Extracorporeal Ablation of Liver Tissue by High-Intensity Focused Ultrasound

Sibille, Alain; Prat, Frédéric; Chapelon, Jean‐Yves; Fadil, Fatima Abou El; Henry, Luc; Theillère, Y.; Ponchon, Thierry; Cathignol, D.

doi:10.1159/000227213

Cited by 66 publications

(38 citation statements)

References 16 publications

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“…Similar lesions have been observed when high-intensity focused ultrasound was used to create lesions in noncardiac tissue. 1,5,7,11,15 The pathology of the acute lesions noted in the present study is similar to that of the well-demarcated lesions created with radiofrequency energy. 16 -18 This type of well-demarcated lesion is not believed to be associated with a risk of proarrhythmia.…”

Section: Pathology and Mechanism Of Lesion Formationsupporting

confidence: 74%

“…6 Therapeutic ultrasound has been used to treat a variety of conditions. 1,2,4,5,[7][8][9][10][11][12][13][14] However, the use of extracardiac ultrasound to ablate functioning myocardium has not been reported. The purpose of this study was to determine whether extracorporeal focused ultrasound can be used to create atrioventricular (AV) block within the beating canine heart.…”

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confidence: 99%

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Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound

et al. 1999

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Background-High-intensity focused ultrasound has been applied to internal organs from outside the body to ablate tissue.No published study has assessed the feasibility of ablating cardiac tissue within the beating heart by use of this type of therapeutic ultrasound. The purpose of this study was to determine whether high-intensity focused ultrasound can be used to ablate the atrioventricular (AV) junction within the beating heart. Methods and Results-Ten dogs were anesthetized and underwent a thoracotomy. The heart was covered with a polyvinyl chloride membrane. The thorax above the membrane was perfused with degassed water, which functioned as a coupling medium for the ultrasound. A 7.0-MHz diagnostic ultrasound probe was affixed to a spherically focused 1.4-MHz high-intensity focused ultrasound transducer with a 1.1ϫ8.3-mm focal zone 63.5 mm from the ablation transducer. The diagnostic ultrasound probe was calibrated such that the location of the focal zone of the ablation transducer was identifiable on the 2-dimensional ultrasound image. Target sites were identified with the diagnostic ultrasound. The maximum ultrasound intensity for ablation (2.8 kW/cm 2 ) was delivered to the AV junction only during electrical diastole and for a total of 30 seconds. Complete AV block was achieved in each of the 10 dogs with 6.5Ϯ5.6 (range, 3 to 21) 30-second applications of therapeutic ultrasound. Gross inspection showed that the mean lesion volume was 124Ϯ143 mm 3 , with a depth of 6.7Ϯ3.6 mm, a length of 5.7Ϯ2.5 mm, and a width of 4.7Ϯ1.8 mm. Four hours after the dogs were killed, histopathological study demonstrated a well-demarcated area of necrosis and early inflammation. Conclusions-High-intensity focused ultrasound produces well-demarcated lesions and appears to be a feasible energy source to create complete AV block within the beating heart without damaging the overlying or underlying cardiac tissue. This energy source may allow for a noninvasive approach to ablation of cardiac arrhythmias. (Circulation. 1999;100:203-208.)

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Section: Pathology and Mechanism Of Lesion Formationsupporting

confidence: 74%

mentioning

confidence: 99%

Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound

et al. 1999

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“…Research results of home and abroad using animals showed that HIFU can safely and effectively destroy inner liver tissue or liver transplant tumor [23][24][25][26][27][28][29][30] . Clinic results showed that HIFU can also treat liver cancer securely and effectively [11,31,32] .…”

Section: Discussionmentioning

confidence: 99%

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

Li¹,

Xu²,

Jiang³

et al. 2004

WJG

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AIM:To evaluate the clinical effect of high-intensity focused ultrasound (HIFU) in the treatment of patients with liver cancer.METHODS: HIFU treatment was performed in 100 patients with liver cancer under general anesthesia and by a targeted ultrasound. Evaluation of efficacy was made on the basis of clinical symptoms, liver function tests, AFP, MRI or CT before and after the treatment. RESULTS:After HIFU treatment, clinical symptoms were relieved in 86.6%(71/82) of patients. The ascites disappeared in 6 patients. ALT (95±44) U/L and AST (114±58) U/L before HIFU treatment were reduced to normal in 83.3%(30/36) and 72.9%(35/48) patients, respectively, after the treatment. AFP was lowered by more than 50% in 65.3%(32/49) patients. After HIFU treatment, MRI or CT findings indicated coagulation necrosis and blood supply reduction or disappearance of tumor in the target region.CONCLUSION: HIFU can efficiently treat the patients with liver cancer. It will offer a significant noninvasive therapy for local treatment of liver tumor.

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“…The aim of ultrasound thermal therapy [1][2][3][4][5] is to use high intensity, short-duration, focused ultrasound [6][7][8] to deliver enough energy into a specific tumor volume such that tissue necrosis is formed and the overheating of the intervening normal tissue can be avoided [2,9]. The external ultrasound heating is a noninvasive and very flexible modality for heating deep-seated tumors for its vast penetration and focusing ability.…”

Section: Introductionmentioning

confidence: 99%

Thermal Lesion Formation and Determination for External Ultrasound Thermal Therapy

Liu

Chen

Yen

et al. 2003

Biomed. Eng. Appl. Basis Commun.

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The purpose of this paper is to investigate the relationship between the formation of the thermal lesion and the major parameters of the external ultrasound heating systems, and to propose a useful thermal lesion determination procedure, which is capable of specifying the range of a thermal lesion by temperature feedback in external ultrasound thermal therapy. This work is based on an ideal ultrasound power deposition formed by an external ultrasound heating system and the temperature distribution is calculated by the transient bioheat transfer equation. A simplified model was employed to determine the heating pattern for four most important parameters. Through the simplified power expression, the property of a new parameter, T300, which is defined as the maximal temperature corresponding to the thermal dose of 300 minutes, is also investigated. When the target volume is large enough such that the thermal conduction effect becomes negligible, the T300 value is almost independent of the system parameters and the heating strategies, and is dominated by the blood perfusion rate with a monotonic correlation. The method enables us to use feedback information in the ultrasound heating process and to pre-determine the heating range of the thermal lesion, which will be very useful in ultrasound treatment planning.

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Extracorporeal Ablation of Liver Tissue by High-Intensity Focused Ultrasound

Cited by 66 publications

References 16 publications

Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound

Extracardiac Ablation of the Canine Atrioventricular Junction by Use of High-Intensity Focused Ultrasound

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

Thermal Lesion Formation and Determination for External Ultrasound Thermal Therapy

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