High Intensity Focused Ultrasound Technology, its Scope and Applications in Therapy and Drug Delivery

Phenix, Christopher P.; Togtema, Melissa; Pichardo, Samuel; Zehbe, Ingeborg; Curiel, Laura

doi:10.18433/j3zp5f

Cited by 123 publications

(95 citation statements)

References 177 publications

(171 reference statements)

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“…59 The power output of HIFU is typically on the order of 10 2 -10 4 W/cm 2 , and several technological advances have enabled safe and efficient delivery of this power. Hemispheric, large-aperture, multielement phased-array transducers minimize focal skull attenuation by spreading acoustic energy across a wide region of the calvaria.…”

Section: Technology and Techniquesmentioning

confidence: 99%

Magnetic resonance–guided, high-intensity focused ultrasound sonolysis: potential applications for stroke

Ilyas

Chen

Ding

et al. 2018

Neurosurgical Focus

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Stroke is one of the leading causes of death worldwide and a significant source of long-term morbidity. Unfortunately, a substantial number of stroke patients either are ineligible or do not significantly benefit from contemporary medical and interventional therapies. To address this void, investigators recently made technological advances to render transcranial MR-guided, high-intensity focused ultrasound (MRg-HIFU) sonolysis a potential therapeutic option for both acute ischemic stroke (AIS)—as an alternative for patients with emergent large-vessel occlusion (ELVO) who are ineligible for endovascular mechanical thrombectomy (EMT) or as salvage therapy for patients in whom EMT fails—and intracerebral hemorrhage (ICH)—as a neoadjuvant means of clot lysis prior to surgical evacuation. Herein, the authors review the technological principles behind MRg-HIFU sonolysis, its results in in vitro and in vivo stroke models, and its potential clinical applications. As a noninvasive transcranial technique that affords rapid clot lysis, MRg-HIFU thrombolysis may develop into a therapeutic option for patients with AIS or ICH. However, additional studies of transcranial MRg-HIFU are necessary to ascertain the merit of this treatment approach for thrombolysis in both AIS and ICH, as well as its technical limitations and risks.

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Section: Technology and Techniquesmentioning

confidence: 99%

Magnetic resonance–guided, high-intensity focused ultrasound sonolysis: potential applications for stroke

Ilyas

Chen

Ding

et al. 2018

Neurosurgical Focus

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“…The basic idea is to focus ultrasound waves from multiple sources on one point in the body thus transferring very high energy to the target region. Systems with several hundred elements that have a slightly lower frequency (approximately 1 MHz) compared to diagnostic ultrasound but achieve a significantly higher average intensity (up to 10 000 W/cm 2 ) in the target volume are typically used [50]. Maximum penetration depths of up to 15 cm can be achieved with currently available systems.…”

Section: Mr-guided Focused Ultrasoundmentioning

confidence: 99%

“…A further approach is the use of HIFU effects for the local application of medications [50]. For example, thermosensitive liposomes that release the medication contained in the liposomes in the target region in the case of mild hyperthermia without thermal damage to the tissue can be used for this purpose.…”

Section: Mr-guided Focused Ultrasoundmentioning

confidence: 99%

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 2: Liver and Other Applications in Oncology

Barkhausen

Kahn

Krombach

et al. 2017

Fortschr Röntgenstr

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Background MRI is attractive for guiding and monitoring interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure flow and cardiac function. Methods Technical solutions have been developed for all procedural steps including imaging guidance, MR-safe catheters and instruments and patient monitoring. This has led to widening of the clinical applications. Interventional MRI is becoming increasingly important for the treatment of patients suffering from malignant diseases. The detectability of masses and consequently their accessibility for biopsy is higher, compared to other modalities, due to the high intrinsic soft tissue contrast of MRI. Temperature-dependent sequences allow for minimally invasive and tissue-sparing ablation (A-0 ablation). Conclusion Interventional MRI has become established in the clinical routine for a variety of indications, including biopsies and tumor ablation. Since the economic requirement of covering costs by reimbursement is met and interventional MRI decreases the mortality and morbidity of interventional procedures, broader application of interventional MRI can be expected in the clinical routine in the future. Key points Citation Format

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“…Several good reviews on the use of HIFU in nanoparticle drug delivery have been published [27, 103–105]. Ultrasound technology can impart both thermal and mechanical effects to improve liposome drug delivery.…”

Section: Current Strategiesmentioning

confidence: 99%

Strategies for improving the intratumoral distribution of liposomal drugs in cancer therapy

Goins

Phillips

Bao

2016

Expert Opinion on Drug Delivery

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Introduction A major limitation of current liposomal cancer therapies is the inability of liposome therapeutics to penetrate throughout the entire tumor mass. This inhomogeneous distribution of liposome therapeutics within the tumor has been linked to treatment failure and drug resistance. Both liposome particle transport properties and tumor microenvironment characteristics contribute to this challenge in cancer therapy. This limitation is relevant to both intravenously and intratumorally administered liposome therapeutics. Areas covered Strategies to improve the intratumoral distribution of liposome therapeutics are described. Combination therapies of intravenous liposome therapeutics with pharmacologic agents modulating abnormal tumor vasculature, interstitial fluid pressure, extracellular matrix components, and tumor associated macrophages are discussed. Combination therapies using external stimuli (hyperthermia, radiofrequency ablation, magnetic field, radiation, and ultrasound) with intravenous liposome therapeutics are discussed. Intratumoral convection-enhanced delivery (CED) of liposomal therapeutics is reviewed. Expert opinion Optimization of the combination therapies and drug delivery protocols are necessary. Further research should be conducted in appropriate cancer types with consideration of physiochemical features of liposomes and their timing sequence. More investigation of the role of tumor associated macrophages in intratumoral distribution is warranted. Intratumoral infusion of liposomes using CED is a promising approach to improve their distribution within the tumor mass.

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High Intensity Focused Ultrasound Technology, its Scope and Applications in Therapy and Drug Delivery

Cited by 123 publications

References 177 publications

Magnetic resonance–guided, high-intensity focused ultrasound sonolysis: potential applications for stroke

Magnetic resonance–guided, high-intensity focused ultrasound sonolysis: potential applications for stroke

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 2: Liver and Other Applications in Oncology

Strategies for improving the intratumoral distribution of liposomal drugs in cancer therapy

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