MR-Guided High-Intensity Focused Ultrasound Ablation of Breast Cancer with a Dedicated Breast Platform

Abstract

Optimizing the treatment of breast cancer remains a major topic of interest. In current clinical practice, breast-conserving therapy is the standard of care for patients with localized breast cancer. Technological developments have fueled interest in less invasive breast cancer treatment. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a completely noninvasive ablation technique. Focused beams of ultrasound are used for ablation of the target lesion without disrupting the skin and subcutaneous tissues in the beam path. MRI is an excellent imaging method for tumor targeting, treatment monitoring, and evaluation of treatment results. The combination of HIFU and MR imaging offers an opportunity for image-guided ablation of breast cancer. Previous studies of MR-HIFU in breast cancer patients reported a limited efficacy, which hampered the clinical translation of this technique. These prior studies were performed without an MR-HIFU system specifically developed for breast cancer treatment. In this article, a novel and dedicated MR-HIFU breast platform is presented. This system has been designed for safe and effective MR-HIFU ablation of breast cancer. Furthermore, both clinical and technical challenges are discussed, which have to be solved before MR-HIFU ablation of breast cancer can be implemented in routine clinical practice.

Image-guided Tumor Ablation: Standardization of Terminology and Reporting Criteria—A 10-Year Update

“…Ultrasound ablation.-There are currently two methods (2,24) for the application of ultrasound energy-extracorporeal (or transcutaneous) (25) and direct (or interstitial) for percutaneous application with a needlelike SPECIAL REPORT: Tumor Ablation: Updated Standardization of Terminology and Reporting Criteria Ahmed et al cm) electrodes are used simultaneously to approximate a larger-diameter electrode (38). Many refer to these electrodes as "an array," which may not adequately reflect the true underlying mechanism for enhanced energy deposition and ablation.…”

Advances in MR image-guided high-intensity focused ultrasound therapy

“…However, the chest wall, the lung and the heart may be at risk, especially if the tumour is deeply located [47,48]. To minimise this risk, a MR-HIFU system with a breastdedicated platform (Philips Healthcare) has adopted the strategy of lateral sonications by using a recently developed cup-shaped transducer design [49].…”

Tumour localisation in ultrasound‐guided high‐intensity focused ultrasound ablation using improved gradient and direction vector flow

“…Actually, a fold line can be regarded as a combination of several straight lines. Therefore for a fold line, we can use (7) to compute the vector field W( x, y).…”