Ultrasound surgery with a toric transducer allows the treatment of large volumes over short periods of time

Melodelima, David; N’Djin, W. Apoutou; Preissl, Hubert; Sabrina, Chesnais; Rivoire, Michel; Chapelon, Jean‐Yves

doi:10.1063/1.2805113

Cited by 41 publications

(39 citation statements)

References 19 publications

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“…Regarding HIFU precoagulation duration, the toroid geometry of the probe was optimized to induce a large coagulation volume (volume: 7.0 ± 2.5 cm 3 ) in only 40 s. 27 The results of this study indicated that this procedure could be used in human patients for whom precoagulation may offer better control of blood loss, for example, for patients with postchemotherapy fragile liver. 28 Patients undergoing iterative hepatic resection might also benefit from HIFU precoagulation: In these cases, segmental and nonanatomical resections to spare liver parenchyma can be mandatory.…”

Section: Discussionmentioning

confidence: 99%

High-Intensity Focused Ultrasound (HIFU)-Assisted Hepatic Resection in an Animal Model

et al. 2011

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Background. Bleeding is the main cause of postoperative complications of hepatic surgery. To minimize intraoperative bleeding during hepatectomy, resections are generally carried out under hepatic vascular control despite the risk of liver dysfunction in patients with chronic liver disease. This study evaluates the feasibility and safety of highintensity focused ultrasound (HIFU)-assisted hepatic resection during an open procedure in an animal model. Methods. Three groups of 12-14-week-old Landrace pigs (n = 7/group) were used to evaluate HIFU-assisted liver resection (group A) vs liver resection with or without portal triad clamping (groups B and C). In each pig, liver resection was performed on the right and left paramedian lobes. The following were evaluated and compared in the 3 groups: total blood loss, blood loss/cm 2 of resection area, clip density, procedure duration, morbidity, and mortality.

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Section: Discussionmentioning

confidence: 99%

High-Intensity Focused Ultrasound (HIFU)-Assisted Hepatic Resection in an Animal Model

et al. 2011

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“…An interface enabled the user to visualize the focal point of the HIFU device on the ultrasound image, as well as on the tissues to coagulate. A preliminary study has been performed to determine the optimal parameters for in vivo HIFU treatment in pig livers [3].…”

Section: B Tolerance Of Tumor-mimicsmentioning

confidence: 99%

P0-5 An In Vivo Tumor-Mimic Model for Evaluating the Accuracy of HIFU Treatments: Preclinical Studies

N’Djin

Melodelima

Preissl

et al. 2007

2007 IEEE Ultrasonics Symposium Proceedings

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The purpose of this preclinical study was to use an in vivo tumor-mimic model on pig liver for evaluating the accuracy of large HIFU ablations as required for Human treatments. Tumor-mimics were created in in vivo porcine livers by injecting a 1 cc warm mixture of agarose, cellulose, glycerol and methylene blue, which formed 1 cm hyperechoic discrete lesions on sonograms. Three studies were conducted: (i) in vitro experiments were carried out to study the acoustical proprieties of the tumor-mimics. (ii) in vivo experiments were conducted in 10 pigs to evaluate the tolerance of the tumor-mimics and the evolution of their dimensions at mid-term (30 days). (iii) in vivo ultrasound-guided HIFU ablations have been performed in 10 pigs to demonstrate the feasibility of treating accurately a predetermined zone. Thereby, elementary lesions at 10 mm from the tumor-mimic were created. In addition, HIFU ablations were performed by juxtaposing single lesions to surround tumormimics with an average margin of 2 mm in all directions. It has been shown that the acoustical properties of tumor-mimics made them visible on sonograms and did not modify the shape and dimensions of HIFU lesions. The local and biological tolerances of tumor-mimics were excellent. Tumor-mimics were measured on sonogram with reproducible dimensions (average diameter at D0: 9.7 ± 1.0 mm (range 5.6-12.0 mm)), similar to those measured on the sample removed after surgery (average diameter at D0: 10.1 ± 0.7 mm (range 6.3-11.5 mm)). HIFU ablations at 10 mm from the tumor-mimics were measured on the sample at 11.3 ± 1.0 mm (range 8.0-14.0 mm), this is a 13% difference. In addition, it has been showed that 90% of the margins established with juxtaposed HIFU ablations were upper than 2 mm. Therefore this tumormimic can be used to learn HIFU ablation before starting clinical studies especially when the ultrasound device is to be used manually as the one presented in this study.

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“…Acquisitions of US images were performed during experiments involving HIFU exposures during an open procedure [2]. Pigs were anaesthetised and mechanically ventilated.…”

Section: A Ultrasound Imagesmentioning

confidence: 99%

P3C-1 Modelling of In Vivo Liver Motion on HIFU Treatments: A Combined Method

N’Djin

Melodelima

Chapelon

et al. 2007

2007 IEEE Ultrasonics Symposium Proceedings

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Accurate HIFU treatments of abdominal tumors is difficult because of organs motions during breathing. Here we report that a combined method can be used for simulating HIFU lesion in the liver by considering effective in vivo motion. Sequences of ultrasound images were acquired in vivo during an open procedure on 4 pigs using a 2D ultrasound imaging probe working at a frequency of 12 MHz. Sequences were acquired during either breathing or apnea. Effects of real liver motions on a HIFU treatment were modeled on the basis of the combination of two techniques. An accurate ultrasound correlation-based method was used to estimate liver motion using speckle tracking. Effects of liver motion on HIFU lesions were observed by including these measured displacements in numerical simulations based on Bio Heat Transfer Equation.A first set of data was acquired on 2 pigs during breathing showed that the main movements were encountered in the cranial-caudal direction (f=0.2 MHz, average magnitude: 13.3 ± 1.1 mm (range 9.0 -15.5)). A second set of data was acquired on 2 pigs during breathing and apnea in order to separate the motion due to cardiovascular activity only (f=0.96 MHz, magnitude < 0.5 mm). The results of simulated HIFU lesions considering real in vivo liver motion revealed that the lesions were significantly different in terms of size and homogeneity between control (no motion) and breathing samples. Therefore this study provides a useful and practical mean of determining the influence of effective 2D actual in vivo motions on HIFU treatments which can be applied to the liver or to any other moving organ.

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Ultrasound surgery with a toric transducer allows the treatment of large volumes over short periods of time

Cited by 41 publications

References 19 publications

High-Intensity Focused Ultrasound (HIFU)-Assisted Hepatic Resection in an Animal Model

High-Intensity Focused Ultrasound (HIFU)-Assisted Hepatic Resection in an Animal Model

P0-5 An In Vivo Tumor-Mimic Model for Evaluating the Accuracy of HIFU Treatments: Preclinical Studies

P3C-1 Modelling of In Vivo Liver Motion on HIFU Treatments: A Combined Method

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