MRI-Guided HIFU Methods for the Ablation of Liver and Renal Cancers

Abstract

MRI-guided High Intensity Focused Ultrasound (MRI-HIFU) is a promising method for the non-invasive ablation of pathological tissue in many organs, including mobile organs such as liver and kidney. The possibility to locally deposit thermal energy in a non-invasive way opens a path towards new therapeutic strategies with improved reliability and reduced associated trauma, leading to improved efficacy, reduced hospitalization and costs. Liver and kidney tumors represent a major health problem because not all patients are suitable for curative treatment with surgery. Currently, radio-frequency is the most used method for percutaneous ablation. The development of a completely non-invasive method based on MR guided high intensity focused ultrasound (HIFU) treatments is of particular interest due to the associated reduced burden for the patient, treatment related patient morbidity and complication rate. The objective of MR-guidance is hereby to control heat deposition with HIFU within the targeted pathological area, despite the physiological motion of these organs, in order to provide an effective treatment with a reduced duration and an increased level of patient safety. Regarding this, several technological challenges have to be addressed: Firstly, the anatomical location of both organs within the thoracic cage requires inter-costal ablation strategies, which preserve the therapeutic efficiency, but prevent undesired tissue damage to the ribs and the intercostal muscle. Secondly, both therapy guidance and energy deposition have to be rendered compatible with the continuous physiological motion of the abdomen.

Efficacy and safety of US-guided thermal ablation for primary hyperparathyroidism: a systematic review and meta-analysis

“…It has been proved to be safe and effective for the treatment of liver cancer, renal cancer and thyroid nodules, and has become an alternative of surgery in these fields [16][17][18]. Up to now, there has been several options of thermal ablation such as microwave ablation (MWA), radiofrequency ablation (RFA), laser ablation (LA), and high-intensity focused ultrasound (HIFU) [16,[19][20][21][22]. Compared to surgical treatment, local ablation remains to be a relatively simple procedure, easily tolerant for patients, with fewer complications, a shorter hospitalization and convalescence period [23].…”

Simultaneous MR thermometry and acoustic radiation force imaging using interleaved acquisition

“…MR‐guided focused ultrasound (MRgFUS) is a noninvasive therapeutic modality that shows great promise for treating diseases such as cancer of the breast, brain, and liver , as well as movement disorders such as essential tremor . The ability of MRI to measure temperature change in real time using the proton resonance frequency (PRF) shift method enables precise treatment monitoring and thermal dose determination for ablation and hyperthermia applications.…”

Increased Tissue Penetration of Doxorubicin in Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) after High-Intensity Ultrasound (HIUS)

“…Besides its effects described here, it has additional antitumor effects including ablation and mechanical disruption of cancer tissue [28,29]. HIUS has already been shown to be useful in the treatment of uterine fibroids [30], various solid tumors of pancreas, liver, renal system, and prostate, and breast cancer [31][32][33][34]. So far, there have been no or few studies for potential use in peritoneal metastases (PM).…”