Volumetric MR-HIFU ablation of uterine fibroids: Role of treatment cell size in the improvement of energy efficiency

Kim, Youngsun; Keserci, Bilgin; Partanen, Ari; Rhim, Hyunchul; Lim, Hyo Keun; Park, Min Jung; Köhler, Max O.

doi:10.1016/j.ejrad.2011.09.005

Cited by 78 publications

(78 citation statements)

References 16 publications

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“…The energy efficiencies calculated from the ratio of coagulation volume to total acoustic energy were 1.7 and 1.0 mm 3 /J with spot scanning and direct synthesis, respectively. Even with direct synthesis, the efficiency was 1.0 mm 3 /J, which was comparable to those in volumetric HIFU ablation studies [68][69][70], for example, the ratios of 240 equivalent minutes (EM) uterine fibroids volume to applied energy of 0.29 and 0.91 mm 3 /J with treatment cell sizes of 8 and 16 mm, respectively [70]. As a result, the spot scanning trigger pulses followed by the spot scanning heating bursts achieved an efficient heating and those followed by the heating bursts with a directly synthesized focus generated a coagulation region with high efficiency and predictability.…”

Section: Coagulation Region Size and Predictabilitysupporting

confidence: 55%

“…Methods of focal spot scanning have been investigated for highly efficient ultrasonic heating [67][68][69][70][71]. In the studies, the distribution of estimated temperature was used as a feedback information to obtain uniform thermal doses in the larger target regions than that by a conventional HIFU exposure.…”

Section: Cavitation Generated In Multiple Focal Spotsmentioning

confidence: 99%

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Enhancement of High-Intensity Focused Ultrasound Heating by Short-Pulse Generated Cavitation

2017

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Abstract:A target tissue can be thermally coagulated in high-intensity focused ultrasound (HIFU) treatment noninvasively. HIFU thermal treatments have been clinically applied to various solid tumors. One of the problems in HIFU treatments is a long treatment time. Acoustically driven microbubbles can accelerate the ultrasonic heating, resulting in the significant reduction of the treatment time. In this paper, a method named "trigger HIFU exposure" which employs cavitation microbubbles is introduced and its results are reviewed. A trigger HIFU sequence consists of high-intensity short pulses followed by moderate-intensity long bursts. Cavitation bubbles induced in a multiple focal regions by rapidly scanning the focus of high-intensity pulses enhanced the temperature increase significantly and produced a large coagulation region with high efficiency.

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Section: Coagulation Region Size and Predictabilitysupporting

confidence: 55%

Section: Cavitation Generated In Multiple Focal Spotsmentioning

confidence: 99%

Enhancement of High-Intensity Focused Ultrasound Heating by Short-Pulse Generated Cavitation

2017

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“…The use of large treatment cells is accompanied by increased energy efficiency, resulting in a relative reduction in treatment time [19]. However, maintaining generous safety distances resulted in limited applicability of large treatment cell volumes.…”

Section: Discussionmentioning

confidence: 99%

MR-Guided HIFU Treatment of Symptomatic Uterine Fibroids Using Novel Feedback-Regulated Volumetric Ablation: Effectiveness and Clinical Practice

Ruhnke

Eckey

Bohlmann

et al. 2013

Fortschr Röntgenstr

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Purpose: To evaluate a novel feedback-regulated volumetric sonication method in MR-guided HIFU treatment of symptomatic uterine fibroids. Materials and Methods: 27 fibroids with an average volume of 124.9???139.8 cc in 18 women with symptomatic uterine fibroids were ablated using the new HIFU system Sonalleve (1.5?T MR system Achieva, Philips). 21 myomas in 13 women were reevaluated 6 months later. Standard (treatment) cells (TC) and feedback-regulated (feedback) cells (FC) with a diameter of 4, 8, 12, and 16?mm were used and compared concerning sonication success, diameter of?induced necrosis, and maximum achieved temperature. The non-perfused volume ratio (NPV related to myoma volume) was quantified. The fibroid volume was measured before, 1 month, and 6 months after therapy. Symptoms were quantified using a specific questionnaire (UFS-QoL). Results: In total, 205 TC and 227 FC were applied. The NPV ratio was 23???15?% (2???55). The TC were slightly smaller than intended (?3.9???52?%; range, ?100???81), while the FC were 20.1???25.3?% bigger (p?=?0.02). Feedback mechanism is less diversifying in diameter (p?

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“…In the treatment of uterine fibroids, the volumetric sonication method improves the energy efficiency and treatment speed of MRgFUS. [35][36][37] Huisman et al showed a treatment response in 6 of their 9 patients remaining at 1-month follow-up. 21 Throughout this pilot study, we also employed a volumetric ablation technique using the Philips Sonalleve system.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance–Guided High-Intensity-Focused Ultrasound for Palliation of Painful Skeletal Metastases: A Pilot Study

Chan

Dennis

Huang

et al. 2016

Technol Cancer Res Treat

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Background: Bone is one of the most common sites of metastases, with bone metastases-related pain representing a significant source of morbidity among patients with cancer. Magnetic resonance-guided focused ultrasound is a noninvasive, outpatient modality with the potential for treating painful bone metastases. The aim of this study is to report our initial experience with magnetic resonance-guided focused ultrasound in the treatment of bone metastases and our preliminary analysis of urinary cytokine levels after therapy. Methods: This was a single-center pilot study of 10 patients with metastatic cancer to investigate the feasibility of magnetic resonance-guided focused ultrasound for primary pain control in device-accessible skeletal metastases. Treatments were performed on a clinical magnetic resonance-guided focused ultrasound system using a volumetric ablation technique. Primary efficacy was assessed using Brief Pain Inventory scores and morphine equivalent daily dose intake at 3 time points: before, day 14, and day 30 after the magnetic resonance-guided focused ultrasound treatment. Urine cytokines were measured 3 days before treatment and 2 days after the treatment. Results: Of the 10 patients, 8 were followed up 14 days and 6 were followed up 30 days after the treatment. At day 14, 3 patients (37.5%) exhibited partial pain response and 4 patients (50%) exhibited an indeterminate response, and at day 30 after the treatment, 5 patients (83%) exhibited partial pain response. No treatment-related adverse events were recorded. Of the urine cytokines measured, only Transforming growth factor alpha (TGFa) demonstrated an overall decrease, with a trend toward statistical significance (P ¼ .078). Conclusion: Our study corroborates magnetic resonance-guided focused ultrasound as a feasible and safe modality as a primary, palliative treatment for painful bone metastases and contributes to the limited body of literature using magnetic resonance-guided focused ultrasound for this clinical indication.

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Volumetric MR-HIFU ablation of uterine fibroids: Role of treatment cell size in the improvement of energy efficiency

Cited by 78 publications

References 16 publications

Enhancement of High-Intensity Focused Ultrasound Heating by Short-Pulse Generated Cavitation

Enhancement of High-Intensity Focused Ultrasound Heating by Short-Pulse Generated Cavitation

MR-Guided HIFU Treatment of Symptomatic Uterine Fibroids Using Novel Feedback-Regulated Volumetric Ablation: Effectiveness and Clinical Practice

Magnetic Resonance–Guided High-Intensity-Focused Ultrasound for Palliation of Painful Skeletal Metastases: A Pilot Study

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