Preclinical in vivo Evaluation of an Extracorporeal HIFU Device for Ablation of Pancreatic Tumors

Hwang, Joo Ha; Wang, Yak Nam; Warren, C. Gerald; Upton, Melissa P.; Starr, Frank; Zhou, Yufeng; Mitchell, Stuart B.

doi:10.1016/j.ultrasmedbio.2008.12.006

Cited by 60 publications

(52 citation statements)

References 4 publications

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“…Animal studies All the preclinical in vivo studies of HIFU ablation of the pancreas utilized the swine model because of its size and anatomy relevance to humans (46)(47)(48). The animals were not bearing tumors in the pancreas, therefore, it was not possible to evaluate survival benefits of HIFU therapy; however, the main goal of these studies was to systematically evaluate the safet y and eff icacy of HIFU ablation of the pancreas.…”

Section: Hifu Of Pancreatic Tumorsmentioning

confidence: 99%

“…The animals were not bearing tumors in the pancreas, therefore, it was not possible to evaluate survival benefits of HIFU therapy; however, the main goal of these studies was to systematically evaluate the safet y and eff icacy of HIFU ablation of the pancreas. In the earliest study the pancreata of 12 common swine were successfully treated in vivo using the FEP-BY02 dev ice, w ithout any significant adverse effects such as sk in burns or evidence for pancreatitis during the 7-day post-treatment observation period (46). A subsequent study by another g roup ut i l izi ng t he H A I F U dev ice used bot h l ig ht microscopy and electron microscopy to confirm that complete necrosis is confined to the target regions with clear boundaries and no damage to adjacent tissues (47).…”

Section: Hifu Of Pancreatic Tumorsmentioning

confidence: 99%

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HIFU for Palliative Treatment of Pancreatic Cancer

Khokhlova

Hwang

2016

Advances in Experimental Medicine and Biology

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KEY WORDSHigh intensity focused ultrasound (HIFU) is a novel non-invasive modality for ablation of various solid tumors including uterine fibroids, prostate cancer, hepatic, renal, breast and pancreatic tumors. HIFU therapy utilizes mechanical energy in the form of a powerful ultrasound wave that is focused inside the body to induce thermal and/or mechanical effects in tissue. Multiple preclinical and non-randomized clinical trials have been performed to evaluate the safety and efficacy of HIFU for palliative treatment of pancreatic tumors. Substantial tumor-related pain reduction was achieved in most cases after HIFU treatment, and no significant side-effects were observed. This review provides a description of different physical mechanisms underlying HIFU therapy, summarizes the clinical experience obtained to date in HIFU treatment of pancreatic tumors, and discusses the challenges, limitations and new approaches in this modality. therapeutic ultrasound; focused ultrasound; HIFU; pancreas cancer; review J Gastrointest Oncol 2011; 2: 175-184.

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Section: Hifu Of Pancreatic Tumorsmentioning

confidence: 99%

Section: Hifu Of Pancreatic Tumorsmentioning

confidence: 99%

HIFU for Palliative Treatment of Pancreatic Cancer

Khokhlova

Hwang

2016

Advances in Experimental Medicine and Biology

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“…A preclinical in vivo study of HIFU ablation of the pancreas in swine resulted in effective ablation of the pancreas without any significant adverse effects such as skin burns or evidence of pancreatitis on biochemical analysis suggesting that HIFU treatment for pancreatic cancer may be feasible and safe. 13 HIFU treatment is non-invasive with ultrasound energy delivered from an extracorporeal source (Fig. 1).…”

Section: Hifu Of Pancreatic Tumorsmentioning

confidence: 99%

“…There have been several case series reporting on the use of HIFU to treat patients with pancreatic cancer (Table 1). 5,6,[13][14][15][16][17][18][19] These reports, all from China, investigated the use of HIFU as monotherapy or as combination therapy with chemotherapy. In general, these reports suggest that HIFU is an effective therapy for palliation of pain related to pancreatic cancer.…”

Section: Hifu Of Pancreatic Tumorsmentioning

confidence: 99%

“…It is important to account for attenuation of the acoustic energy between the transducer and the target by the intervening tissue (primarily abdominal wall and viscera) when determining the amount of energy delivered to the tumor. 13 Lastly, respiratory movement of the tumor during the treatment must be considered and minimized. Respiratory motion tracking techniques to achieve more safe and effective therapy are currently in development.…”

Section: Enhancement Of Treatment Efficacymentioning

confidence: 99%

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Current and Future Clinical Applications of High-Intensity Focused Ultrasound (HIFU) for Pancreatic Cancer

Jang¹,

Lee²,

Lee³

et al. 2010

Gut Liver

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High-intensity focused ultrasound (HIFU) is a novel therapeutic modality that permits noninvasive treatment of various benign and malignant solid tumors, including prostatic cancer, uterine fibroids, hepatic tumors, renal tumors, breast cancers, and pancreatic cancers. Several preclinical and clinical studies have investigated the safety and efficacy of HIFU for treating solid tumors, including pancreatic cancer. The results of nonrandomized studies of HIFU therapy in patients with pancreatic cancer have suggested that HIFU treatment can effectively alleviate cancer-related pain without any significant complications. This noninvasive method of delivering ultrasound energy into the body has recently been evolving from a method for purely thermal ablation to harnessing the mechanical effects of HIFU to induce a systemic immune response and to enhance targeted drug delivery. This review provides a brief overview of HIFU, describes current clinical applications of HIFU for pancreatic cancer, and discusses future applications and challenges. (Gut Liver 2010;4(Suppl. 1):S57-61)

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Characterization and Ex Vivo evaluation of an extracorporeal high‐intensity focused ultrasound (HIFU) system

Zhou¹,

Cunitz

Dunmire

et al. 2021

J Applied Clin Med Phys

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Background: High-intensity focused ultrasound (HIFU) has been in clinical use for a variety of solid tumors and cancers. Accurate and reliable calibration is in a great need for clinical applications. An extracorporeal clinical HIFU system applied for the investigational device exemption (IDE) to the Food and Drug Administration (FDA) so that evaluation of its characteristics, performance, and safety was required.Methods: The acoustic pressure and power output was characterized by a fiber optic probe and a radiation force balance, respectively, with the electrical power up to 2000 W. An in situ acoustic energy was established as the clinical protocol at the electrical power up to 500 W. Temperature elevation inside the tissue sample was measured by a thermocouple array. Generated lesion volume at different in situ acoustic energies and pathological examination of the lesions was evaluated ex vivo.Results: Acoustic pressure mapping showed the insignificant presence of side/grating lobes and pre-or post-focal peaks (≤−12 dB). Although distorted acoustic pressure waveform was found in the free field, the nonlinearity was reduced significantly after the beam propagating through tissue samples (i.e., the second harmonic of −11.8 dB at 500 W). Temperature elevation was <10°C at a distance of 10 mm away from a 20-mm target, which suggests the well-controlled HIFU energy deposition and no damage to the surrounding tissue. An acoustic energy in the range of 750-1250 J resulted in discrete lesions with an interval space of 5 mm between the treatment spots. Histology confirmed that the lesions represented a region of permanently damaged cells by heat fixation, without causing cell lysis by either cavitation or boiling.Conclusions: Our characterization and ex vivo evaluation protocol met the IDE requirement. The in-situ acoustic energy model will be used in clinical trials to deliver almost consistent energy to the various targets.

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Preclinical in vivo Evaluation of an Extracorporeal HIFU Device for Ablation of Pancreatic Tumors

Cited by 60 publications

References 4 publications

HIFU for Palliative Treatment of Pancreatic Cancer

HIFU for Palliative Treatment of Pancreatic Cancer

Current and Future Clinical Applications of High-Intensity Focused Ultrasound (HIFU) for Pancreatic Cancer

Characterization and Ex Vivo evaluation of an extracorporeal high‐intensity focused ultrasound (HIFU) system

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