High-Intensity Focused Ultrasound: Current Status for Image-Guided Therapy

Copelan, Alexander; Hartman, Jason; Chehab, Monzer; Venkatesan, Aradhana M.

doi:10.1055/s-0035-1564793

Cited by 86 publications

(79 citation statements)

References 127 publications

(158 reference statements)

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“…Applications of MR‐guided focused ultrasound (MRgFUS) with CE mark and US FDA approval include ablation of uterine fibroids and bone metastases‐related pain management, while the clinical use of MRgFUS for the treatment of breast cancer is still waiting for CE and US FDA approval. However, several clinical studies and reviews showed the potential role of this technique for breast benign and malignant lesions ablation . The most commonly used devices are the ExAblate systems 2000 and 2001 (Fig.…”

Section: Hifu Ablationmentioning

confidence: 99%

“…However, several clinical studies and reviews showed the potential role of this technique for breast benign and malignant lesions ablation. 44,51,[54][55][56][57][58] The most commonly used devices are the ExAblate systems 2000 and 2001 (Fig. 2, GE Healthcare, and InSightec-TxSonics, Israel) and the Sonalleve MR HIFU system (Philips, Best, The Netherlands).…”

Section: Hifu Ablationmentioning

confidence: 99%

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MRI‐guided treatment in the breast

Pediconi

Marzocca

Marincola

et al. 2018

Magnetic Resonance Imaging

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In the last decades, an increasing interest has developed towards non‐invasive breast lesion treatments, which offer advantages such as the lack of surgery‐related complications, better cosmetic outcomes, and less psychological distress. In addition, these treatments could be an option for patients with poor health who are not candidates for surgery. Non‐surgical ablation can be performed under magnetic resonance (MR) or ultrasound (US) guidance. US is cheaper and easily available, while contrast‐enhanced MR is more accurate, ensuring better safety and efficacy for the patient. Overall results of studies about MRI‐guided tumor ablation reported complete ablation rates ranging between 20% and 100%. High‐intensity focused ultrasound (HIFU or FUS) is the most studied ablative technique and it is already established as a valid technique for ablation of benign and malignant tumors in various organs. Ultrasound‐guided FUS is very useful for young patients who refuse surgery or with multiple nodules; however, MR‐guided FUS is more sensitive and allows a better evaluation of thermal accumulation within the ablated tissue or the adjacent structures. Most MR‐guided FUS studies used a dedicated high‐field MR scanner and complete tumor ablation was reported in 17–90% of cases. Other techniques using thermal tissue destruction are radiofrequency ablation (RFA) and laser interstitial thermal therapy (LITT). Only a few studies assessed the efficacy of these treatments, all were performed with open MR devices. RFA showed complete tumor ablation in 30–96% of patients, while LITT in 10–71%, but all the studies had a small number of patients. Cryoablation obtains tissue ablation by a rapid decrease of temperature, with a complete tumor removal reported in 18–52% of cases with MR guidance. No serious complications were reported with these techniques. Currently, breast conservative surgery replaced radical surgery when possible. Therefore, future research should focus on these treatments to shift towards an even less invasive approach to breast neoplasms. Level of Evidence: 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:1479–1488

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Section: Hifu Ablationmentioning

confidence: 99%

Section: Hifu Ablationmentioning

confidence: 99%

MRI‐guided treatment in the breast

Pediconi

Marzocca

Marincola

et al. 2018

Magnetic Resonance Imaging

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“…Ultrasound imaging-guided HIFU treatment has been widely performed because it is real-time and cost-effective. 22 However, there are several issues in this approach which require more exploration, including the hyperechoic changes on both the treated target and surrounding tissue during heating, relatively low tissue contrast, and a limited field of view. 22 Many studies have also reported thermal monitoring of cancer treatment using magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

“…22 However, there are several issues in this approach which require more exploration, including the hyperechoic changes on both the treated target and surrounding tissue during heating, relatively low tissue contrast, and a limited field of view. 22 Many studies have also reported thermal monitoring of cancer treatment using magnetic resonance imaging (MRI). 14,23,24 It has shown potential application in the clinic because of its superior depiction of three-dimensional (3D) anatomic structure, high tissue contrast, and real-time thermometry during thermal ablation.…”

Section: Introductionmentioning

confidence: 99%

“…14,23,24 It has shown potential application in the clinic because of its superior depiction of three-dimensional (3D) anatomic structure, high tissue contrast, and real-time thermometry during thermal ablation. 22 However, apart from the limitation of motion artifacts and inability to monitor temperature in fat, 22,25,26 an inevitable limitation of MRI-guided thermometry is that only MRI-compatible equipment is allowed during the measurement for safety. Ferromagnetic objects, such as cardiac pacemaker and implantable cardioverter-defibrillator (ICD), are not compatible with MRI unit due to the magnetic field of MRI system.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating HIFU‐mediated local drug release using thermal strain imaging: Phantom and preliminary in‐vivo studies

Lee

Gao

et al. 2019

Medical Physics

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Purpose High‐intensity focused ultrasound (HIFU)‐mediated drug release becomes a promising therapeutic technique for treatment of cancer, which has merits of deep penetration, noninvasive approach and nonionizing radiation. However, conventional thermocouple‐based approach for treatment monitoring would encounter big challenges such as the viscous heating artifact and difficulty in monitoring in the deep region. In this study, we develop an effective method based on thermal strain imaging (TSI) for the evaluation of HIFU‐mediated drug release. Methods Both phantom experiments and preliminary animal experiments were performed to investigate the feasibility of the proposed approach. Doxorubicin (DOX)‐loaded cerasomes (HIFU and temperature‐sensitive cerasomes, HTSCs) were prepared. In the phantom experiments, the HTSC solution is contained inside a cylindrical chamber within a tissue‐mimicking phantom. In the animal experiments, the HTSCs are intravenously injected into tumor‐bearing mice. An HIFU transducer is used to trigger DOX release from the HTSCs within the phantom or mice, and TSI is performed during HIFU heating. In the phantom experiments, the accuracy of temperature estimation using TSI is validated by measuring with a thermocouple. In animal experiments, the spatial consistency between the distribution of DOX released within the tumor and the location of the heating region estimated by TSI is validated using a spectrofluorophotometer. Results In the phantom experiments, the HTSCs show a burst release of DOX when the temperature of the HTSC solution estimated by TSI reaches about 42°C, which is in agreement with the condition for drug release from the HTSCs. The temperature estimation using TSI has high accuracy with error below 2.5%. In animal experiments, fluorescence imaging of the tumor validates that the heating region of HIFU could be localized by the low‐strain region of TSI. Conclusion The present framework demonstrates a reliable and effective solution to the evaluation of HIFU‐mediated local drug delivery.

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Harnessing Nanomaterials for Cancer Sonodynamic Immunotherapy

et al. 2023

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Immunotherapy has made remarkable strides in cancer therapy over the past decade. However, such emerging therapy still suffers from the low response rates and immune‐related adverse events. Various strategies have been developed to overcome these serious challenges. Therein, sonodynamic therapy (SDT), as a non‐invasive treatment, has received ever‐increasing attention especially in the treatment of deep‐seated tumors. Significantly, SDT can effectively induce immunogenic cell death to trigger systemic anti‐tumor immune response, termed sonodynamic immunotherapy. The rapid development of nanotechnology has revolutionized SDT effects with robust immune response induction. As a result, more and more innovative nanosonosensitizers and synergistic treatment modalities are established with superior efficacy and safe profile. In this review, the recent advances in cancer sonodynamic immunotherapy are summarized with a particular emphasis on how nanotechnology can be explored to harness SDT for amplifying anti‐tumor immune response. Moreover, the current challenges in this field and the prospects for its clinical translation are also presented. It is anticipated that this review can provide rational guidance and facilitate the development of nanomaterials‐assisted sonodynamic immunotherapy, helping to pave the way for next‐generation cancer therapy and eventually achieve a durable response in patients.

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High-Intensity Focused Ultrasound: Current Status for Image-Guided Therapy

Cited by 86 publications

References 127 publications

MRI‐guided treatment in the breast

MRI‐guided treatment in the breast

Evaluating HIFU‐mediated local drug release using thermal strain imaging: Phantom and preliminary in‐vivo studies

Harnessing Nanomaterials for Cancer Sonodynamic Immunotherapy

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