Analysis of clinical effect of high-intensity focused ultrasound on liver cancer

Li, Chuanxing; Xu, Guoliang; Jiang, Zhuhua; Li, Jianjun; Luo, Guangyu; Shan, Hong; Zhang, Rong; Li, Yin

doi:10.3748/wjg.v10.i15.2201

Cited by 78 publications

(46 citation statements)

References 30 publications

(25 reference statements)

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“…Forty-four studies reported on the clinical use of HIFU (7,(10)(11)(12)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) to treat liver lesions , while 19 series were found on HIFU treatment for pancreatic cancers (6,(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73) and 4 studies included patients suffering from both liver and pancreatic cancers (74)(75)(76)(77), reporting on a total of 1,682 and 823 cases for the liver and pancreas, respectively. However, the real number of patients who benefited from HIFU treatment is much larger, since a recent review article from Zhou reported on over 3,000 cases of advanced pancreatic cancer treated with HIFU alone or in combination with chemotherapy (CHT) or radiotherapy (RT) (78).…”

Section: Study Selection and Level Of Evidencementioning

confidence: 99%

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

Diana¹,

Schiraldi²,

Liu³

et al. 2016

Hepatobiliary Surg. Nutr.

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Background: High intensity focused ultrasound (HIFU) is emerging as a valid minimally-invasive imageguided treatment of malignancies. We aimed to review to current state of the art of HIFU therapy applied to the digestive system and discuss some promising avenues of the technology.Methods: Pertinent studies were identified through PubMed and Embase search engines using the following keywords, combined in different ways: HIFU, esophagus, stomach, liver, pancreas, gallbladder, colon, rectum, and cancer. Experimental proof of the concept of endoluminal HIFU mucosa/submucosa ablation using a custom-made transducer has been obtained in vivo in the porcine model. Results:Forty-four studies reported on the clinical use of HIFU to treat liver lesions, while 19 series were found on HIFU treatment of pancreatic cancers and four studies included patients suffering from both liver and pancreatic cancers, reporting on a total of 1,682 and 823 cases for liver and pancreas, respectively. Only very limited comparative prospective studies have been reported. Conclusions:Digestive system clinical applications of HIFU are limited to pancreatic and liver cancer. It is safe and well tolerated. The exact place in the hepatocellular carcinoma (HCC) management algorithm remains to be defined. HIFU seems to add clear survival advantages over trans arterial chemo embolization (TACE) alone and similar results when compared to radio frequency (RF). For pancreatic cancer, HIFU achieves consistent cancer-related pain relief. Further research is warranted to improve targeting accuracy and efficacy monitoring. Furthermore, additional work is required to transfer this technology on appealing treatments such as endoscopic HIFU-based therapies.Keywords: High intensity focused ultrasound (HIFU); liver cancer; pancreatic cancer; miniature HIFU delivery system; endoluminal applications of HIFU; mucosa and submucosal ablations using HIFU

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Section: Study Selection and Level Of Evidencementioning

confidence: 99%

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

Diana¹,

Schiraldi²,

Liu³

et al. 2016

Hepatobiliary Surg. Nutr.

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“…HIFU ablation has also been used for symptom palliation in patients with advanced-stage liver cancer. Li et al [10] reported a series of 100 patients with liver cancer who were treated with HIFU, including 62 patients with primary liver cancer and 38 with metastatic liver cancer. Following treatment, symptoms (such as pain and lethargy) were relieved in 87% of the patients.…”

mentioning

confidence: 99%

High-intensity focused ultrasound treatment of liver tumours: post-treatment MRI correlates well with intra-operative estimates of treatment volume

Leslie

Ritchie²,

Illing³

et al. 2012

BJR

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Objectives: To assess the safety and feasibility of high-intensity focused ultrasound (HIFU) ablation of liver tumours and to determine whether post-operative MRI correlates with intra-operative imaging. Methods: 31 patients were recruited into two ethically approved clinical trials (median age 64; mean BMI 26 kg m 22). Patients with liver tumours (primary or metastatic) underwent a single HIFU treatment monitored using intra-operative Bmode ultrasound. Follow-up consisted of radiology and histology (surgical trial) or radiology alone (radiology trial). Radiological follow-up was digital subtraction contrast-enhanced MRI. Results: Treatment according to protocol was possible in 30 of 31 patients. One treatment was abandoned because of equipment failure. Transient pain and superficial skin burns were seen in 81% (25/31) and 39% (12/31) of patients, respectively. One moderate skin burn occurred. One patient died prior to radiological follow-up. Radiological evidence of ablation was seen in 93% (27/29) of patients. Ablation accuracy was good in 89% (24/27) of patients. In three patients the zone of ablation lay #2 mm outside the tumour. The median cross-sectional area (CSA) of the zone of ablation was 5.0 and 5.1 cm 2 using intra-operative and post-operative imaging, respectively. The mean MRI:B-mode CSA ratio was 1.57 [95% confidence interval (CI)50.57-2.71]. There was positive correlation between MRI and B-mode CSA (Spearman's r50.48; 95% CI 0.11-0.73; p50.011) and the slope of linear regression was significantly non-zero (1.23; 95% CI50.68-1.77; p,0.0001). Conclusions: HIFU ablation of liver tumours is safe and feasible. HIFU treatment is accurate, and intra-operative assessment of treatment provides an accurate measure of the zone of ablation and correlates well with MRI follow-up. Colorectal cancer is one of the leading causes of mortality in Europe and the USA [1]. Of those diagnosed with colorectal cancer, 20-30% will have metastases in the liver at the time of diagnosis, and overall 50% will develop liver metastases during the course of their disease [2,3]. Despite this, at post-mortem, approximately one-quarter of patients are found to have metastases confined to the liver, and so the possibility of cure in such patients is available if these metastases can be treated effectively. Hepatic resection is feasible in only 10-25%, and although it is associated with an operative mortality of up to 5%, it can achieve 5-year survival rates in the region of 40% [4]. The favoured current alternative to surgery is combination chemotherapy, but this is associated with an objective response rate of just 20-50%, and relatively short median overall survival of approximately 12 months [5]. As a result there have been considerable efforts to provide minimally invasive alternatives to surgery for these patients. These alternatives include transarterial chemo-embolisation (TACE), direct percutaneous ethanol injection (PEI), and energy-based ablative techniques such as radiofrequency ablation (RFA), cryoablation, microwave th...

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“…HIFU is an effective treatment for many types of malignant tumor, 5,10,24,25 especially for superficial tumors with poor blood supply. Because ultrasound resistance and absorption are relatively small for these superficial tumors, energy is more easily focused and thus HIFU provides a particularly great outcome for tumor ablation.…”

Section: Resultsmentioning

confidence: 99%

“…The tumor therapy system (model JC; Chongqing Haifu Technology, Chongqing, China) used in this study is guided by means of real-time ultrasonographic imaging and has been described in detail previously. 4,10 Focused ultrasound is produced by a 12 cm diameter piezoelectric ceramic (lead zirconate titanate) transducer of 135 mm focal length operating at a frequency of 0.8 MHz (continuous wave). The focal region is an ellipsoid with dimensions of 3.3 mm along the beam axis and 1.1 mm in the transverse direction.…”

Section: Methodsmentioning

confidence: 99%

“…[7][8][9] More recently, extracorporeal HIFU has been used to treat patients with various malignancies, including those originating from the liver, breast and kidney and osteosarcoma. 5,6,10 In this study, we applied HIFU to noninvasively ablate and inactivate recurrent or metastatic superficial malignant tumors in our hospital from June 2001-December 2006. The results were inspiring, and herein we discuss the safety, effectiveness and clinic application potential of HIFU ablation.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Superficial malignant tumors: Non-invasive treatment with ultrasonographically guided high-intensity focused ultrasound

Li¹,

Zhang²,

Rong³

et al. 2009

Cancer Biology & Therapy

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Analysis of clinical effect of high-intensity focused ultrasound on liver cancer

Cited by 78 publications

References 30 publications

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

High-intensity focused ultrasound treatment of liver tumours: post-treatment MRI correlates well with intra-operative estimates of treatment volume

Superficial malignant tumors: Non-invasive treatment with ultrasonographically guided high-intensity focused ultrasound

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