Clinical Application of High-intensity Focused Ultrasound in Cancer Therapy

Hsiao, Yi‐Hsuan; Kuo, Shou‐Jen; Tsai, Horng‐Der; Chou, Ming-Chih; Yeh, Guang-Perng

doi:10.7150/jca.13906

Cited by 127 publications

(75 citation statements)

References 68 publications

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“…This makes heat-regulated drug release with temperature-sensitive liposomes highly promising in the clinic 44 . MRI-based drug-release monitoring may play an important role in the clinical translation of this technology 45 . Ultrasound imaging will be another important tool to guild HIFU ablation and to monitor drug release 46 .…”

Section: Key Concepts and The Status Quomentioning

confidence: 99%

Rethinking cancer nanotheranostics

et al. 2017

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Advances in nanoparticle synthesis and engineering have produced nanoscale agents affording both therapeutic and diagnostic functions that are often referred to by the portmanteau ‘nanotheranostics’. The field is associated with many applications in the clinic, especially in cancer management. These include patient stratification, drug-release monitoring, imaging-guided focal therapy and post-treatment response monitoring. Recent advances in nanotheranostics have expanded this notion and enabled the characterization of individual tumours, the prediction of nanoparticle–tumour interactions, and the creation of tailor-designed nanomedicines for individualized treatment. Some of these applications require breaking the dogma that a nanotheranostic must combine both therapeutic and diagnostic agents within a single, physical entity; instead, it can be a general approach in which diagnosis and therapy are interwoven to solve clinical issues and improve treatment outcomes. In this Review, we describe the evolution and state of the art of cancer nanotheranostics, with an emphasis on clinical impact and translation.

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Section: Key Concepts and The Status Quomentioning

confidence: 99%

Rethinking cancer nanotheranostics

et al. 2017

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“…High intensity focused ultrasound (HIFU) is a promising therapeutic modality for treatment of tumors [2–5]. Noninvasive HIFU methods employ a transducer that is acoustically coupled to the skin to generate and focus ultrasound to a targeted tissue structure in the body through aberrating and attenuating intervening tissue layers.…”

Section: Introductionmentioning

confidence: 99%

A Prototype Therapy System for Transcutaneous Application of Boiling Histotripsy

Maxwell

Yuldashev

Kreider

et al. 2017

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Boiling histotripsy is a method of focused ultrasound surgery that noninvasively applies millisecond-length pulses with high-amplitude shock fronts to generate liquefied lesions in tissue. Such a technique requires unique outputs compared to a focused ultrasound thermal therapy apparatus, particularly to achieve high in situ pressure levels through intervening tissue. This article describes the design and characterization of a system capable of producing the necessary pressure to transcutaneously administer boiling histotripsy therapy through clinically relevant overlying tissue paths using pulses with duration up to 10 ms. A high-voltage electronic pulser was constructed to drive a 1-MHz focused ultrasound transducer to produce shock waves with amplitude capable of generating boiling within the pulse duration in tissue. The system output was characterized by numerical modeling with the 3D Westervelt equation using boundary conditions established by acoustic holography measurements of the source field. Such simulations were found to be in agreement with directly measured focal waveforms. An existing derating method for nonlinear therapeutic fields was used to estimate in situ pressure levels at different tissue depths. The system was tested in ex vivo bovine liver samples to create boiling histotripsy lesions at depths up to 7 cm. Lesions were also created through excised porcine body wall (skin, adipose, muscle) with 3–5 cm thickness. These results indicate that the system is capable of producing the necessary output for transcutaneous ablation with boiling histotripsy.

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“…Thermal therapy is a promising way to improve cancer treatment, but it is largely an experimental technique with few clinically approved applications [3], [4], [5], [6]. High-efficacy thermal therapy would provide destruction of the targeted lesion, while preventing damage to adjacent healthy tissues.…”

Section: Introductionmentioning

confidence: 99%

Temperature-dependent optoacoustic response and transient through zero Grüneisen parameter in optically contrasted media

et al. 2017

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Non-invasive optoacoustic mapping of temperature in tissues with low blood content can be enabled by administering external contrast agents. Some important clinical applications of such approach include temperature mapping during thermal therapies in a prostate or a mammary gland. However, the technique would require a calibration that establishes functional relationship between the measured normalized optoacoustic response and local tissue temperature. In this work, we investigate how a key calibration parameter – the temperature of zero optoacoustic response (T0) – behaves in different environments simulating biological tissues augmented with either dissolved or particulate (nanoparticles) contrast agents. The observed behavior of T0 in ionic and molecular solutions suggests that in-vivo temperature mapping is feasible for contrast agents of this type, but requires knowledge of local concentrations. Oppositely, particulate contrast agents (plasmonic or carbon nanoparticles) demonstrated concentration-independent thermal behavior of optoacoustic response with T0 defined by the thermoelastic properties of the local environment.

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Clinical Application of High-intensity Focused Ultrasound in Cancer Therapy

Cited by 127 publications

References 68 publications

Rethinking cancer nanotheranostics

Rethinking cancer nanotheranostics

A Prototype Therapy System for Transcutaneous Application of Boiling Histotripsy

Temperature-dependent optoacoustic response and transient through zero Grüneisen parameter in optically contrasted media

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