFU, local salvage and systemic therapy. 12% required re-treatment with HIFU. 8% transitioned into local salvage or systemic therapy of which 1 patient had radiotherapy and 4 were subsequently treated with androgen deprivation therapy). The table below outlines the complication rates associated with focal HIFU. Conclusions: Focal HIFU has been shown to be both feasible and effective in the elderly population. It is a safe modality of treatment to use in this patient cohort with a low complication profile. Long-term studies are however necessary. [Table: see text]
15
Zulkifli, Dania, Hanani Abdul Manan, Noorazrul Yahya, and Hamzaini Abdul Hamid. "The Applications of High-Intensity Focused Ultrasound (HIFU) Ablative Therapy in the Treatment of Primary Breast Cancer: A Systematic Review." Diagnostics 13, no. 15 (August 4, 2023): 2595. http://dx.doi.org/10.3390/diagnostics13152595.
Abstract:
Background: This study evaluates the role of high-intensity focused ultrasound (HIFU) ablative therapy in treating primary breast cancer. Methods: PubMed and Scopus databases were searched according to the PRISMA guidelines to identify studies from 2002 to November 2022. Eligible studies were selected based on criteria such as experimental study type, the use of HIFU therapy as a treatment for localised breast cancer with objective clinical evaluation, i.e., clinical, radiological, and pathological outcomes. Nine studies were included in this study. Results: Two randomised controlled trials and seven non-randomised clinical trials fulfilled the inclusion criteria. The percentage of patients who achieved complete (100%) coagulation necrosis varied from 17% to 100% across all studies. Eight of the nine studies followed the treat-and-resect protocol in which HIFU-ablated tumours were surgically resected for pathological evaluation. Most breast cancers were single, solitary, and palpable breast tumours. Haematoxylin and eosin stains used for histopathological evaluation showed evidence of coagulation necrosis. Radiological evaluation by MRI showed an absence of contrast enhancement in the HIFU-treated tumour and 1.5 to 2 cm of normal breast tissue, with a thin peripheral rim of enhancement indicative of coagulation necrosis. All studies did not report severe complications, i.e., haemorrhage and infection. Common complications related to HIFU ablation were local mammary oedema, pain, tenderness, and mild to moderate burns. Only one third-degree burn was reported. Generally, the cosmetic outcome was good. The five-year disease-free survival rate was 95%, as reported in two RCTs. Conclusions: HIFU ablation can induce tumour coagulation necrosis in localised breast cancer, with a favourable safety profile and cosmetic outcome. However, there is variable evidence of complete coagulation necrosis in the HIFU-treated tumour. Histopathological evidence of coagulation necrosis has been inconsistent, and there is no reliable radiological modality to assess coagulation necrosis confidently. Further exploration is needed to establish the accurate ablation margin with a reliable radiological modality for treatment and follow-up. HIFU therapy is currently limited to single, palpable breast tumours. More extensive and randomised clinical trials are needed to evaluate HIFU therapy for breast cancer, especially where the tumour is left in situ.
16
Yee, Chi-Hang, Peter Ka-Fung Chiu, Jeremy Yuen-Chun Teoh, Chi-Fai Ng, Chi-Kwok Chan, and See-Ming Hou. "High-Intensity Focused Ultrasound (HIFU) Focal Therapy for Localized Prostate Cancer with MRI-US Fusion Platform." Advances in Urology 2021 (December 14, 2021): 1–7. http://dx.doi.org/10.1155/2021/7157973.
Abstract:
Objective. The study aimed at investigating the outcome of prostate HIFU focal therapy using the MRI-US fusion platform for treatment localization and delivery. Methods. It is a prospectively designed case series of HIFU focal therapy for localized prostate cancer. The inclusion criteria include clinical tumor stage ≤T2, visible index lesion on multiparametric MRI less than 20 mm in diameter, absence of Gleason 5 pattern on prostate biopsy, and PSA ≤ 20 ng/ml. HIFU focal therapy was performed in the conventional manner in the beginning 50% of the series, whereas the subsequent cases were performed with MRI-US fusion platform. The primary outcome was treatment failure rate which is defined by the need of salvage therapy. Secondary outcomes included tumor recurrence in follow-up biopsy, PSA change, perioperative complications, and postoperative functional outcomes. Results. Twenty patients underwent HIFU focal ablation. HIFU on an MRI-US fusion platform had a trend of a longer total operative time than the conventional counterpart (124.2 min vs. 107.1 min, p = 0.066 ). There was no difference in the mean ablation volume to lesion volume ratio between the two. The mean PSA percentage change from baseline to 6-month is more significant in the conventional group (63.3% vs. 44.6%, p = 0.035 ). No suspicious lesion was seen at 6-month mpMRI in all 20 patients. Two patients, one from each group, eventually underwent radical treatment because of the presence of clinically significant prostate cancer in the form of out-of-field recurrences during follow-up biopsy. No significant difference was observed before and after HIFU concerning uroflowmetry, SF-12 score, and EPIC-26 score. It was observed that energy used per volume was positively correlated with PSA density of the patient (r = 0.6364, p = 0.014 ). Conclusion. In conclusion, HIFU with conventional or MRI-US fusion platform provided similar oncological and functional outcomes.
17
Inamoto, Teruo, Kazumasa Komura, Toshikazu Watsuji, and Haruhito Azuma. "Rapid Increase of the Serum PSA Level in Response to High-Intensity Focused Ultrasound Therapy may be a Potential Indicator of Biochemical Recurrence of Low- and Intermediate-Risk Prostate Cancer." Clinical Medicine Insights: Oncology 5 (January 2011): CMO.S7073. http://dx.doi.org/10.4137/cmo.s7073.
Abstract:
Objectives To determine the incidence and magnitude of the rapid increase in the serum PSA (riPSA) level after high-intensity focused ultrasound (HIFU) therapy for prostate cancer, and its correlation with clinical factors. Methods A total of 176 patients with localized prostate cancer underwent HIFU therapy. Serum riPSA was determined on the basis of the same criteria as those for “PSA bounce”, ie, an increase of ≥0.2 ng/ml with a spontaneous return to the prebounce level or lower. Patients were stratified according to neoadjuvant PSA level, T stage, risk group, age, Gleason score, pretreatment PSA level, post-treatment PSA nadir, and number of HIFU sessions. Results riPSA was seen in 53% of patients during a median follow-up period of 43 months. A PSA nadir was achieved within 3 months for 85.1% of the treatments. In all cases, onset of riPSA was seen two days after HIFU therapy, and the median magnitude was 23.69 ng/ml. A magnitude of >2 ng/ml was seen in 89.4% of cases. Univariate analysis revealed that patients with riPSA were associated with usage of hormonal therapy and the post-treatment PSA nadir level. Multivariate Cox regression analysis revealed that riPSA and the number of HIFU sessions were predictors of biochemical recurrence. A significant statistical association was found between the presence of riPSA and the risk of biochemical failure only in the low- and intermediate-risk group. Conclusion Patients treated with HIFU who experience post-treatment riPSA may have an increased risk of biochemical recurrence, especially in non-high-risk patients.
18
Li, Wei, Jiayu Mao, Yang Liu, Ying Zhu, Xiaojing Li, Zhigang Zhang, Xuechai Bai, Wei Zheng, and Liang Wang. "Clinical effectiveness and potential long-term benefits of high-intensity focused ultrasound therapy for patients with adenomyosis." Journal of International Medical Research 48, no. 12 (December 2020): 030006052097649. http://dx.doi.org/10.1177/0300060520976492.
Abstract:
Objectives Adenomyosis is a common and refractory disease in gynecology. Preserving the uterus during treatment for adenomyosis remains a problem. High-intensity focused ultrasound (HIFU) is widely used in treatment of solid tumors. This study aimed to analyze patients with adenomyosis who were treated by HIFU and to preliminarily examine the characteristics of patients who are more suitable for HIFU to treat adenomyosis with reliable efficacy. Methods Over 2 years, 67 women who were diagnosed with adenomyosis and treated with HIFU at our gynecology department were included in this study. We investigated outcomes of their symptoms (dysmenorrhea and hypermenorrhea) and the volume of their uterine lesions. We also compared the patients’ clinical profiles. Results The women had a mean follow-up duration of 11.6 ± 0.46 months. In the numerical rating scale, used to assess the degree of dysmenorrhea, the score was significantly lower (mean difference: −1.94, 95% confidence interval: −2.704 to −1.176) 3 months after HIFU treatment compared with before treatment, then it remained stable for 3 to 12 months. Hypermenorrhea was reduced to a certain degree, with a mean difference of −0.54 (−1.01–0.02). Conclusions HIFU is a new noninvasive treatment method for adenomyosis that may help relieve dysmenorrhea.
19
Wang, James, Chin-Hsin Huang, Oscar Echeagaray, Siamak Amirfakhri, Sarah Blair, William Trogler, Andrew Kummel, and Clark Chen. "SURG-33. IMMUNO-STIMULATION THROUGH SURGICALLY ADMINISTERED MECHANICAL HIGH INTENSITY FOCUSED ULTRASOUND." Neuro-Oncology 21, Supplement_6 (November 2019): vi246. http://dx.doi.org/10.1093/neuonc/noz175.1033.
Abstract:
Abstract INTRODUCTION While immunotherapy through anti-PD1 checkpoint inhibition has demonstrated impressive clinical efficacy against a number of tumor types, its application has been ineffective against glioblastomas. METHODS We wished to determine whether high intensity focused ultrasound (HIFU) augment the efficacy of anti-PD1 checkpoint inhibition against glioblastomas. HIFU can be surgically administered through low-duty cycle to induce subcellular fragmentation without causing temperature elevation (termed mechanical HIFU). Alternatively, HIFU delivered through high duty cycle can induce foci of temperature elevation and thermal ablation (termed thermal HIFU). We tested the impact of mechanical and thermal HIFU on the anti-glioblastoma effects of the immune checkpoint inhibitor, ipililumab. RESULTS In an in vivomurine glioblastoma model, sites targeted by mechanical HIFU exhibited a 10–100 fold increase in accumulation in tumor infiltrating lymphocytes and interferon-γ (IFN-γ) in the presence of PD-1 blockade. At least 75% of mice engrafted with glioblastomas achieved remission when treated with mechanical HIFU and PD-1 blockade. In contrast, none of the mice treated with single therapies achieved durable remission. Likelihood of remission correlated with the abundance of tumor infiltrating lymphocytes (p< 0.001) and IFN- γ levels (p=0.001). The synergy observed between mechanical HIFU and PD-1 blockade was not seen when combining thermal HIFU and PD-1 blockade, suggesting thermal protein denaturation is prohibitive to immune-stimulatory effects of HIFU. CONCLUSION Mechanical HIFU, but not thermal HIFU, augments the anti-glioblastoma effects of PD-1 blockade. Our findings inform the utility of HIFU as an immune-adjuvant in glioblastoma therapy that can be surgically administered.
20
Umemura, Shin-ichiro, Shin Yoshizawa, Jun Okamoto, and Kazuhito Nemoto. "Cavitation-enhanced high-intensity focused ultrasound treatment for cancer therapy." Journal of the Acoustical Society of America 154, no. 4_supplement (October 1, 2023): A258. http://dx.doi.org/10.1121/10.0023462.
Abstract:
Cavitation has been known to have a potential to enhance HIFU treatment in a few ways. It can multiply the particle displacement by orders of magnitude and thereby enhance the mechanical effect (1) of ultrasound hugely and the in vivo thermal effect (2) significantly. It can even induce chemical effect (3) when its bubble collapses. We are developing a cavitation-enhanced HIFU therapy system by which the effects (2) and (3) are aimed to obtain. The higher priority was set on the effect (2), because combination with a certain drug may be needed for the effect (3), which can make the process for the approval more difficult. In vivo cavitation threshold can hugely vary on the conditions. It can be reduced by stabilized microbubbles and nanobubbles, nanodroplets, and certain chemicals. However, these are not assumed in combination with our system for the same reason above. Instead, an ultrasonic pulse at an extremely high-intensity in the order of 10 MPa with a duration in the order of 10 ms is used to generate cavitation, which is immediately followed by a typical HIFU burst to obtain the effect (2). The results from swine tests of our HIFU system will be shown in the presentation.
21
Pasticier, Gilles, Sebastien Crouzet, Pascal Pommier, Christian Carrie, Olivier Rouviere, Jean-Yves Chapelon, Muriel Rabilloud, et al. "External beam radiation therapy or high intensity-focused ultrasound for localized prostate cancer: A matched pair analysis in the prostate-specific antigen era." Journal of Clinical Oncology 33, no. 7_suppl (March 1, 2015): 109. http://dx.doi.org/10.1200/jco.2015.33.7_suppl.109.
Abstract:
109 Background: In the absence of randomised study data institutional series have shown High Intensity Focused Ultrasound (HIFU) to produce excellent overall and cancer specific survival rates in patients with localized prostate cancer (LPCa) compared with alternative curative treatments. The aim of this study was to evaluate the oncologic outcome of patients treated with HIFU versus conformal external beam radiation therapy (C-EBRT) without previous or associated androgen deprivation(AD).This study was designed to overcome limitations of case series studies by using a matched pair design in patients treated contemporaneously with HIFU and C- EBRT in two institutions in the same town. Methods: 256 eligible patients with intermediate risk prostate cancer (d’Amico classification) treated between 2000 and 2005 were prospectively followed and matched to a 1:1 basis following know prognostic variables: prostate-specific antigen (PSA) level and Gleason score.190 perfect matches of patients (95 in each group) were further analysed. Progression free survival rate were the primary endpoint. Other endpoints were secondary used of salvage therapy, and survival rate without salvage palliative androgen deprivation therapy (S-ADT).The progression free survival rates were calculated with Kaplan-Meier estimate. For progression free calculation, failure was defined using the Phoenix definition (nadir + 2ng/ml) or at the time of a salvage treatment for local relapse evidenced by control biopsy. Results: The seven years progression free survival rate was not significantly different after HIFU than after C-EBRT (47% versus 52%, p: 0.311) . The palliative androgen deprivation free rate at seven years was significantly different after HIFU than after C-EBRT (85% versus 58%, p: 0.002). Conclusions: The progression free survival rate was not significantly different after HIFU use than after C-EBRT but the rate of patients who need palliative S-ADT was significantly different after HIFU or C-EBRT: Higher rate of S-ADT was associated with C-EBRT use than with HIFU use.
22
Xiao, Juhua, Xin Zhou, Ye Luo, Shuang Wang, Zhili Yang, Yingchun Yi, and Hui Xiong. "A Novel High-Intensity Focused Ultrasound-Treated Herpes Simplex Virus 2 Vaccine Induces Long-Term Protective Immunity against Lethal Challenge in Mice." mSphere 5, no. 6 (December 23, 2020): e00859-20. http://dx.doi.org/10.1128/msphere.00859-20.
Abstract:
ABSTRACTHigh-intensity focused ultrasound (HIFU), a noninvasive ablation therapy that has been widely used clinically in ablation of solid tumors, induces immune sensitization. We therefore in this study investigated whether HIFU treatment could enhance the efficacy of a herpes simplex virus 2 (HSV-2) vaccine. First, we observed that in HSV-2-positive cervical intraepithelial neoplasia (CIN) II patients, HIFU treatment induced significantly higher anti-HSV-2 neutralization response than surgical removal. Next, we tested the efficacy of HIFU-treated, UV-inactivated HSV-2-infected cells as a proof-of-concept vaccine in mice. Our data showed that HIFU-treated formulation significantly enhanced HSV-2 antibody titers and neutralization titers, compared to UV-, microwave (MW)-, or freeze-thaw (FT)-treated formulations. HIFU treatment also promoted the Th1/2 cell-mediated response. A long-term full protection was observed in mice that received the HIFU-treated formulation, and no weight loss was detected. Our findings indicate that the novel application of HIFU in vaccine production may represent a rational way to improve vaccine efficacy.IMPORTANCE High-intensity focused ultrasound (HIFU) is mainly used in tumor ablation and tumor vaccinology study. It has been shown to induce immune sensitization and enhance tumor responsiveness to other therapies. Our study has shown enhanced anti-HSV-2 response in HIFU-treated CIN II patients. Furthermore, in a murine model, we have demonstrated that HIFU-treated HSV-2 vaccine induced long-term protective immunity against lethal challenge. Our findings indicate that the novel application of HIFU in vaccine production may represent a rational way to improve vaccine efficacy.
23
Lopez, William, Nhu Nguyen, Jessica Cao, Christine Eddow, K. Kirk Shung, Nan Sook Lee, and Mosses S. S. Chow. "Ultrasound Therapy, Chemotherapy and Their Combination for Prostate Cancer." Technology in Cancer Research & Treatment 20 (January 1, 2021): 153303382110119. http://dx.doi.org/10.1177/15330338211011965.
Abstract:
Prostate cancer is the second leading cause of cancer death in men. Its current treatment includes various physical and chemical approaches for the localized and advanced prostate cancer [e.g. metastatic castrate resistant prostate cancer (mCRPC)]. Although many new drugs are now available for prostate cancer, none is suitable for local treatment that can reduce adverse effects often associated with the current physical treatment. Of the drugs approved by FDA for mCRPC, the best mean improvement in overall survival is only about 4.8 months. Therefore, there is a need for improved treatment approaches for prostate cancer, especially drug-resistant cancer. Ultrasound therapy represents a useful new physical approach for the drug-resistant cancer treatment by facilitating the entry of the related chemotherapy drug into the target cancer cells. There are two versions of ultrasound: High Intensity Focused Ultrasound (HIFU) and Low Intensity Pulsed Ultrasound (LIPUS). HIFU has been a promising treatment option for prostate cancer due to its noninvasiveness and various biological effects on cancer tissue. It has been approved for the treatment of cancer and in recent years there have been numerous findings suggesting HIFU can reduce cancer cell viability and possibly reverse the spread of cancerous tumors. LIPUS is currently being studied as an alternative treatment option for prostate cancer. Preliminary studies have found LIPUS to reduce cancer cell viability without the side effects seen in HIFU. Reversible cell membrane damage caused by LIPUS could allow increased uptake of anticancer drugs, enhancing cytotoxicity and death of cancer cells. In this way, a low dose of anticancer drug is more effective toward cancer cells while there is less damage to normal cells. The combination of LIPUS with certain chemotherapeutic agents can be an exciting physical-chemical combination therapy for prostate cancer. This review will focus on this topic as well as the clinical use of HIFU to provide an understanding of their current use and future potential role for prostate cancer therapy.
24
Daschner, Rosa, Holger Hewener, Wolfgang Bost, Steffen Weber, Steffen Tretbar, and Marc Fournelle. "Ultrasound Thermometry for HIFU-Therapy." Current Directions in Biomedical Engineering 7, no. 2 (October 1, 2021): 554–57. http://dx.doi.org/10.1515/cdbme-2021-2141.
Abstract:
Abstract High-Intensity Focused Ultrasound (HIFU) is an alternative tumour therapy with the ability for non-invasive thermal ablation of tissue. For a safe application, the heat deposition needs to be monitored over time, which is currently done with Magnetic Resonance Imaging. Ultrasound (US) based monitoring is a promising alternative, as it is less expensive and allows the use of a single device for both therapy and monitoring. In this work, a method for spatial and temporal US thermometry has been investigated based on simulation studies and in-vitro measurements. The chosen approach is based on the approximately linear dependence between temperature and speed of sound (SoS) in tissue for a given temperature range. By tracking the speckles of successive B-images, the possibility of detecting local changes in SoS and therefore in temperature is given. A speckle tracking algorithm was implemented for 2D and 3D US thermometry using a spatial compounding method to reduce artifacts. The algorithm was experimentally validated in an agar-based phantom and in porcine tissue for temperature rises up to △ 8°C. We used a focusing single element US transducer as therapeutic probe, a linear (/matrix array) transducer with 128 (/32∙32) elements for imaging and thermocouples for validation and calibration. In all experiments, both computational and in-vitro, we succeeded in monitoring the thermal induced SoS changes over time. The in-vitro measurements were in good agreement with the simulation results and the thermocouple measurements (rms temperature difference = 0.53 °C, rms correlation coefficient = 0. 96).
25
Garnier, C., J. J. Bellanger, Ke Wu, Huazhong Shu, N. Costet, R. Mathieu, R. de Crevoisier, and J. L. Coatrieux. "Prostate Segmentation in HIFU Therapy." IEEE Transactions on Medical Imaging 30, no. 3 (March 2011): 792–803. http://dx.doi.org/10.1109/tmi.2010.2095465.
26
Shaw, Caroline J., Ian Rivens, John Civale, Kimberley J. Botting, Beth J. Allison, Kirsty L. Brain, Y. Niu, Gail ter Haar, Dino A. Giussani, and Christoph C. Lees. "Maternal and fetal cardiometabolic recovery following ultrasound-guided high-intensity focused ultrasound placental vascular occlusion." Journal of The Royal Society Interface 16, no. 154 (May 2019): 20190013. http://dx.doi.org/10.1098/rsif.2019.0013.
Abstract:
High-intensity focused ultrasound (HIFU) is a non-invasive method of selective placental vascular occlusion, providing a potential therapy for conditions such as twin–twin transfusion syndrome. In order to translate this technique into human studies, evidence of prolonged fetal recovery and maintenance of a healthy fetal physiology following exposure to HIFU is essential. At 116 ± 2 days gestation, 12 pregnant ewes were assigned to control ( n = 6) or HIFU vascular occlusion ( n = 6) groups and anaesthetized. Placental blood vessels were identified using colour Doppler ultrasound; HIFU-mediated vascular occlusion was performed through intact maternal skin (1.66 MHz, 5 s duration, in situ I SPTA 1.8–3.9 kW cm −2 ). Unidentifiable colour Doppler signals in targeted vessels following HIFU exposure denoted successful occlusion. Ewes and fetuses were then surgically instrumented with vascular catheters and transonic flow probes and recovered from anaesthesia. A custom-made wireless data acquisition system, which records continuous maternal and fetal cardiovascular data, and daily blood sampling were used to assess wellbeing for 20 days, followed by post-mortem examination. Based on a comparison of pre- and post-treatment colour Doppler imaging, 100% (36/36) of placental vessels were occluded following HIFU, and occlusion persisted for 20 days. All fetuses survived. No differences in maternal or fetal blood pressure, heart rate, heart rate variability, metabolic status or oxygenation were observed between treatment groups. There was evidence of normal fetal maturation and no evidence of chronic fetal stress. There were no maternal injuries and no placental vascular haemorrhage. There was both a uterine and fetal burn, which did not result in any obstetric or fetal complications. This study demonstrates normal long-term recovery of fetal sheep from exposure to HIFU-mediated placental vascular occlusion and underlines the potential of HIFU as a potential non-invasive therapy in human pregnancy.
27
Strunk, Holger, Caroline Lützow, Jana Henseler, Martin Mücke, Maximilian Rauch, Christian Marx, Hans Schild, and Milka Marinova. "Mesenteric Vessel Patency Following HIFU Therapy in Patients with Locally Invasive Pancreatic Cancer." Ultraschall in der Medizin - European Journal of Ultrasound 39, no. 06 (January 18, 2018): 650–58. http://dx.doi.org/10.1055/s-0043-125391.
Abstract:
Abstract Purpose To evaluate the effects of HIFU therapy on visceral vessel patency in patients with inoperable locally invasive pancreatic cancer. Materials and Methods 50 pancreatic cancer patients (26 men, 24 women) aged 41 – 82 years (65.0 ± 10.2) underwent ultrasonography (US) and computed tomography (CT) examinations before and within one day after HIFU treatment, as well as at follow-up at six weeks, three months and six months. Evaluation and grading were performed by two experienced independent radiologists according to a classification scheme based on vessel involvement, vessel diameter, patency, and defects in flow. Results Before HIFU treatment, arterial vessel involvement was noted in 42 patients, venous involvement in 47, and 47 patients presented with both. Superior mesenteric artery occlusion was found in three carcinomas while nearly half of the cases (n = 24) displayed signs of superior mesenteric vein, portal vein, or splenic vein occlusion. High-grade tumor-associated arterial narrowing was seen in ten patients. Despite vessel encasement and partially extensive propagation of collateral vessels, it was possible to safely perform HIFU treatment in all patients without complications. US and CT studies performed within one day after therapy did not show any change in vessel patency in 47 patients (94 %). Follow-up controls at the six-week mark revealed increased vessel narrowing and finally occlusion after six months in 11 patients due to tumor progression. Conclusion This study demonstrates that HIFU treatment can be safely applied to pancreatic cancers enveloping large mesenteric vessels despite vessel narrowing or extensive collateral propagation. Most patients (94 %) did not experience adverse effects regarding vessel patency.
28
Shaw, C. J., G. R. ter Haar, I. H. Rivens, D. A. Giussani, and C. C. Lees. "Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery." Journal of The Royal Society Interface 11, no. 95 (June 6, 2014): 20140029. http://dx.doi.org/10.1098/rsif.2014.0029.
Abstract:
High-intensity focused ultrasound (HIFU) is a non-invasive technology, which can be used occlude blood vessels in the body. Both the theory underlying and practical process of blood vessel occlusion are still under development and relatively sparse in vivo experimental and therapeutic data exist. HIFU would however provide an alternative to surgery, particularly in circumstances where serious complications inherent to surgery outweigh the potential benefits. Accordingly, the HIFU technique would be of particular utility for fetal and placental interventions, where open or endoscopic surgery is fraught with difficulty and likelihood of complications including premature delivery. This assumes that HIFU could be shown to safely and effectively occlude blood vessels in utero . To understand these mechanisms more fully, we present a review of relevant cross-specialty literature on the topic of vascular HIFU and suggest an integrative mechanism taking into account clinical, physical and engineering considerations through which HIFU may produce vascular occlusion. This model may aid in the design of HIFU protocols to further develop this area, and might be adapted to provide a non-invasive therapy for conditions in fetal medicine where vascular occlusion is beneficial.
29
Du, Zhiyu, Pisong Yan, Qiang Luo, Dan Zhang, and Yu Zhang. "Keratorefractive Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Eyes." Journal of Ophthalmology 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/5260531.
Abstract:
Purpose. To evaluate high intensity focused ultrasound (HIFU) as an innovation and noninvasive technique to correct presbyopia by altering corneal curvature in the rabbit eye.Methods. Eighteen enucleated rabbit eyes were treated with a prototype HIFU keratoplasty. According to the therapy power, these eyes were divided three groups: group 1 (1 W), group 2 (2 W), and group 3 (3 W). The change in corneal power was quantified by a Sirius Scheimpflug camera. Light microscopy (LM) and transmission electron microscopy (TEM) were performed to determine the effect on the corneal stroma.Results. In the treated eyes, the corneal curvature increases from 49.42 ± 0.30 diopters (D) and 48.00 ± 1.95 D before procedure to 51.37 ± 1.11 D and 57.00 ± 1.84 D after HIFU keratoplasty application in groups 1 and 3, respectively. The major axis and minor axis of the focal region got longer when the powers of the HIFU got increased; the difference was statistically significant (p<0.05). LM and TEM showed HIFU-induced shrinkage of corneal stromal collagen with little disturbance to the underlying epithelium.Conclusions. We have preliminarily exploited HIFU to establish a new technique for correcting presbyopia. HIFU keratoplasty will be a good application prospect for treating presbyopia.
30
Mala, Katharina Sophie, Henning Plage, Lukas Mödl, Sebastian Hofbauer, Frank Friedersdorff, Martin Schostak, Kurt Miller, Thorsten Schlomm, and Hannes Cash. "Follow-Up of Men Who Have Undergone Focal Therapy for Prostate Cancer with HIFU—A Real-World Experience." Journal of Clinical Medicine 12, no. 22 (November 14, 2023): 7089. http://dx.doi.org/10.3390/jcm12227089.
Abstract:
Purpose: To determine oncological and functional outcomes and side effects after focal therapy of prostate cancer (PCa) with high-intensity focused ultrasound (HIFU). Methods: This retrospective single-center study included 57 consecutive patients with localised PCa. Aged 18–80 with ≤2 suspicious lesions on mpMRI (PIRADS ≥ 3), PSA of ≤15 ng/mL, and an ISUP GG of ≤2. HIFU was performed between November 2014 and September 2018. All men had an MRI/US fusion-guided targeted biopsy (TB) combined with a TRUS-guided 10-core systematic biopsy (SB) prior to focal therapy. HIFU treatment was performed as focal, partial, or hemiablative, depending on the prior histopathology. Follow-up included Questionnaires (IIEF-5, ICIQ, and IPSS), prostate-specific antigen (PSA) measurement, follow-up mpMRI, and follow-up biopsies. Results: The median age of the cohort was 72 years (IQR 64–76), and the median PSA value before HIFU was 7.3 ng/mL (IQR 5.75–10.39 ng/mL). The median follow-up was 27.5 (IQR 23–41) months. At the time of the follow-up, the median PSA value was 2.5 ng/mL (IQR 0.94–4.96 ng/mL), which shows a significant decrease (p < 0.001). In 17 (29.8%) men, mpMRI revealed a suspicious lesion, and 19 (33.3%) men had a positive biopsy result. Only IIEF values significantly decreased from 16 (IQR 10.75–20.25) to 11.5 (IQR 4.5–17) (p < 0.001). The rate of post-HIFU complications was low, at 19.3% (11 patients). The limitation of this study is the lack of long-term follow-up. Conclusions: HIFU as a therapy option for nonmetastatic, significant prostate cancer is effective in the short term for carefully selected patients and shows a low risk of adverse events and side effects.
31
Yadav, Ajay Kumar, Suman Gnawali, Sandip Kumar Mandal, Gyan Bahadur Shrestha, Ganga Dutta Adhikari, Bhanu Pratap Shah, and Gengbiao Yuan. "High-intensity focused ultrasound (HIFU) therapy for pain palliation in advanced stage pancreatic carcinoma: A Meta-Analysis with recent studies." Nepalese Journal of Cancer 6, no. 1 (April 3, 2022): 48–66. http://dx.doi.org/10.3126/njc.v6i1.44209.
Abstract:
Background: Day by day, High-intensity focused ultrasound (HIFU) therapy is becoming more familiar in medical field because it is non-invasive technique with fewer side effects and provides promising therapeutic results. Several HIFU therapy applications have approved by many approval authorities of deferent countries since last decade. It is a novel, emerging, therapeutic modality that uses ultrasound waves, propagated through tissue media, as carriers of energy. HIFU has great potential for tumor ablation and the main mechanisms of HIFU ablation involve mechanical and thermal effects. Pancreatic adenocarcinoma is currently the fourth-leading cause of cancer-related death. Up to 60–90% of patients with advanced disease suffer cancer-related pain, severely impacting their quality of life. Current management involves primarily pharmacotherapy with opioid narcotics and celiac plexus neurolysis; unfortunately, both approaches offer transient relief and cause undesired side-effects. High intensity focused ultrasound (HIFU) is a non-invasive thermal ablation technique that has been used to treat pancreatic cancer. This meta-analysis aims to evaluate the role of HIFU in pain palliation of advanced unresectable pancreatic adenocarcinoma. Methods: Paper selection was performed electronically in PubMed up to the end of March 2021, for pain palliation treatment of advanced staged pancreatic cancer with HIFU. Relevant papers were identified through the PubMed search engine using these keywords: HIFU, pancreas, pancreatic cancer, pain and palliation. Additional studies were also done included after manual search of the selected bibliographies. Palliation results reported in studies were analyzed using a logit-transformed random-effects model using the inverse variance method, with the DerSimonian-Laird estimator for t2, and Cochran’s Q test for heterogeneity among studies. The I2 was also calculated to assess the percentage of the total variability in the different effect size estimates that can be attributed to heterogeneity among the true effects and rank correlation test of funnel plot asymmetry was done to assess possible publication bias. Results: In this meta-analysis, we includes only recent 10 year studies i.e. total number of 16 studies with 687total patients with pancreatic cancer. The total patients enrolled ranges from 7 patients in the smallest series, up to 120 in the largest study. The calculated τ2was 0.187, and I2was 41%, the Q test p-value was 0. 026, is indicating significant heterogeneity among studies. The random effects estimate of the proportion of patients with pain reduction was 0.89.08. Conclusions: We concluded that HIFU performs to be an effective tool for pain palliation in advanced staged pancreatic cancer. Prospective randomized and standardized studies are necessary to confirm the effectiveness of HIFU in relieving pain, and to evaluate for any potential impact on tumor control and patient survival.
32
Dason, Shawn, Christopher Brian Allard, Jen Hoogenes, William Orovan, and Bobby Shayegan. "High-intensity focused ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: Predictors of disease response." Journal of Clinical Oncology 34, no. 2_suppl (January 10, 2016): 135. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.135.
Abstract:
135 Background: Some patients with localized radio-recurrent prostate cancer (PCa) may have long-term recurrence-free (RFS) survival with salvage high-intensity focused ultrasound (HIFU). In this study, we describe our previously unreported oncologic outcomes and predictors of disease response after salvage HIFU. Methods: Participants were prospectively enrolled in this study from January 2005 to December 2014 if they had localized radio-recurrent prostate cancer. Participants had to meet both biochemical (PSA nadir+ 2ng/ml) and histologic (positive biopsy) definitions of recurrence. Study exclusion criteria included the receipt of prior salvage therapy, presence of metastastatic disease, and receipt of ADT in the 6-months prior to enrollment. Participants were treated with a single session of whole-gland HIFU ablation with the Ablatherm device (EDAP, France). The primary endpoint of this study was RFS, defined as a composite endpoint of PSA progression (PSA nadir + 2 ng/ml), receipt of any further salvage therapy, receipt of ADT, clinical progression, or death. Kaplan-Meier survival analysis was used to determine the primary end-point and stratifications were used to determine the significance of 6 pre-specified predictors of improved RFS (undetectable PSA nadir, low TRUS biopsy grade, >3 TRUS biopsy cores positive, pre-HIFU PSA<4ng/ml, receipt of prior ADT and presence of pre-HIFU palpable disease). Survival analysis was performed on participants with a minimum of 1-year follow-up. Results: Twenty-four participants were eligible for study inclusion with a median follow-up of 31.0 months. Median PSA at study entry was 4.02 ng/ml. Median time to PSA nadir was 3 months after treatment and median post-HIFU PSA nadir was 0.04 ng/ml. 2-year and 5-year RFS were 66.3% and 51.6% respectively. An undetectable PSA nadir was the only significant predictor of improved RFS (HR 0.07, 95% CI 0.02-0.29, log-rank P<0.001). No participants developed a rectourethral fistula. Conclusions: Salvage HIFU allows for disease control in select patients with localized radio-recurrent prostate cancer. An undetectable PSA nadir serves as an early predictor of disease response.
33
Bui, Ngoc Thang, Thi My Tien Nguyen, Gebremedhin Yonatan Ataklti, Quoc Cuong Bui, Tran Thanh Nam Dinh, Duc Tri Phan, Sumin Park, Jaeyeop Choi, Thi Thu Ha Vu, and Junghwan Oh. "Design of a High-Power Multilevel Sinusoidal Signal and High-Frequency Excitation Module Based on FPGA for HIFU Systems." Electronics 10, no. 11 (May 29, 2021): 1299. http://dx.doi.org/10.3390/electronics10111299.
Abstract:
High-intensity focused ultrasound (HIFU) is a noninvasive therapy that uses focused ultrasound to treat a part of the tissue; high temperatures can damage tissues by heat. HIFU has many applications in the field of surgery and aesthetics and is used increasingly in everyday life. In this article, we discuss the mainboard design that controls the HIFU system with the ability to create a multistep sine wave compatible with many different applications. The signal used to trigger the transducer is a sinusoidal signal with a frequency adjustable from 0.1 to 3 MHz. In addition, the power supplied to the HIFU transducer is also controlled easily by the configuration parameters installed in the control circuit board. The proposed control and design method generates a voltage signal that doubles the supply voltage, thereby reducing the current on the MOSFET. The hardware design is optimized for a surface-mounted device-type MOSFET without the need for an external heat sink. In tests, we conducted a harmonious combination of two output signals to activate the same HIFU probe. The results showed that the energy transferred to the HIFU transducer increased by 1.5 times compared to a single channel. This means that the HIFU treatment time is reduced when using this method, with absolutely no changes in the system structure.
34
Doan, Vu Hoang Minh, Van Tu Nguyen, Jaeyeop Choi, Sumin Park, and Junghwan Oh. "Fuzzy Logic Control-Based HIFU System Integrated with Photoacoustic Imaging Module for Ex Vivo Artificial Tumor Treatment." Applied Sciences 10, no. 21 (November 6, 2020): 7888. http://dx.doi.org/10.3390/app10217888.
Abstract:
The objective of this study is to design a therapeutic method combining a portable high intensity focused ultrasound (HIFU) design which is suitable for the laboratory environment and a tailored integrated photo-acoustic imaging (PAI) system for monitoring thermal treatment. The electrical HIFU design is fabricated with changeable operating frequency and justified output power for resonating with different kinds of commercial transducers. The system’s control interface is built based on a touch screen to create a companionable interaction for users. The embedded fuzzy logic controller using the thermal input from the thermocouple sensor precisely drives the target temperature during HIFU exposure to achieve the expectedly coagulating results. The PAI system with 532-nm laser excitation is also integrated to define the affected region before and after HIFU treatment. The proposed fuzzy controller-integrated HIFU setup compatible with the PAI system is a feasible instrument in thermal therapy for ex vivo artificial tumors management.
35
Kim, AeRang, Karun Sharma, Pavel Yarmolenko, Haydar Celik, Rosandra N. Kaplan, Jeffrey Dome, Lauren Musso, et al. "Phase 1 trial of lyso-thermosensitive liposomal doxorubicin (LTLD) and magnetic resonance guided high intensity focused ultrasound (MR-HIFU) for pediatric refractory solid tumors." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): TPS10579. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.tps10579.
Abstract:
TPS10579 Background: Prognosis for children and young adults with refractory solid tumors remains unacceptably poor. Current approaches have reached the limits of maximal dose intensification, and the acute and late side effects of therapy are substantial. MR-HIFU is an innovative therapy that uses an external applicator to focus ultrasound energy inside a tumor non-invasively and without radiation. The resulting heating is precisely controlled and accurately targeted with the aid of MR thermometry and anatomic imaging. The flexibility and control over local heating by MR-HIFU provide an ideal system to be used with LTLD, a novel formulation of liposomal doxorubicin with the unique property of rapid heat-activated release of doxorubicin, an active agent in most pediatric solid tumors. The potential synergistic effects include enhanced permeability of the tumor vasculature, enhanced extravasation of the drug and subsequent high local concentrations of doxorubicin in the targeted tumor, inhibition of DNA repair, and stimulation of immune responses. Methods: This is the first pediatric trial of LTLD with MR-HIFU in refractory solid tumors (NCT02536183). Part A is a phase 1 dose escalation study to determine the maximum tolerated dose (MTD) or recommended phase 2 dose (RP2D) of LTLD combined with MR-HIFU ablation in children. Part B combines LTLD at the MTD/RP2D with MR-HIFU induced mild hyperthermia (MHT) in an expanded cohort. Patients ≤21 (Part A) and ≤30 (Part B) years of age with refractory solid tumors at sites accessible to MR-HIFU, adequate organ function including cardiac function, and prior anthracycline dose of ≤ 450 mg/m2 are eligible. LTLD is administered intravenously over 30 min followed immediately by MR-HIFU on day 1 of a 21-day cycle. Patients can receive a maximum of 6 cycles (or lifetime of 600 mg/m2 of cumulative anthracycline) provided treatment is tolerated and have at least stable disease. Secondary objectives evaluate changes in quality of life and pharmacodynamic immune markers in children treated with LTLD and MR-HIFU. Clinical trial information: NCT02536183.
36
Tang, Rui, Hongye He, Xiaohong Lin, Nianhong Wu, Li Wan, Qiaoqi Chen, Yaqin Hu, et al. "Novel combination strategy of high intensity focused ultrasound (HIFU) and checkpoint blockade boosted by bioinspired and oxygen-supplied nanoprobe for multimodal imaging-guided cancer therapy." Journal for ImmunoTherapy of Cancer 11, no. 1 (January 2023): e006226. http://dx.doi.org/10.1136/jitc-2022-006226.
Abstract:
BackgroundHigh-intensity focused ultrasound (HIFU) has shown considerable promise in treating solid tumors, but its ultrasonic energy is easily attenuated, resulting in insufficient energy accumulation in the target area. Moreover, HIFU ablation alone may inevitably lead to the presence of residual tumors, which may cause tumor recurrence and metastasis. Here, we describe a synergistic regimen combining HIFU facilitation with immunomodulation based on a novel oxygen-carrying biomimetic perfluorocarbon nanoparticle (M@P-SOP) to stimulate immunogenic cell death in tumor cells while alleviating immune suppression tumor microenvironment.MethodsM@P-SOP was prepared by double emulsion and film extrusion method. The anticancer and antimetastatic effects of M@P-SOP were evaluated on a preclinical transplanted 4T1 tumor model by combining HIFU and immunotherapy. Flow cytometry and immunofluorescence were used to clarify the potential mechanism of HIFU+M@P-SOP and their role in anti-programmed death ligand-1 (PD-L1) therapy.ResultsGuided by photoacoustic/MR/ultrasound (US) multimodal imaging, M@P-SOP was abundantly enriched in tumor, which greatly enhanced HIFU’s killing of tumor tissue in situ, induced stronger tumor immunogenic cell death, stimulated dendritic cell maturation and activated CD8+T cells. At the same time, M@P-SOP released oxygen to alleviate the tumor hypoxic environment, repolarizing the protumor M2-type macrophages into antitumor M1-type. With concurrent anti-PD-L1 treatment, the antitumor immune response was further amplified to the whole body, and the growth of mimic distant tumor was effectively suppressed.ConclusionsOur findings offer a highly promising HIFU synergist for effectively ameliorating acoustic and hypoxia environment, eventually inhibiting tumor growth and metastasis by stimulating host’s antitumor immunity under HIFU ablation, especially in synergizing with PD-L1 antibody immunotherapy.
37
Yadav, Sumit Kumar, Souradip Paul, and Mayanglambam Suheshkumar Singh. "Effect of HIFU-Induced Thermal Ablation in Numerical Breast Phantom." Photonics 10, no. 4 (April 9, 2023): 425. http://dx.doi.org/10.3390/photonics10040425.
Abstract:
Breast cancer is a leading cause of cancer-related deaths in women, and treatment involved invasive surgery such as lumpectomy. In the last decade, a non-invasive, non-contact high-intensity focused ultrasound (HIFU) therapy was developed for treatment with promising results. However, its success rate depends on patient selection, tissue heterogeneities, HIFU operational parameters, and even imaging techniques. In this emerging field, computer simulations can provide us with a much-needed platform to learn, test, and deduce results virtually before conducting experiments. In this study, we used three different classes of anatomically realistic numerical breast phantoms from clinical contrast-enhanced magnetic resonance imaging (MRI) data, including scattered-, heterogeneous-, and extremely dense-type breasts. Upon assigning the appropriate acoustic and optical parameters to the tissues within, we simulated HIFU propagation by using the k-Wave toolbox in MATLAB and compared the changes introduced in the three types of breasts. It was found that scattered-type breast was best-suited for HIFU therapy. Furthermore, we simulated light-beam propagation with the ValoMC toolbox in MATLAB after introducing the lesion to compare the distribution of the initial pressure generated via the photoacoustic effect. This simulation study will be of significant clinical impact, especially in the study and management of HIFU-based treatments, which are individual/tissue-selective in nature.
38
Yao, Yuanzhi, Ke Yang, Yang Cao, Xuan Zhou, Jinshun Xu, Jianxin Liu, Qi Wang, Zhigang Wang, and Dong Wang. "Comparison of the synergistic effect of lipid nanobubbles and SonoVue microbubbles for high intensity focused ultrasound thermal ablation of tumors." PeerJ 4 (February 22, 2016): e1716. http://dx.doi.org/10.7717/peerj.1716.
Abstract:
Microbubbles (MBs) are considered as an important enhancer for high intensity focused ultrasound (HIFU) treatment of benign or malignant tumors. Recently, different sizes of gas-filled bubbles have been investigated to improve the therapeutic efficiency of HIFU thermal ablation and reduce side effects associated with ultrasound power and irradiation time. However, nanobubbles (NBs) as an ultrasound contrast agent for synergistic therapy of HIFU thermal ablation remain controversial due to their small nano-size in diameter. In this study, phospholipid-shell and gas-core NBs with a narrow size range of 500–600 nm were developed. The synergistic effect of NBs for HIFU thermal ablation was carefully studied both in excised bovine livers and in breast tumor models of rabbits, and made a critical comparison with that of commercial SonoVue microbubbles (SonoVue MBs). In addition, the pathological changes of the targeted area in tumor tissue after HIFU ablation were further investigated. Phosphate buffer saline (PBS) was used as the control. Under the same HIFU parameters, the quantitative echo intensity of B-mode ultrasound image and the volume of coagulative necrosis in lipid NBs groups were significantly higher and larger than that in PBS groups, but could not be demonstrated a difference to that in SonoVue MBs groups bothex vivoandin vivo. These results showed that the synergistic effect of lipid NBs for HIFU thermal ablation were similar with that of SonoVue MBs, and further indicate that lipid NBs could potentially become an enhancer for HIFU thermal ablation of tumors.
39
Bolotina, L. B., L. I. Moskvicheva, A. L. Kornietskaya, D. V. Sidorov, N. A. Grishin, M. V. Lozhkin, and A. D. Kaprin. "PRELIMINARY EVALUATION OF THE EFFECTIVENESS OF HIFU-THERAPY IN PATIENTS WITH PANCREATIC CANCER." Siberian journal of oncology 20, no. 3 (June 29, 2021): 18–27. http://dx.doi.org/10.21294/1814-4861-2021-20-3-18-27.
Abstract:
Purpose: to conduct a preliminary analysis of the safety and effectiveness of hifu-therapy with a lowenergy hifu-2001 device (shenzhen Huikang Medical apparatus Co., ltd) performed concurrently with chemotherapy in pancreatic cancer patients who are not suitable for surgery or chemoradiotherapy.Material and Method. The study included 24 pancreatic cancer patients who were treated at the Hertsen Moscow Oncology Research institute in the period from 2016 to 2019. There were 17 (71 %) women and 7 (29 %) men. The percentage of patients in the elderly group was 79 %. Stage iia pancreatic cancer was diagnosed in 3 (12.5 %) patients, stage ii in 5 (21 %) patients, stage iii in 9 (37.5 %) patients, and stage iv in 7 (29 %) patients. All patients received combination therapy, including systemic chemotherapy and hifu-therapy. Results. The most frequent adverse events of treatment were skin burns (n=6), with third-degree burns occurring in 2 (8.3 %) patients. Local sclerosis of subcutaneous adipose tissue was observed in 4 (17 %) patients; development of asymptomatic pancreatic pseudocysts in the area of hifu exposure was observed in 1 (4 %) patient. Pain control was achieved in 17 (85 %) patients, and local tumor control was achieved in 19 (79.2 %) patients. The follow-up time ranged from 5 to 30 months with a median time of 14.5 months. The median total life expectancy of patients was 16 months, and the median time to progression was 9 months. The overall 6-month survival rate was 100 %. The 1- and 1.5-year survival rates were 75.0 % and 41.7 %, respectively. The 2-year survival rate was 17.2 %. The 6-month and 1-year disease-free survival rates were 62.5 % and 12.5 %, respectively. Conclusion. The short- and long-term outcomes were consistent with those described in other studies, which indicated that a combination of systemic drug therapy and hifu-therapy is an appropriate approach for the treatment of patients with pancreatic cancer.
40
Suehiro, Satoshi, Takanori Ohnishi, Akihiro Inoue, Daisuke Yamashita, Masahiro Nishikawa, Shiro Ohue, and Takeharu Kunieda. "EXTH-70. ENHANCEMENT OF ANTITUMOR ACTIVITY BY USING 5-ALA–MEDIATED SONODYNAMIC THERAPY TO INDUCE APOPTOSIS AND NECROSIS IN A MOUSE GLIOMA MODEL." Neuro-Oncology 21, Supplement_6 (November 2019): vi97. http://dx.doi.org/10.1093/neuonc/noz175.400.
Abstract:
Abstract OBJECTIVE High invasiveness of malignant gliomas frequently causes local tumor recurrence. To control such recurrence, novel therapies targeted toward infiltrating glioma cells are required. Here, we examined cytotoxic effects of sonodynamic therapy (SDT) combined with a sonosensitizer, 5-aminolevulinic acid (5-ALA), on malignant gliomas both in vitro and in vivo. METHODS In vitro cytotoxicity of 5-ALA-SDT was evaluated in U87 and U251 glioma cells and in U251Oct-3/4 glioma stemlike cells. Treatment-related apoptosis was analyzed using flow cytometry. Intracellular reactive oxygen species (ROS) were measured and the role of ROS in treatment-related cytotoxicity was examined. Effects of 5-ALA-SDT with high-intensity focused ultrasound (HIFU) on tumor growth, survival of glioma-transplanted mice, and histological features of the mouse brains were investigated. RESULTS The 5-ALA-SDT inhibited cell growth and changed cell morphology. Flow cytometric analysis indicated that 5-ALA-SDT induced apoptotic cell death. The 5-ALA-SDT generated higher ROS than in the control group, and inhibition of ROS generation completely eliminated the cytotoxic effects of 5-ALA-SDT. In the in vivo study, 5-ALA-SDT with HIFU greatly prolonged survival of the tumor-bearing mice compared with that of the control group (p < 0.05). Histologically, 5-ALA-SDT produced mainly necrosis of the tumor tissue in the focus area and induced apoptosis of the tumor cells in the perifocus area around the target of the HIFU-irradiated field. Normal brain tissues around the ultrasonic irradiation field of HIFU remained intact. CONCLUSIONS The 5-ALA-SDT was cytotoxic toward malignant gliomas. Generation of ROS by the SDT was thought to promote apoptosis of glioma cells. The 5-ALA-SDT with HIFU induced tumor necrosis in the focus area and apoptosis in the perifocus area of the HIFU-irradiated field. These results suggest that 5-ALA-SDT with HIFU may present a less invasive and tumor-specific therapy, not only for a tumor mass but also for infiltrating tumor cells in malignant gliomas.
41
Leslie, T. A., R. O. Illing, J. E. Kennedy, M. F. Wu, G. R. Ter Haar, R. R. Phillips, A. S. Protheroe, and D. W. Cranston. "High intensity focused ultrasound in the treatment of small kidney tumours— The Oxford experience." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 14645. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.14645.
Abstract:
14645 Background: High-intensity focused ultrasound (HIFU) provides a potential non-invasive alternative to conventional therapies. We have been using the extracorporeal ultrasound-guided Model-JC Tumor Therapy System (HAIFU Technology Company, China) in clinical trials to evaluate the safety and feasibility of treating small renal tumours. Methods: Patients with renal tumours less than 4cm diameter and unsuitable for surgery were treated with HIFU were enrolled into this phase II prospective trial. Treatment was delivered under general anaesthesia in a single session using the Model-JC Tumor Therapy System. Magnetic resonance imaging (MRI) 12 days after treatment provided an initial assessment of response (technical success). Patients are followed-up with further MR imaging at 6 months and one year to gauge technique effectiveness. A total of 14 patients will be included in the trial. Results: Eight patients with kidney tumours have been treated to date. All eight have had pre- and 12-day post-treatment MR imaging. One patient was not included in the analysis as treatment was suspended due bowel interposition in the treatment field during therapy. MRI changes suggestive of kidney tumour response have been seen in 4/7 (57%) cases. Complete ablation has been seen in two cases and partial ablation in two cases. One patient remains disease free 12 months after HIFU. Mild transient discomfort was reported by 4/8 patients (50%), and moderate discomfort in 3/8 (38%) but more severe pain needing opiate analgesia has not been encountered in this series. Minor skin toxicity (1mm blister at the treatment site) was seen in two patients. All patients were discharged the day after the procedure. There have been no adverse effects on renal, haematological or hepatic function. Conclusions: Extracorporeal HIFU has the ability to completely ablate small renal tumours. Our early clinical experience suggests that HIFU treatment of kidney tumours is safe and extremely well tolerated. The reasons for the variability in observed response remain obscure, and reliability of tumour ablation will need to improve before extracorporeal HIFU can be proposed for wider clinical use. [Table: see text]
42
Chen, Gin-Shin, Jonathan Cannata, Ruibin Liu, Hsu Chang, and K. Kirk Shung. "DESIGN AND FABRICATION OF HIGH-INTENSITY FOCUSED ULTRASOUND PHASED ARRAY FOR LIVER TUMOR THERAPY." Biomedical Engineering: Applications, Basis and Communications 21, no. 03 (June 2009): 187–92. http://dx.doi.org/10.4015/s1016237209001246.
Abstract:
Noninvasive surgery of the liver tumors has been carried out by using the high-intensity focused ultrasound (HIFU). However, the liver tumor can be moved by the human respirations and heartbeats, which may cause the ablation and damage of normal tissues during the sonications of HIFU. The purpose of this study was to design and fabricate a cylindrical HIFU phased array transducer for treating the moving liver tumor efficiently. The total number of the element was 512 but only 256 channels were required since the elements along the elevation direction were connected in pairs with respect to the central line of the array. Field II software was used to simulate the acoustic field, and a formula for predicting the spatial averaged intensity at focus was developed based on the practical factors. The results of the simulations showed that the cylindrical HIFU phased array in water had a dynamic focusing range from 145 to 175 mm in the depth direction and a steering range from -15 to 15 mm in azimuthal direction with respect to the center of the array. After the dissipation of cables and the attenuation of various media, the designed array could still generate the intensity at focus up to 1095 W/cm2 when the input electrical power was approximately 410 W. The prototype of the array was fabricated and the preliminary test was completed. The testing results showed that each element of the array prototype can work well.
43
Robertson, Cary N., John Francis Ward, Sebastien Crouzet, Stephen CW Brown, Victor Berge, Christian G. Chaussy, Roman Ganzer, et al. "Biochemical survival and morbidity of high-intensity focused ultrasound (HIFU) as a primary monotherapy for low-risk localized prostate cancer: Outcomes from the @-registry following the ENLIGHT trial inclusion criteria." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e15194-e15194. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e15194.
Abstract:
e15194 Background: Prostate Cancer (PCa) HIFU (Ablatherm, EDAP-TMS, Lyon, France) is currently under investigation in the US. This study reports biochemical, biopsy and morbidity outcomes for a population of low risk localized PCa patients meeting ENLIGHT FDA trial inclusion criteria. These data were accrued from European HIFU centers using an online HIFU database (@-Registry) . Methods: The patient’s selection criteria for this study were: low risk prostate cancer patients (T1c to T2a, PSA<10ng/ml, Gleason≤6), with a prostate A-P diameter and volume of <25mm and <40cc, and no pre-treatment hormone therapy. Kaplan-Meier analysis was performed to determine biochemical survival with failure defined as the Phoenix definition (PSA nadir+2). Morbidity data, need for salvage treatment and biopsy data were analyzed. Results: From 12 European centers, 358 men met the inclusion criteria. The baseline mean age, PSA and median Gleason sum were 69.7±6.4 years, 5.8±2.4 ng/ml and 6, respectively. Stage was 65.9% T1c and 34.1% T2a. Patients were followed for 6.6±3.1 years (range: 0.6 to 18 years). Median PSA nadir was 0.09 which was reached 13.9±10.7 weeks after HIFU. The salvage treatment rate was 8.7%, and the negative biopsy rate was 90.2% Actuarial BDFS at 5 and 10 years was 87% and 73% respectively. The morbidity data identified GradeI, II and III stress incontinence in 12.3%, 4.5% and 1.7% of the population, respectively. The Bladder Outlet Obstruction rate was 20.7% (urinary retention, urethral stenosis ). Urethro-rectal fistula was not observed. Conclusions: HIFU achieved good biochemical control at 10 years of follow-up for low riskPCa patients and negative biopsy rates were high. HIFU demonstrated an acceptable morbidity, especially with the lack of any serious events(specifically fistula). Bladder Outlet Obstruction was the most bothersome adverse event. HIFU appears as a valuable and safe therapy for long term low risk PCa treatment.
44
Nyk, Łukasz, Wojciech Michalak, Stanisław Szempliński, Rafał Woźniak, Bartłomiej Zagożdżon, Wojciech Krajewski, Piotr Kryst, Hubert Kamecki, and Sławomir Poletajew. "High-Intensity Focused-Ultrasound Focal Therapy Versus Laparoscopic Radical Prostatectomy: A Comparison of Oncological and Functional Outcomes in Low- and Intermediate-Risk Prostate Cancer Patients." Journal of Personalized Medicine 12, no. 2 (February 9, 2022): 251. http://dx.doi.org/10.3390/jpm12020251.
Abstract:
To compare oncological and functional outcomes of high-intensity focused-ultrasound (HIFU) focal therapy (FT) versus laparoscopic radical prostatectomy (LRP) in patients treated for low- or intermediate-risk prostate cancer (PCa), we retrospectively analyzed data of consecutive patients comprising 30 men, who underwent HIFU-FT, and 96 men who underwent LRP, in an academic center. Oncological outcomes were assessed based on the follow-up prostate-specific antigen values. We used the International Index of Erectile Function short form score to assess erectile function (EF). Urinary continence status was defined based on the number of pads used per day. Median follow-up was 12.5 and 19.1 months in the LRP and HIFU-FT groups, respectively. The effects were computed after propensity score matching and expressed as average treatment effect (ATE). Compared to LRP, HIFU-FT was associated with increased risk of treatment failure (ATE 0.103–0.164, depending on definition, p < 0.01) and lower risk of urinary incontinence (ATE −0.808 at 12 months, p < 0.01). Risk of erectile dysfunction was higher in the LRP group (ATE 5.092, p < 0.01). Our results demonstrate that HIFU-FT may be a reasonable treatment option in selected PCa patients, willing to preserve their EF and urinary continence yet accepting a higher risk of treatment failure.
45
Marinova, Milka, Hannah C. Huxold, Jana Henseler, Martin Mücke, Rupert Conrad, Roman Rolke, Hojjat Ahmadzadehfar, et al. "Clinical Effectiveness and Potential Survival Benefit of US-Guided High-Intensity Focused Ultrasound Therapy in Patients with Advanced-Stage Pancreatic Cancer." Ultraschall in der Medizin - European Journal of Ultrasound 40, no. 05 (April 17, 2018): 625–37. http://dx.doi.org/10.1055/a-0591-3386.
Abstract:
Abstract Purpose Pancreatic cancer (PaC) is a life-limiting tumor with a wide range of incapacitating symptoms such as cancer pain in more than 80 % of patients. This prospective interventional study addresses the clinical effectiveness of ultrasound-guided high-intensity focused ultrasound (HIFU) treatment for patients with advanced-stage PaC, including pain perception, tumor size and survival benefit. Materials and Methods 50 patients with late-stage PaC underwent HIFU. Clinical assessment included evaluation of tumor volume by imaging and pain burden (pain severity, pain sensation, interference with daily activities) using the Brief Pain Inventory at baseline and follow-up. Median overall survival, progression-free survival and time to local progression were estimated using Kaplan-Meier analysis. Results In 84 % of patients, significant early relief of cancer-induced abdominal pain was achieved by HIFU independent of metastatic status; it persisted during follow-up. Tumor volume reduction was 37.8 ± 18.1 % after 6 weeks and 57.9 ± 25.9 % after 6 months. 21 % of HIFU-treated patients had local tumor progression with a median time of 14.4 months from intervention. The median overall survival and progression-free survival were 16.2 and 16.9 months from diagnosis and 8.3 and 6.8 months from intervention. Conclusion In patients with advanced pancreatic cancer and otherwise limited treatment options, HIFU resulted in significant early and long-lasting pain relief and tumor size reduction over time independent of metastatic status. Clinical data suggest an additional potential survival benefit.
46
Maloney, Ezekiel, and Joo Ha Hwang. "Emerging HIFU applications in cancer therapy." International Journal of Hyperthermia 31, no. 3 (November 4, 2014): 302–9. http://dx.doi.org/10.3109/02656736.2014.969789.
47
Solovov, V. A., and A. A. Tiurin. "High-Intensity Focused Ultrasound Ablation of Prostate Cancer: 15 Years of Follow-up." Creative surgery and oncology 13, no. 4 (December 20, 2023): 271–77. http://dx.doi.org/10.24060/2076-3093-2023-13-4-271-277.
Abstract:
Introduction. Prostate cancer (PC) is considered to be one of the most common malignancies in men. In recent years, conventional PC treatments have been supplemented with highly effective minimally invasive therapies such as highintensity focused ultrasound ablation (HIFU). Only a few studies have been published on the long-term oncological effectiveness of HIFU therapy for prostate cancer. Aim. To evaluate the oncological efficacy of HIFU in the treatment of prostate cancer in a long-term follow-up. Materials and methods. The retrospective analysis included the treatment outcomes of 171 patients with prostate cancer who underwent HIFU therapy at the Samara Clinical Oncology Dispensary in 2007–2009. The mean age of the patients was 69.7 years. Of these, 48 had a low risk of progression according to D’Amico, 57 patients — intermediate risk and 66 — high risk of progression. The follow-up period comprised 13–15 years (median 14.3 years). Positive histological findings, elevated PSA and/or the appearance of local or distant metastases were interpreted as recurrence. The Kaplan-Meier method was used to graphically represent survival curves. A multiparameter Cox proportional hazards regression analysis was performed to assess the prognostic significance of various clinical data in overall, cancer-specific and recurrence-free survival. All values of p<0.05 were considered statistically significant. Results and discussion. The overall fifteen-year survival for patients in the low-risk, intermediate-risk, and high-risk groups accounted for 52.1, 56.1, and 37.9%, respectively. Fifteen-year PC-specific survival was determined in 90.1% of patients. Fifteen-year recurrence-free survival for patients in the low-risk, intermediate-risk, and high-risk groups comprised 95.4, 80.7 and 69.7%, respectively. A significant risk factor for recurrence was the distribution according to the D’Amico progression risk scale. Conclusion. HIFU therapy demonstrated good long-term oncologic results in the treatment of patients with prostate cancer.
48
Pasticier, Gilles, Sebastien Crouzet, Marc Colombel, Olivier Rouviere, Muriel Rabilloud, Jean-Yves Chapelon, Florence Mege-Lechevallier, Helene Tonoli-Catez, Xavier Martin, and Albert Gelet. "Radical prostatectomy versus high intensity-focused ultrasound for localized prostate cancer: A matched-pair comparison." Journal of Clinical Oncology 33, no. 7_suppl (March 1, 2015): 74. http://dx.doi.org/10.1200/jco.2015.33.7_suppl.74.
Abstract:
74 Background: Radical prostatectomy is the gold standard treatment for localized prostate cancer. HIFU is a treatment option with promising outcomes. No randomized study is available to compare those techniques. The goal of the study was to evaluate the oncologic outcome of patients treated with HIFU and radical prostatectomy by using a matched pair analysis to compare the 2 groups. Methods: A total of 710 patients treated between 2000 and 2005 were prospectively followed in our institutional database and matched to a 1:1 basis following know prognostic variables: prostate-specific antigen (PSA) level, Gleason score, and clinical stage. After matching, 588 patients (294 in each group) were further analysed. The starts of salvage external beam radiotherapy (S-EBRT) or definitive palliative androgen deprivation therapy (ADT) were primary endpoints. Other endpoints were overall, cancer specific and metastasis free survival rates: The survival rates were calculated with Kaplan-Meier estimate Results: The seven years S-EBRT free survival rate was significantly lower after HIFU than after RP (62% versus 78%, p=0.001). The palliative androgen deprivation free rate at nine years was not significantly different between HIFU and RP (86% versus 87%, p=0.271). At nine years the overall, cancer specific and metastasis free survival rates were similar: 89%, 97%, 94 % and 89%, 97% and 97% for HIFU and RP respectively (p=0.186, 0.312, 0.107). Conclusions: Matched pair comparison of HIFU and RP has shown a higher rate of S-EBRT for HIFU. At 9 years, the rate of patients who need palliative ADT, the overall cancer specific and metastasis free survival rates were not significantly different between HIFU and RP.
49
Abufaraj, Mohammad, Abdelmuez Siyam, Mustafa Rami Ali, Rodrigo Suarez-Ibarrola, Lin Yang, Beat Foerster, and Shahrokh F. Shariat. "Functional Outcomes after Local Salvage Therapies for Radiation-Recurrent Prostate Cancer Patients: A Systematic Review." Cancers 13, no. 2 (January 11, 2021): 244. http://dx.doi.org/10.3390/cancers13020244.
Abstract:
Purpose: To assess the rate and severity of functional outcomes after salvage therapy for radiation recurrent prostate cancer. Methods: This systematic review of the MEDLINE/PubMed database yielded 35 studies, evaluating salvage radical prostatectomy (RP), brachytherapy (BT), high-intensity focal ultrasound (HIFU) and cryotherapy (CT) after failure of primary radiation therapy. Data on pre- and post-salvage rates and severity of functional outcomes (urinary incontinence, erectile dysfunction, and lower urinary tract symptoms) were collected from each study. Results: The rates of severe urinary incontinence ranged from 28–88%, 4.5–42%, 0–6.5%, 2.4–8% post salvage RP, HIFU, CT and BT, respectively. The rates of erectile dysfunction were relatively high reaching as much as 90%, 94.6%, 100%, 62% following RP, HIFU, CT and BT, respectively. Nonetheless, the high pre-salvage rates of ED preclude accurate estimation of the effect of salvage therapy. There was an increase in the median IPSS following salvage HIFU, BT and CT ranging from 2.5–3.4, 3.5–12, and 2, respectively. Extended follow-up showed a return-to-baseline IPSS in a salvage BT study. The reported data suffer from selection, reporting, publication and period of study biases, making inter-study comparisons inappropriate. Conclusions: local salvage therapies for radiation recurrent PCa affect continence, lower urinary tract symptoms and sexual functions. The use of local salvage therapies may be warranted in the setting of local disease control, but each individual decision must be made with the informed patient in a shared decision working process.
50
Abufaraj, Mohammad, Abdelmuez Siyam, Mustafa Rami Ali, Rodrigo Suarez-Ibarrola, Lin Yang, Beat Foerster, and Shahrokh F. Shariat. "Functional Outcomes after Local Salvage Therapies for Radiation-Recurrent Prostate Cancer Patients: A Systematic Review." Cancers 13, no. 2 (January 11, 2021): 244. http://dx.doi.org/10.3390/cancers13020244.
Abstract:
Purpose: To assess the rate and severity of functional outcomes after salvage therapy for radiation recurrent prostate cancer. Methods: This systematic review of the MEDLINE/PubMed database yielded 35 studies, evaluating salvage radical prostatectomy (RP), brachytherapy (BT), high-intensity focal ultrasound (HIFU) and cryotherapy (CT) after failure of primary radiation therapy. Data on pre- and post-salvage rates and severity of functional outcomes (urinary incontinence, erectile dysfunction, and lower urinary tract symptoms) were collected from each study. Results: The rates of severe urinary incontinence ranged from 28–88%, 4.5–42%, 0–6.5%, 2.4–8% post salvage RP, HIFU, CT and BT, respectively. The rates of erectile dysfunction were relatively high reaching as much as 90%, 94.6%, 100%, 62% following RP, HIFU, CT and BT, respectively. Nonetheless, the high pre-salvage rates of ED preclude accurate estimation of the effect of salvage therapy. There was an increase in the median IPSS following salvage HIFU, BT and CT ranging from 2.5–3.4, 3.5–12, and 2, respectively. Extended follow-up showed a return-to-baseline IPSS in a salvage BT study. The reported data suffer from selection, reporting, publication and period of study biases, making inter-study comparisons inappropriate. Conclusions: local salvage therapies for radiation recurrent PCa affect continence, lower urinary tract symptoms and sexual functions. The use of local salvage therapies may be warranted in the setting of local disease control, but each individual decision must be made with the informed patient in a shared decision working process.