Liver hemostasis using high-intensity focused ultrasound

Vaezy, Shahram; Martin, Roy W.; Schmiedl, Udo P.; Caps, Michael; Taylor, Scott L.; Beach, Kirk W.; Carter, Steve; Kaczkowski, Peter J.; Keilman, George; Helton, Scott; Chandler, Wayne L.; Mourad, Pierre D.; Rice, Matthew; Roy, Ronald A.; Crum, Lawrence A.

doi:10.1016/s0301-5629(97)00143-9

Cited by 135 publications

(73 citation statements)

References 29 publications

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“…The delivery of an accurate thermal dose is essential for the success of ablative thermal therapies such as high intensity focused ultrasound (HIFU) (Vaezy et al 1997;Sanghvi et al 1999;ter Haar 2001;Wu et al 2002) and radio-frequency ablation (Mahnken et al 2004;Frericks et al 2005;Nour and Lewin 2005) in the clinic. The thermal parameters at the ablation site, namely, thermal diffusivity and perfusion loss, play important roles in the final therapeutic outcome as they influence the evolution of temperature distributions in space and time achieved in the tissue.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Measurement of Local Thermal Diffusivity Using Backscattered Ultrasound and Focused Ultrasound Heating

Anand

Kaczkowski

2008

Ultrasound in Medicine & Biology

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Previously, noninvasive methods of estimating local tissue thermal and acoustic properties using backscattered ultrasound have been proposed in the literature. In this article, a noninvasive method of estimating local thermal diffusivity in situ during focused ultrasound heating using beamformed acoustic backscatter data and applying novel signal processing techniques is developed. A high intensity focused ultrasound (HIFU) transducer operating at subablative intensities is employed to create a brief local temperature rise of no more than 10°C. Beamformed radio-frequency (RF) data are collected during heating and cooling using a clinical ultrasound scanner. Measurements of the time-varying "acoustic strain", that is, spatiotemporal variations in the RF echo shifts induced by the temperature related sound speed changes, are related to a solution of the heat transfer equation to estimate the thermal diffusivity in the heated zone. Numerical simulations and experiments performed in vitro in tissue mimicking phantoms and excised turkey breast muscle tissue demonstrate agreement between the ultrasound derived thermal diffusivity estimates and independent estimates made by a traditional hot-wire technique. The new noninvasive ultrasonic method has potential applications in thermal therapy planning and monitoring, physiological monitoring and as a means of noninvasive tissue characterization.

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Section: Introductionmentioning

confidence: 99%

Noninvasive Measurement of Local Thermal Diffusivity Using Backscattered Ultrasound and Focused Ultrasound Heating

Anand

Kaczkowski

2008

Ultrasound in Medicine & Biology

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“…[7][8][9] In consideration of the role of vascular occlusion by HIFU, many studies demonstrated that HIFU could stop the bleeding from injuries of different organs. [10][11][12][13][14][15][16][17][18][19][20] Spleen haemostasis is one of the clinical issues we often face. HIFU is effective in achieving haemostasis in haemorrhagic spleen models of pigs and rabbits, 3,4 and no major adverse effects were observed.…”

Section: Discussionmentioning

confidence: 99%

High-intensity focused ultrasound ablation: an effective and safe treatment for secondary hypersplenism

Zhu¹,

Mei²,

L³

et al. 2014

BJR

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Objective: Hypersplenism is a common disease. The conventional treatment is splenectomy and partial splenic embolization; however, both of them have high complication rates and technical defects. Therefore, safer and more effective techniques should be considered for the treatment of hypersplenism. High-intensity focused ultrasound (HIFU) may provide an effective and safe way for treatment of hypersplenism. Therefore, we conducted this study to assess the safety and efficacy of HIFU in treatment of secondary hypersplenism. Methods: A total of 28 patients who suffered from secondary hypersplenism were treated with HIFU ablation. All patients who underwent HIFU were closely followedup over a year. MRI scan was performed, and the spleens were observed. Blood counts and liver function tests were also carried out.Results: In the follow-up process, the levels of white blood cells and platelets in the blood after HIFU were significantly higher than those before HIFU, liver function also improved after HIFU treatment. In addition, the symptoms were ameliorated significantly or even disappeared. The MRI showed that the ablation area had turned into a non-perfused volume, and after 12 months of HIFU ablation, the ablated area shrank evidently; the sunken spleen formed a lobulated shape and the splenic volume decreased. Conclusion: HIFU ablation is a safe, effective and noninvasive approach for secondary hypersplenism. Advances in knowledge: For the first time we used HIFU ablation to treat secondary hypersplenism. It not only expands indications of HIFU but also provides better choice for the treatment of secondary hypersplenism.Hypersplenism is a common manifestation in cirrhotic patients with portal hypertension. Liangpunsakul et al 1 reported that 70-80% of cirrhotic patients with portal hypertension have different degrees of splenomegaly and hypersplenism. Hypersplenism is a clinical syndrome characterized by splenomegaly, a variable combination of anaemia, leucopenia and/or thrombocytopaenia, compensatory bone marrow hyperplasia, reduced immunity and improvement after splenectomy. 1 The conventional treatment for patients with hypersplenism is splenectomy. However, after the first report of overwhelming post-splenectomy infection, clinical practitioners started realizing the important immunological function of the spleen. What is more, splenectomy is associated with increased risk of splenic vein thrombosis, secondary thrombocythemia and infection, particularly with encapsulated micro-organisms. 2 Several studies have shown that the spleen is an organ with a variety of important functions such as anti-infection and antitumour immunity. Therefore, it is important to retain the splenic function as much as possible when using splenomegaly treatment. Recently, partial splenic embolization (PSE) has been used in the treatment of splenomegaly and hypersplenism, but it has high incidence of complications. Local ablation therapies, such as radiofrequency ablation (RFA) and microwave ablation, also have marked improvement for...

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“…4,16,17 HIFU treatment also has been shown to stimulate patient immunity against tumors and inhibit the growth of remaining tumors, [18][19][20] which reduce the metastatic ability of tumors. In this study, all patients had late stage malignant tumors, and the original tumors were removed by conventional surgery, chemotherapy or radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

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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Liver hemostasis using high-intensity focused ultrasound

Cited by 135 publications

References 29 publications

Noninvasive Measurement of Local Thermal Diffusivity Using Backscattered Ultrasound and Focused Ultrasound Heating

Noninvasive Measurement of Local Thermal Diffusivity Using Backscattered Ultrasound and Focused Ultrasound Heating

High-intensity focused ultrasound ablation: an effective and safe treatment for secondary hypersplenism

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

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