Mechanical High-Intensity Focused Ultrasound Destruction of Soft Tissue: Working Mechanisms and Physiologic Effects

Hoogenboom, Martijn; Eikelenboom, Dylan; Brok, Martijn H. den; Heerschap, Arend; Fütterer, Jurgen J.; Adema, Gosse J.

doi:10.1016/j.ultrasmedbio.2015.02.006

Cited by 115 publications

(73 citation statements)

References 92 publications

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“…g, h Fractionated tissue with bleeding and formation of a cavity filled with erythrocytes were not found, possibly because only transient damage was created while the tumor was removed after 3 days. Further, increasing the acoustical output power might be a solution for a more complete mechanical destruction of the tissue, as is shown in boiling histotripsy ablation methods [6,14]. In future studies, a longer follow-up after treatment is of interest to evaluate further tumor responses after the different ablation techniques.…”

Section: Discussionmentioning

confidence: 99%

“…The thermal effect is the consequence of absorption of ultrasound energy by the tissue and conversion into heat, inducing irreversible damage and local coagulative necrosis [4,5]. The mechanical effect is created by the mechanical force and shock wave effect of the ultrasound wave which could result in acoustic cavitations [6]. With a low duty cycle, the local temperature rise remains limited due to thermal diffusion.…”

Section: Introductionmentioning

confidence: 99%

“…While thermal HIFU ablation is already clinically used for more than a decade, mechanical HIFU ablation techniques are still in an early stage of development [6,17]. Whether thermal or mechanical HIFU is the best possible way to treat tumors is not known.…”

Section: Introductionmentioning

confidence: 99%

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Development of a high-field MR-guided HIFU setup for thermal and mechanical ablation methods in small animals

et al. 2015

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BackgroundThermal and mechanical high intensity focused ultrasound (HIFU) ablation techniques are in development for non-invasive treatment of cancer. However, knowledge of in vivo histopathologic and immunologic reactions after HIFU ablation is still limited. This study aims to create a setup for evaluation of different HIFU ablation methods in mouse tumors using high-field magnetic resonance (MR) guidance. An optimized MR-guided-HIFU setup could be used to increase knowledge of the different pathologic and immunologic reactions to different HIFU ablation methods.MethodsThree different HIFU treatment strategies were applied in mouse melanomas (B16): a thermal (continuous wave), a mechanical (5 ms pulsed wave), and an intermediate setting (20 ms pulsed wave) for HIFU ablation, all under MR guidance using a 7 tesla animal MR system. Histopathologic evaluation was performed 3 days after treatment.ResultsThe focus of the ultrasound transducer could accurately be positioned within the tumor under MR image guidance, without substantial damage to the surrounding tissue and skin. All mice retained complete use of the treated leg after treatment. Temperatures of >60, <50, and <44 °C were reached during thermal, intermediate, and mechanical HIFU ablation, respectively. Thermal-treated tumors showed large regions of coagulative necrosis. Tumors of both the mechanical and intermediate groups showed fractionated tissue with islands of necrosis and some pseudocysts with hemorrhage.ConclusionA stable small animal MR-guided HIFU setup was designed and evaluated for follow-up MR imaging and histopathologic responses of the treated tumors. This will facilitate further studies with a larger number of mice for detailed evaluation of the pathologic and immunologic response to different HIFU strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development of a high-field MR-guided HIFU setup for thermal and mechanical ablation methods in small animals

et al. 2015

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“…The major effect is an extreme temperature rise (greater than 80°C) due to the absorption of the ultrasound energy [7,41]. This increment results in a complete and irreversible cell death through coagulative necrosis in the focal region, minimizing the possibility of thermal damages to the tissues outside the irradiated region [1].…”

Section: High Intensity Focused Ultrasoundmentioning

confidence: 99%

Nanoparticle-assisted ultrasound: A special focus on sonodynamic therapy against cancer

Canavese

Ancona

Racca

et al. 2018

Chemical Engineering Journal

327

247

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• Ultrasound-based therapies are opening new horizons in the oncological field.• Innovative and promising solutions derive from different nanoparticles-assisted ultrasound treatments.• Sonodynamic therapy (SDT) emerged recently as a novel approach for cancer treatment.• Different and complex cell death mechanisms are involved in nanoparticles-assisted SDT.• Nanoparticles-assisted ultrasound is still at its infancy in clinics. A R T I C L E I N F O Keywords:Inertial cavitation Reactive oxygen species Sonoluminescence Sonodynamic Tumor Therapy Cytotoxicity A B S T R A C TAt present, ultrasound radiation is broadly employed in medicine for both diagnostic and therapeutic purposes at various frequencies and intensities. In this review article, we focus on therapeutically-active nanoparticles (NPs) when stimulated by ultrasound. We first introduce the different ultrasound-based therapies with special attention to the techniques involved in the oncological field, then we summarize the different NPs used, ranging from soft materials, like liposomes or micro/nano-bubbles, to metal and metal oxide NPs. We therefore focus on the sonodynamic therapy and on the possible working mechanisms under debate of NPs-assisted sonodynamic treatments. We support the idea that various, complex and synergistics physical-chemical processes take place during acoustic cavitation and NP activation. Different mechanisms are therefore responsible for the final cancer cell death and strongly depends not only on the type and structure of NPs or nanocarriers, but also on the way they interact with the ultrasonic pressure waves. We conclude with a brief overview of the clinical applications of the various ultrasound therapies and the related use of NPs-assisted ultrasound in clinics, showing that this very innovative and promising approach is however still at its infancy in the clinical cancer treatment.

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“…The advantages of mechanical ablation are that thermal protein denaturation remains limited, and less damage is created to the surrounding tissue by thermal diffusion. 107 During HIFU applications, tissue necrosis may be obtained by heating, or the tissue can be emulsified by cavitation; as recently reported, the tissue can also be emulsified by using repetitive millisecond boiling (caused by shock wave heating). 108 During treatment, ultrasound reflections from distal media interfaces can shift prescribed treatment locations.…”

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confidence: 99%

MRI-guided focused ultrasound surgery in musculoskeletal diseases: the hot topics

Bazzocchi¹,

Napoli²,

Sacconi³

et al. 2016

BJR

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MRI-guided focused ultrasound surgery (MRgFUS) is a minimally invasive treatment guided by the most sophisticated imaging tool available in today's clinical practice. Both the imaging and therapeutic sides of the equipment are based on non-ionizing energy. This technique is a very promising option as potential treatment for several pathologies, including musculoskeletal (MSK) disorders. Apart from clinical applications, MRgFUS technology is the result of long, heavy and cumulative efforts exploring the effects of ultrasound on biological tissues and function, the generation of focused ultrasound and treatment monitoring by MRI. The aim of this article is to give an updated overview on a "new" interventional technique and on its applications for MSK and allied sciences

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Mechanical High-Intensity Focused Ultrasound Destruction of Soft Tissue: Working Mechanisms and Physiologic Effects

Cited by 115 publications

References 92 publications

Development of a high-field MR-guided HIFU setup for thermal and mechanical ablation methods in small animals

Development of a high-field MR-guided HIFU setup for thermal and mechanical ablation methods in small animals

Nanoparticle-assisted ultrasound: A special focus on sonodynamic therapy against cancer

MRI-guided focused ultrasound surgery in musculoskeletal diseases: the hot topics

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