A portable high-intensity focused ultrasound system for the pancreas with 3D electronic steering: a preclinical study in a swine model

Abstract

PurposeThe aim of this animal study was to evaluate the safety and feasibility of a portable, ultrasonography-guided, high-intensity focused ultrasound (USg-HIFU) system to treat the pancreas.MethodsEight swine were included. Using a portable HIFU device (ALPIUS 900, Alpinion Medical Systems), ablations were performed on the pancreas in vivo. Different acoustic intensities were applied (1.7 kW/cm2 or 1.5 kW/cm2, n=2 [group A for a pilot study]; 1.5 kW/ cm2, n=3 [group B]; and 1.2 kW/cm2, n=3 [group C]). Magnetic resonance imaging (MRI) was performed immediately (group A) or 7 days (groups B and C) after HIFU treatment. In groups B and C, serum amylase and lipase levels were measured on days 0 and 7, and performance status was observed every day. Necropsy was performed on days 0 (group A) or 7 (groups B and C) to assess the presence of unintended injuries and to obtain pancreatic and peripancreatic tissue for histological analysis.ResultsAblation was noted in the pancreas in all swine on MRI, and all pathologic specimens showed coagulation necrosis in the treated area. The mean ablation areas on MRI were 85.3±38.1 mm2, 90.7±21.2 mm2, and 54.4±30.6 mm2 in groups A, B, and C, respectively (P>0.05). No animals showed evidence of complications, except for one case of a pseudocyst in group B.ConclusionThis study showed that pancreas ablation using a portable USg-HIFU system may be safe and feasible, and that coagulation necrosis of the pancreas was successfully achieved with a range of acoustic intensities.

Intraoperative HIFU Ablation of the Pancreas Using a Toroidal Transducer in a Porcine Model. The First Step towards a Clinical Treatment of Locally Advanced Pancreatic Cancer

“…However, the diameter of this hepatic artery (5 mm) is similar to the diameter of the mesenteric artery in humans. Despite these differences, the similarities in terms of the anatomical dimensions and structure between the human and porcine pancreas make the pig the predominant model for preclinical studies on the treatment of pancreatic carcinoma with HIFU [ 24 , 31 , 32 , 33 , 34 , 35 , 36 ]. Therefore, in this study, the feasibility of selective ablation of the porcine pancreas and tissues around the peripancreatic hepatic artery using an intraoperative toroidal HIFU transducer was investigated under Doppler guidance in 20 healthy, female landrace pigs 12 to 14 weeks old and weighing between 25 and 30 kg.…”

Review of Robot-Assisted HIFU Therapy

“…The Alpius 900 is a commercial, portable HIFU system developed by Alpinion Medical System for extracorporeal ablation and hyperthermia of stationary tumors (thyroid, breast, etc.) [ 52 ]. A 1.0 MHz multi-element HIFU transducer and imaging transducer are mounted confocally at the end of a robot hybrid positioning arm.…”

“…This system has the advantage of minimal repositioning due to the software pre-targeting tools and 3D modeling of the volumes for optimal treatment path planning [ 52 ]. During the treatment, the Alpius 900 HIFU system continuously monitors the temperature of the tissue being treated to ensure that the correct amount of energy is being delivered to the target area.…”

<p>A Retrospective Case Series Of High-Intensity Focused Ultrasound (HIFU) In Combination With Gemcitabine And Oxaliplatin (Gemox) On Treating Elderly Middle And Advanced Pancreatic Cancer</p>

“…Besides, the immunomodulatory function of HIFU has also been reported 20,21. In the pancreas, the local treatment of cancer shows a unique advantage 22. Several clinical trials of HIFU palliative therapy for pancreatic carcinoma cases have provided promising results 23,24.…”