Toric HIFU Transducer for Large Thermal Ablation

Melodelima, David; N’Djin, W. Apoutou; Preissl, Hubert; Rivoire, Michel; Chapelon, J. Y.

doi:10.1109/iembs.2007.4352265

Cited by 3 publications

(3 citation statements)

References 14 publications

(9 reference statements)

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“…49 The second technique involves the impact on the focus with a volumetric plan. 50 The limitation of the use of HIFU therapy is the impossibility of its use in situations where structures containing gas lie in the path of ultrasound. In such situations, there is a risk of thermal damage to the intestinal wall or anterior abdominal wall.…”

Section: Hifu Therapymentioning

confidence: 99%

Management of Patients with Synchronous Liver Colorectal Cancer Metastasis

Sidorova¹,

Мелехина

Bashankaev

2023

Digestive Disease Interventions

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Half of patients with colorectal cancer face liver metastasis. Tactically different approaches to the treatment of hepatic metastases, including using minimally invasive surgical techniques, have proven their effectiveness in improving oncological results. The correct choice of surgical treatment method depending on the number, localization, size of metastases, and their response to chemotherapy plays a crucial role in the further risks of disease progression. Liver resection is the standard of surgical treatment. If for some reason it is impossible to perform it, then the choice of the method of surgical treatment is performed among various methods of ablation and radiation therapy. The possibilities of intra-arterial chemotherapy, chemoembolization, and radioembolization are realized with chemoresistance and unresectability of foci for all types of surgery.

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Section: Hifu Therapymentioning

confidence: 99%

Management of Patients with Synchronous Liver Colorectal Cancer Metastasis

Sidorova¹,

Мелехина

Bashankaev

2023

Digestive Disease Interventions

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“…204 Another possibility is to use transducers designed specifically to ablate larger volumes. Melodelima et al report an eight-element toric transducer that can create a 19.5 mm diameter lesion in as little as 40 s. 223 While large volume sonication remains a challenge in current clinical systems, there are few technical hurdles that would prevent larger sonication volumes from being included. This should help to reduce the overall time of treatment.…”

Section: B Volumetric Sonicationmentioning

confidence: 99%

MR-guided focused ultrasound surgery, present and future

et al. 2013

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MR-guided focused ultrasound surgery (MRgFUS) is a quickly developing technology with potential applications across a spectrum of indications traditionally within the domain of radiation oncology. Especially for applications where focal treatment is the preferred technique (for example, radiosurgery), MRgFUS has the potential to be a disruptive technology that could shift traditional patterns of care. While currently cleared in the United States for the noninvasive treatment of uterine fibroids and bone metastases, a wide range of clinical trials are currently underway, and the number of publications describing advances in MRgFUS is increasing. However, for MRgFUS to make the transition from a research curiosity to a clinical standard of care, a variety of challenges, technical, financial, clinical, and practical, must be overcome. This installment of the Vision 20∕20 series examines the current status of MRgFUS, focusing on the hurdles the technology faces before it can cross over from a research technique to a standard fixture in the clinic. It then reviews current and near-term technical developments which may overcome these hurdles and allow MRgFUS to break through into clinical practice.

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“…We previously developed a toroidal HIFU transducer that enables the destruction of large volumes of tissue over short periods of time [ 20 ]. This work led to the development of a prototype that has been tested in vitro and in preclinical studies.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of high-intensity focused ultrasound-assisted hepatic resection (HIFU-AR) on blood loss reduction in patients with liver metastases requiring hepatectomy: study protocol for a randomized controlled trial

Dupré

Pérol

Blanc

et al. 2017

Trials

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BackgroundLiver resection is the only potentially curative treatment for colorectal liver metastases (LM). It is considered a safe procedure, but is often associated with blood loss during liver transection. Blood transfusions are frequently needed, but they are associated with increased morbidity and risk of recurrence. Many surgical devices have been developed to decrease blood loss. However, none of them has proven superior to the standard crushing technique. We developed a new, powerful intra-operative high-intensity focused ultrasound (HIFU) transducer which destroys tissue by coagulative necrosis. We aim to evaluate whether HIFU-assisted liver resection (HIFU-AR) results in reduced blood loss.MethodsThis is a prospective, single-centre, randomized (1:1 ratio), comparative, open-label phase II study. Patients with LM requiring a hepatectomy for ≥ 2 segments will be included. Patients with cirrhosis or sinusoidal obstruction syndrome with portal hypertension will be excluded. The primary endpoint is normalized blood loss in millilitres per square centimetre of liver section plane. Secondary endpoints are: total blood loss, transection time, transection time per square centimetre of liver area, haemostasis time, clip density on the liver section area, rate and duration of the Pringle manœuvre, rate of patients needing a blood transfusion, length of hospital stay, morbidity, patients with positive resection margin, and local recurrence. Assuming a blood loss of 7.6 ± 3.7 mL/cm2 among controls, the study will have 85% power to detect a twofold decrease of blood loss in the experimental arm, using a Wilcoxon (Mann-Whitney) rank-sum test with a 0.05 two-sided significance level. Twenty-one randomized patients per arm are required. Considering the risk of contraindications at surgery, up to eight patients may be enrolled in addition to the 42 planned, with an enrolment period of 24 months. Randomization will be stratified by surgeon.DiscussionWe previously demonstrated the safety and efficacy of intra-operative HIFU in patients operated on for LM. We also demonstrated the efficacy of HIFU-AR in a preclinical study. Participants in the HIFU-AR group of this randomized trial can expect to benefit from reduced blood loss and decreased ischemia of liver parenchyma.Trial registrationClinicaltrial.gov, NCT02728167. Registered on 22 March 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1801-2) contains supplementary material, which is available to authorized users.

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Toric HIFU Transducer for Large Thermal Ablation

Cited by 3 publications

References 14 publications

Management of Patients with Synchronous Liver Colorectal Cancer Metastasis

Management of Patients with Synchronous Liver Colorectal Cancer Metastasis

MR-guided focused ultrasound surgery, present and future

Efficacy of high-intensity focused ultrasound-assisted hepatic resection (HIFU-AR) on blood loss reduction in patients with liver metastases requiring hepatectomy: study protocol for a randomized controlled trial

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