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Shin, Eui-Ji, Byungwoo Kang, and Jin Chang. "Real-Time HIFU Treatment Monitoring Using Pulse Inversion Ultrasonic Imaging." Applied Sciences 8, no. 11 (November 11, 2018): 2219. http://dx.doi.org/10.3390/app8112219.
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Real-time monitoring of high-intensity focused ultrasound (HIFU) surgery is essential for safe and accurate treatment. However, ultrasound imaging is difficult to use for treatment monitoring during HIFU surgery because of the high intensity of the HIFU echoes that are received by an imaging transducer. Here, we propose a real-time HIFU treatment monitoring method based on pulse inversion of imaging ultrasound; an imaging transducer fires ultrasound twice in 0° and 180° phases for one scanline while HIFUs of the same phase are transmitted in synchronization with the ultrasound transmission for imaging. By doing so, HIFU interferences can be eliminated after subtracting the two sets of the signals received by the imaging transducer. This function was implemented in a commercial research ultrasound scanner, and its performance was evaluated using the excised bovine liver. The experimental results demonstrated that the proposed method allowed ultrasound images to clearly show the echogenicity change induced by HIFU in the excised bovine liver. Additionally, it was confirmed that the moving velocity of the organs in the abdomen due to respiration does not affect the performance of the proposed method. Based on the experimental results, we believe that the proposed method can be used for real-time HIFU surgery monitoring that is a pivotal function for maximized treatment efficacy.
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Bespalov, Vladimir, Grigoriy Tochilnikov, Konstantin Senchik, Yelena Yermakova, Yelizaveta Kovalevskaya, Georgiy Gafton, and A. Berkovich. "HIGH-INTENSITY FOCUSED ULTRASOUND IN THE TREATMENT OF MALIGNANT AND BENIGN TUMORS." Problems in oncology 66, no. 1 (January 1, 2020): 29–35. http://dx.doi.org/10.37469/0507-3758-2020-66-1-29-35.
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The review article discusses the possibilities of using high-intensity focused ultrasound (HIFU) in oncology. The technical principles and features of HIFU ablation, a brief history of the development of HIFU therapy, the principles of HIFU therapy, the physical basis of the HIFU ablation method, and the mechanisms of antitumor action of HIFU therapy are presented. The results and benefits of HIFU therapy for various malignant and benign tumors are discussed.
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Pasticier, Gilles, Ji-Wann Lee, Sebastien Crouzet, J. Soria, Christelle Medollima, Florence Mege-Lechevallier, Jean-Yves Chapelon, Olivier Rouviere, and Albert Gelet. "Localized prostate cancer and salvage treatment: EBRT first + salvage HIFU or HIFU first + salvage EBRT? A single-institution matched pair analysis over a 20-year period." Journal of Clinical Oncology 35, no. 6_suppl (February 20, 2017): 77. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.77.
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77 Background: In the field of curative treatment for localized prostate cancer, HIFU (High Intensity Focused ultrasound) is one of salvage option after EBRT(external beam radiation therapy) failure and EBRT is the standard salvage option for local relapse after HIFU.Our aim was to compare and evaluate the oncologic outcomes between HIFU first + salvage EBRT versus EBRT first +salvage HIFU. Methods: Using a matched pair analysis, 342 Patients (171 in each group) treated between 1994 and 2014 in the same institution were prospectively followed and matched to a 1:1 basis. Outcome measurements: Overall Survival Rate(OSR), cancer specific(CSSR) and metastasis free (MFSR) survival rates were the primary endpoints. Secondary endpoints were survival rate free of hormone therapy (HTFR) and the rate of side effects Clavien score ≥ 3. Results: Mean follow-up were 114 and 124 months for HIFU+ S-EBRT and EBRT + S-HIFU respectively. At 7 years from the primary treatment , the MFSR were significantly better after HIFU first +S- EBRT than after EBRT first+S- HIFU: 96% vs 91%% (p:0.011). The OSR and the CSSR were not significantly different in the two arms (97% and 99% after HIFU+S- EBRT versus 96% and 98% after EBRT+S- HIFU). The HTFR at 7 years was significantly different (p <0.001) after HIFU+ S-EBRT than after EBRT+ S-HIFU 90% versus 69%. In multivariable Cox regression, the initial Gleason sum ≥ 8 and the treatment strategy were predictors of MFSR (risk ratio 3.2 for treatment modality). The rate of side effect Clavien score≥ 3 was significantly higher (p:0.01) in the EBRT+ S-HIFU arm than in the HIFU+ S-EBRT arm. The rate of urinary toxicity (severe incontinence and bladder outlet obstruction) were worse in the EBRT+ S-HIFU arm than in HIFU+S-EBRT arm: 9.4% and 15.2% vs 1.2% and 7.6% (p:0.01 and 0.078). Conclusions: In this single-institution Matched Pair comparison, the MFSR and HTFR were significantly better in the HIFU+S-EBRT arm than in the EBRT+S-HIFU arm. The rate of urinairy toxicity and Clavien≥3 side-effects were Higher in the EBRT + S-HIFU arm than in the HIFU + S-EBRT arm.
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Wang, James, Chin-Hsin Huang, Oscar Echeagaray, Siamak Amirfakhri, Sarah Blair, William Trogler, Andrew Kummel, and Clark Chen. "SURG-33. IMMUNO-STIMULATION THROUGH SURGICALLY ADMINISTERED MECHANICAL HIGH INTENSITY FOCUSED ULTRASOUND." Neuro-Oncology 21, Supplement_6 (November 2019): vi246. http://dx.doi.org/10.1093/neuonc/noz175.1033.
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Abstract INTRODUCTION While immunotherapy through anti-PD1 checkpoint inhibition has demonstrated impressive clinical efficacy against a number of tumor types, its application has been ineffective against glioblastomas. METHODS We wished to determine whether high intensity focused ultrasound (HIFU) augment the efficacy of anti-PD1 checkpoint inhibition against glioblastomas. HIFU can be surgically administered through low-duty cycle to induce subcellular fragmentation without causing temperature elevation (termed mechanical HIFU). Alternatively, HIFU delivered through high duty cycle can induce foci of temperature elevation and thermal ablation (termed thermal HIFU). We tested the impact of mechanical and thermal HIFU on the anti-glioblastoma effects of the immune checkpoint inhibitor, ipililumab. RESULTS In an in vivomurine glioblastoma model, sites targeted by mechanical HIFU exhibited a 10–100 fold increase in accumulation in tumor infiltrating lymphocytes and interferon-γ (IFN-γ) in the presence of PD-1 blockade. At least 75% of mice engrafted with glioblastomas achieved remission when treated with mechanical HIFU and PD-1 blockade. In contrast, none of the mice treated with single therapies achieved durable remission. Likelihood of remission correlated with the abundance of tumor infiltrating lymphocytes (p< 0.001) and IFN- γ levels (p=0.001). The synergy observed between mechanical HIFU and PD-1 blockade was not seen when combining thermal HIFU and PD-1 blockade, suggesting thermal protein denaturation is prohibitive to immune-stimulatory effects of HIFU. CONCLUSION Mechanical HIFU, but not thermal HIFU, augments the anti-glioblastoma effects of PD-1 blockade. Our findings inform the utility of HIFU as an immune-adjuvant in glioblastoma therapy that can be surgically administered.
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Siedek, Florian, Sin Yuin Yeo, Edwin Heijman, Olga Grinstein, Grischa Bratke, Carola Heneweer, Michael Puesken, Thorsten Persigehl, David Maintz, and Holger Grüll. "Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU): Technical Background and Overview of Current Clinical Applications (Part 1)." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 191, no. 06 (January 10, 2019): 522–30. http://dx.doi.org/10.1055/a-0817-5645.
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Background Extracorporeal high-intensity focused ultrasound (HIFU) is a promising method for the noninvasive thermal ablation of benign and malignant tissue. Current HIFU treatments are performed under ultrasound (US-HIFU) or magnetic resonance (MR-HIFU) image guidance offering integrated therapy planning, real-time control (spatial and temperature guidance) and evaluation. Methods This review is based on publications in peer-reviewed journals addressing thermal ablation using HIFU and includes our own clinical results as well. The technical background of HIFU is explained with an emphasis on MR-HIFU applications. A brief overview of the most commonly performed CE-approved clinical applications for MR-HIFU is given. Results Over the last decade, several HIFU-based applications have received clinical approval in various countries. In particular, MR-HIFU is now approved for the clinical treatment of uterine fibroids, palliation of bone pain, ablation of the prostate and treatment of essential tremor as a first neurological application. Conclusion MR-HIFU is a patient-friendly noninvasive method for thermal ablation which has received clinical approval for several applications. Overall, clinical data demonstrate treatment efficacy, safety and cost efficiency. Key Points: Citation Format
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Youn, Youngwon, Abigail Hellman, Ian Walling, Lucy Gee, Jiang Qian, Clif Burdette, Lance Frith, and Julie G. Pilitsis. "High-Intensity Ultrasound Treatment for Vincristine-Induced Neuropathic Pain." Neurosurgery 83, no. 5 (February 9, 2018): 1068–75. http://dx.doi.org/10.1093/neuros/nyx488.
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Abstract BACKGROUND Vincristine is a commonly used chemotherapeutic agent that results in debilitating untreatable peripheral neuropathy. OBJECTIVE To determine the effects of pulsed high-intensity focused ultrasound (HIFU) on sensory thresholds in a validated vincristine-induced neuropathy (VIN) rodent model. METHODS VIN was induced and mechanical allodynia was confirmed by nociceptive testing. von Frey fibers and Randall-Sellito test were used as measures of innocuous and noxious mechanical thresholds, respectively, and the hot plate test for thermal thresholds. Tests were performed before VIN, after 2 wk of vincristine, at 24, 48, 72, and 120 h after HIFU applied to the left L5 dorsal root ganglia at 3 Watts for 3 min. Comparisons were made between a VIN cohort who underwent HIFU, a VIN cohort who underwent sham HIFU, and naïve rodents who underwent HIFU. RESULTS VIN HIFU rats had significantly increased mechanical thresholds at 24 h (P < .001), 48 h (P = .008), 72 h (P = .003), and 120 h (P = .03) after treatment, when compared to pre-HIFU thresholds. Furthermore, at 24 and 48 h following treatment, VIN HIFU rats had significantly higher innocuous and noxious mechanical thresholds and thermal thresholds than VIN sham HIFU rats (P < .001). Thresholds were not altered in naïve rodents who underwent HIFU. Histological data of L5 dorsal root ganglia of VIN HIFU rats suggest that transient cellular edema resolves by 48 h. CONCLUSION Our data suggest that HIFU increases mechanical and thermal thresholds in VIN rodents. Whether HIFU can preclude the development of reduced thresholds in the VIN model warrants further study.
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Xiao, Juhua, Xin Zhou, Ye Luo, Shuang Wang, Zhili Yang, Yingchun Yi, and Hui Xiong. "A Novel High-Intensity Focused Ultrasound-Treated Herpes Simplex Virus 2 Vaccine Induces Long-Term Protective Immunity against Lethal Challenge in Mice." mSphere 5, no. 6 (December 23, 2020): e00859-20. http://dx.doi.org/10.1128/msphere.00859-20.
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ABSTRACTHigh-intensity focused ultrasound (HIFU), a noninvasive ablation therapy that has been widely used clinically in ablation of solid tumors, induces immune sensitization. We therefore in this study investigated whether HIFU treatment could enhance the efficacy of a herpes simplex virus 2 (HSV-2) vaccine. First, we observed that in HSV-2-positive cervical intraepithelial neoplasia (CIN) II patients, HIFU treatment induced significantly higher anti-HSV-2 neutralization response than surgical removal. Next, we tested the efficacy of HIFU-treated, UV-inactivated HSV-2-infected cells as a proof-of-concept vaccine in mice. Our data showed that HIFU-treated formulation significantly enhanced HSV-2 antibody titers and neutralization titers, compared to UV-, microwave (MW)-, or freeze-thaw (FT)-treated formulations. HIFU treatment also promoted the Th1/2 cell-mediated response. A long-term full protection was observed in mice that received the HIFU-treated formulation, and no weight loss was detected. Our findings indicate that the novel application of HIFU in vaccine production may represent a rational way to improve vaccine efficacy.IMPORTANCE High-intensity focused ultrasound (HIFU) is mainly used in tumor ablation and tumor vaccinology study. It has been shown to induce immune sensitization and enhance tumor responsiveness to other therapies. Our study has shown enhanced anti-HSV-2 response in HIFU-treated CIN II patients. Furthermore, in a murine model, we have demonstrated that HIFU-treated HSV-2 vaccine induced long-term protective immunity against lethal challenge. Our findings indicate that the novel application of HIFU in vaccine production may represent a rational way to improve vaccine efficacy.
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Zhao, Lu-Yan, Jian-Zhong Zou, Zong-Gui Chen, Shan Liu, Jiao Jiao, and Feng Wu. "Acoustic Cavitation Enhances Focused Ultrasound Ablation with Phase-Shift Inorganic Perfluorohexane Nanoemulsions: AnIn VitroStudy Using a Clinical Device." BioMed Research International 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/7936902.
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Purpose.To investigate whether acoustic cavitation could increase the evaporation of a phase-shift inorganic perfluorohexane (PFH) nanoemulsion and enhance high intensity focused ultrasound (HIFU) ablation.Materials and Methods.PFH was encapsulated by mesoporous silica nanocapsule (MSNC) to form a nanometer-sized droplet (MSNC-PFH). It was added to a tissue-mimicking phantom, whereas phosphate buffered saline (PBS) was added as a control (PBS-control). HIFU (Pac=150 W,t=5/10 s) exposures were performed in both phantoms with various duty cycles (DC). US images, temperature, and cavitation emissions were recorded during HIFU exposure. HIFU-induced lesions were measured and calculated.Results.Compared to PBS-control, MSNC-PFH nanoemulsion could significantly increase the volume of HIFU-induced lesion (P<0.01). Peak temperatures were 78.16 ± 5.64°C at a DC of 100%, 70.17 ± 6.43°C at 10%, 53.17 ± 4.54°C at 5%, and 42.00 ± 5.55°C at 2%, respectively. Inertial cavitation was much stronger in the pulsed-HIFU than that in the continuous-wave HIFU exposure. Compared to 100%-DC exposure, the mean volume of lesion induced by 5 s exposure at 10%-DC was significantly larger, but smaller at 2%-DC.Conclusions.MSNC-PFH nanoemulsion can significantly enhance HIFU ablation. Appropriate pulsed-HIFU exposure could significantly increase the volume of lesion and reduce total US energy required for HIFU ablation.
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Gunderman, Anthony, Rudy Montayre, Ashish Ranjan, and Yue Chen. "Review of Robot-Assisted HIFU Therapy." Sensors 23, no. 7 (April 3, 2023): 3707. http://dx.doi.org/10.3390/s23073707.
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This paper provides an overview of current robot-assisted high-intensity focused ultrasound (HIFU) systems for image-guided therapies. HIFU is a minimally invasive technique that relies on the thermo-mechanical effects of focused ultrasound waves to perform clinical treatments, such as tumor ablation, mild hyperthermia adjuvant to radiation or chemotherapy, vein occlusion, and many others. HIFU is typically performed under ultrasound (USgHIFU) or magnetic resonance imaging guidance (MRgHIFU), which provide intra-operative monitoring of treatment outcomes. Robot-assisted HIFU probe manipulation provides precise HIFU focal control to avoid damage to surrounding sensitive anatomy, such as blood vessels, nerve bundles, or adjacent organs. These clinical and technical benefits have promoted the rapid adoption of robot-assisted HIFU in the past several decades. This paper aims to present the recent developments of robot-assisted HIFU by summarizing the key features and clinical applications of each system. The paper concludes with a comparison and discussion of future perspectives on robot-assisted HIFU.
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Yu, Tinghe, and Xiao Fu. "Extracorporeal Ultrasound-Guided High Intensity Focused Ultrasound: Implications from the Present Clinical Trials." Scientific World Journal 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/537260.
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Extracorporeal ultrasound-guided high intensity focused ultrasound (HIFU) has been clinically used for 15 years, and over 36000 cases have been reported. However, there yet lacked a consensus in the clinical values, suggesting the necessity of checking clinical findings. Clinical trials were searched and data reevaluated. HIFU was hardly performed alone; almost all present anticancer means have been applied during an HIFU treatment, and a specific regimen varied between trials; there were heterogeneity and disagreement between trials. The complexity made it difficult to distinguish the effect of HIFU. Based upon evaluable data, the efficacy of HIFU was similar to that of radio frequency, chemoembolization, chemotherapy, radiotherapy, or hormone therapy; a combined therapy did not improve the efficacy. The survival rate of HIFU plus radiotherapy was lower than that of radical surgery in liver cancers. Adverse events had no downtrend in the past years. HIFU was not a standardized procedure where the intensity and insonation mode were modified constantly throughout a treatment, limiting an evaluation from the perspective of ultrasonics. These implied that HIFU should be applied as an alternative at most occasions. The present clinical trials had defects making against the understating of HIFU.
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Takagi, Ryo, Toshikatsu Washio, and Yoshihiko Koseki. "The feasibility of a noise elimination method using continuous wave response of therapeutic ultrasound signals for ultrasonic monitoring of high-intensity focused ultrasound treatment." Journal of Medical Ultrasonics 48, no. 2 (April 2021): 123–35. http://dx.doi.org/10.1007/s10396-021-01083-5.
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Abstract Purpose In this study, the robustness and feasibility of a noise elimination method using continuous wave response of therapeutic ultrasound signals were investigated when tissue samples were moved to simulate the respiration-induced movements of the different organs during actual high-intensity focused ultrasound (HIFU) treatment. In addition to that, the failure conditions of the proposed algorithm were also investigated. Methods The proposed method was applied to cases where tissue samples were moved along both the lateral and axial directions of the HIFU transducer to simulate respiration-induced motions during HIFU treatment, and the noise reduction level was investigated. In this experiment, the speed of movement was increased from 10 to 40 mm/s to simulate the actual movement of the tissue during HIFU exposure, with the intensity and driving frequency of HIFU set to 1.0–5.0 kW/cm2 and 1.67 MHz, respectively. To investigate the failure conditions of the proposed algorithm, the proposed method was applied with the HIFU focus located at the boundary between the phantom and water to easily cause cavitation bubbles. The intensity of HIFU was set to 10 kW/cm2. Results Almost all HIFU noise was constantly able to be eliminated using the proposed method when the phantom was moved along the lateral and axial directions during HIFU exposure. The noise reduction level (PRL in this study) at an intensity of 1.0, 3.0, and 5.0 kW/cm2 was in the range of 28–32, 38–40, and 42–45 dB, respectively. On the other hand, HIFU noise was not basically eliminated during HIFU exposure after applying the proposed method in the case of cavitation generation at the HIFU focus. Conclusions The proposed method can be applicable even if homogeneous tissues or organs move axially or laterally to the direction of HIFU exposure because of breathing. A condition under which the proposed algorithm failed was when instantaneous tissue changes such as cavitation bubble generation occurred in the tissue, at which time the reflected continuous wave response became less steady.
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Byun, Kyung-A., Hyun Jun Park, Seyeon Oh, Sosorburam Batsukh, Hye Jin Sun, Taehui Kim, Sunggeun Kim, Donghwan Kang, Kuk Hui Son, and Kyunghee Byun. "High-Intensity Focused Ultrasound Decreases Subcutaneous Fat Tissue Thickness by Increasing Apoptosis and Autophagy." Biomolecules 13, no. 2 (February 18, 2023): 392. http://dx.doi.org/10.3390/biom13020392.
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High-intensity focused ultrasound (HIFU) leads to decreased subcutaneous adipose tissue (SAT) thickness via heat-induced adipocyte necrosis. Heat can induce adipocyte apoptosis and autophagy, and it is known that nuclear or mitochondrial p53 is involved in apoptosis and autophagy. However, whether HIFU leads to apoptosis or autophagy is unclear. We evaluated whether HIFU decreases SAT thickness via p53-related apoptosis or autophagy in high-fat diet (HFD)-fed animals. The expression of nuclear and mitochondrial p53 was increased by HIFU. HIFU also led to decreased expression of BCL2/BCL-xL (an antiapoptotic signal), increased expression of BAX/BAK (an apoptotic signal), increased levels of cleaved caspase 3/9, and increased numbers of apoptotic cells as evaluated by TUNEL assay. Furthermore, HIFU led to increased levels of ATG5, BECN1, and LC3II/LC3I, and decreased levels of p62, a marker of increased autophagy. The thickness of SAT was decreased by HIFU. In conclusion, HIFU led to nuclear and mitochondrial p53 expression, which led to apoptosis and autophagy, and eventually decreased SAT thickness in HFD-fed animals.
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Wang, Ke, Guangzhen Xing, Min Wang, and Ping Yang. "Discussion on the upper limit of HIFU sound pressure measurement based on laser interferometry." Journal of Physics: Conference Series 2822, no. 1 (September 1, 2024): 012008. http://dx.doi.org/10.1088/1742-6596/2822/1/012008.
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Abstract High intensity focused ultrasound (HIFU) technology is a non-invasive treatment technique that can achieve non-invasive treatment of tumors and other diseases. The accuracy of HIFU sound pressure is crucial for the clinical efficacy and safety of HIFU treatment. The sound pressure measurement technology based on laser interferometry is the recommended method for ICE TC87, which has the advantages of high measurement accuracy and good traceability, and is therefore widely adopted as the new generation of sound pressure standards. However, the upper limit of the laser interferometric HIFU sound pressure measurement currently reported is about 10 MPa, which is far lower than the actual sound pressure of HIFU technology. In response to this issue, the upper limit of HIFU sound pressure measurement was discussed from the perspective of laser interference systems. The mathematical relationship between the HIFU sound pressure and the optical and electrical signals of the laser interference system under the condition of nonlinear sound field is established. The mathematical analysis of HIFU sound pressure requirements for the bandwidth of laser interference systems is discussed. Using experimental and numerical simulation methods, the effect of HIFU sound pressure on the bandwidth of a laser interference system under nonlinear acoustic field conditions was studied.
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Kaplińska-Kłosiewicz, Patrycja Maria, Łukasz Fura, Tamara Kujawska, Kryspin Andrzejewski, Katarzyna Kaczyńska, Damian Strzemecki, Mikołaj Sulejczak, Stanisław J. Chrapusta, Matylda Macias, and Dorota Sulejczak. "Study of Biological Effects Induced in Solid Tumors by Shortened-Duration Thermal Ablation Using High-Intensity Focused Ultrasound." Cancers 16, no. 16 (August 14, 2024): 2846. http://dx.doi.org/10.3390/cancers16162846.
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The HIFU ablation technique is limited by the long duration of the procedure, which results from the large difference between the size of the HIFU beam’s focus and the tumor size. Ablation of large tumors requires treating them with a sequence of single HIFU beams, with a specific time interval in-between. The aim of this study was to evaluate the biological effects induced in a malignant solid tumor of the rat mammary gland, implanted in adult Wistar rats, during HIFU treatment according to a new ablation plan which allowed researchers to significantly shorten the duration of the procedure. We used a custom, automated, ultrasound imaging-guided HIFU ablation device. Tumors with a 1 mm thickness margin of healthy tissue were subjected to HIFU. Three days later, the animals were sacrificed, and the HIFU-treated tissues were harvested. The biological effects were studied, employing morphological, histological, immunohistochemical, and ultrastructural techniques. Massive cell death, hemorrhages, tissue loss, influx of immune cells, and induction of pro-inflammatory cytokines were observed in the HIFU-treated tumors. No damage to healthy tissues was observed in the area surrounding the safety margin. These results confirmed the efficacy of the proposed shortened duration of the HIFU ablation procedure and its potential for the treatment of solid tumors.
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Oh, Seyeon, Hyoung Moon Kim, Sosorburam Batsukh, Hye Jin Sun, Taehui Kim, Donghwan Kang, Kuk Hui Son, and Kyunghee Byun. "High-Intensity Focused Ultrasound Induces Adipogenesis via Control of Cilia in Adipose-Derived Stem Cells in Subcutaneous Adipose Tissue." International Journal of Molecular Sciences 23, no. 16 (August 9, 2022): 8866. http://dx.doi.org/10.3390/ijms23168866.
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During skin aging, the volume of subcutaneous adipose tissue (sWAT) and the adipogenesis potential of adipose-derived stem cells (ASCs) decrease. It is known that the shortening of cilia length by pro-inflammatory cytokines is related to the decreased adipogenic differentiation of ASCs via increase in Wnt5a/β-catenin. High-intensity focused ultrasound (HIFU) is known to upregulate heat shock proteins (HSP), which decrease levels of pro-inflammatory cytokines. In this study, we evaluated whether HIFU modulates the cilia of ASCs by upregulating HSP70 and decreasing inflammatory cytokines. HIFU was applied at 0.2 J to rat skin, which was harvested at 1, 3, 7, and 28 days. All results for HIFU-applied animals were compared with control animals that were not treated. HIFU increased expression of HSP70 and decreased expression of NF-κB, IL-6, and TNF-α in sWAT. HIFU decreased the expression of cilia disassembly-related factors (AurA and HDAC9) in ASCs. Furthermore, HIFU increased the expression of cilia assembly-related factors (KIF3A and IFT88), decreased that of WNT5A/β-catenin, and increased that of the adipogenesis markers PPARγ and CEBPα in sWAT. HIFU increased the number of adipocytes in the sWAT and the thickness of sWAT. In conclusion, HIFU could selectively increase sWAT levels by modulating the cilia of ASCs and be used for skin rejuvenation.
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Pwee, Keng Ho. "VP44 Rapid Health Technology Assessment – High-Intensity Focused Ultrasound For Breast Fibroadenomas And Benign Thyroid Nodules." International Journal of Technology Assessment in Health Care 33, S1 (2017): 167–68. http://dx.doi.org/10.1017/s0266462317003270.
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INTRODUCTION:High-intensity focused ultrasound (HIFU) is a non-invasive ablative technique to treat breast fibroadenomas and benign thyroid nodules. A rapid Health Technology Assessment (HTA) was commissioned to inform the Changi General Hospital's decision on procuring a HIFU system.METHODS:A systematic literature search was conducted for systematic reviews, HTA reports and clinical practice guidelines on the clinical effectiveness of HIFU systems with the following PICO elements:Patients = patients with benign breast fibroadenomas or thyroid nodulesIntervention = HIFUComparator = conventional treatmentOutcomes = clinical outcomesRetrieved studies were summarized in a narrative synthesis.RESULTS:A few small case series showed reduction in volume of fibroadenomas/nodules in the short term and side effects were minor. Additionally, in HIFU for benign thyroid nodules, conference abstracts described a small open-label, randomized controlled trial where patients receiving HIFU had nodule volume reduction of over 30 percent compared to no reduction in the observation group, at 6 months; and a small non-randomized controlled study where volume reduction was about 70 percent in patients receiving HIFU compared to active observation.Recent clinical guidelines do not mention HIFU as a therapeutic option for fibroadenomas/nodules.Major United States health insurers do not cover HIFU and consider it experimental, investigational or unproven. In Germany, HIFU for breast fibroadenomas and benign thyroid nodules are covered by some insurers under special integrated care contracts.CONCLUSIONS:HIFU for fibroadenomas/nodules is a technology still developing its evidence base. The peer-reviewed literature comprises a few small case series and two controlled trials showing fibroadenoma/nodule reduction in the short term (up to 12 months) but no long term outcomes. Professional opinion from current guidelines does not mention HIFU as an option.It may be prudent to await stronger evidence on long-term patient-important outcomes before offering the treatment as a hospital service. HIFU may be suitable for further clinical research.
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Abe, Shinya, Hiroshi Nagata, Erika J. Crosby, Yoshiyuki Inoue, Kensuke Kaneko, Cong-Xiao Liu, Xiao Yang, et al. "Combination of ultrasound-based mechanical disruption of tumor with immune checkpoint blockade modifies tumor microenvironment and augments systemic antitumor immunity." Journal for ImmunoTherapy of Cancer 10, no. 1 (January 2022): e003717. http://dx.doi.org/10.1136/jitc-2021-003717.
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BackgroundDespite multimodal adjuvant management with radiotherapy, chemotherapy and hormonal therapies, most surgically resected primary breast cancers relapse or metastasize. A potential solution to late and distant recurrence is to augment systemic antitumor immunity, in part by appropriately presenting tumor antigens, but also by modulating the immunosuppressive tumor microenvironment (TME). We previously validated this concept in models of murine carcinoma treated with a novel predominately microcavitating version of high-intensity focused ultrasound (HIFU), mechanical high-intensity focused ultrasound (M-HIFU). Here we elucidated the mechanisms of enhanced antitumor immunity by M-HIFU over conventional thermal high-intensity focused ultrasound (T-HIFU) and investigated the potential of the combinatorial strategy with an immune checkpoint inhibitor, anti-PD-L1 antibody.MethodsThe antitumor efficacy of treatments was investigated in syngeneic murine breast cancer models using triple-negative (E0771) or human ErbB-2 (HER2) expressing (MM3MG-HER2) tumors in C57BL/6 or BALB/c mice, respectively. Induction of systemic antitumor immunity by the treatments was tested using bilateral tumor implantation models. Flow cytometry, immunohistochemistry, and single-cell RNA sequencing were performed to elucidate detailed effects of HIFU treatments or combination treatment on TME, including the activation status of CD8 T cells and polarization of tumor-associated macrophages (TAMs).ResultsMore potent systemic antitumor immunity and tumor growth suppression were induced by M-HIFU compared with T-HIFU. Molecular characterization of the TME after M-HIFU by single-cell RNA sequencing demonstrated repolarization of TAM to the immunostimulatory M1 subtype compared with TME post-T-HIFU. Concurrent anti-PD-L1 antibody administration or depletion of CD4+ T cells containing a population of regulatory T cells markedly increased T cell-mediated antitumor immunity and tumor growth suppression at distant, untreated tumor sites in M-HIFU treated mice compared with M-HIFU monotherapy. CD8 T and natural killer cells played major roles as effector cells in the combination treatment.ConclusionsPhysical disruption of the TME by M-HIFU repolarizes TAM, enhances T-cell infiltration, and, when combined with anti-PD-L1 antibody, mediates superior systemic antitumor immune responses and distant tumor growth suppression. These findings suggest M-HIFU combined with anti-PD-L1 may be useful in reducing late recurrence or metastasis when applied to primary tumors.
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Rangraz, Parisa, Hamid Behnam, Pooya Sobhe Bidari, Naser Shakhssalim, and Jahan Tavakkoli. "DYNAMIC CHANGES IN THE ACOUSTO-MECHANICAL AND STATISTICAL PARAMETERS OF TISSUE DURING HIGH INTENSITY FOCUSED ULTRASOUND (HIFU) TREATMENT." Biomedical Engineering: Applications, Basis and Communications 26, no. 01 (February 2014): 1450009. http://dx.doi.org/10.4015/s1016237214500094.
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High intensity focused ultrasound (HIFU) induces focalized tissue coagulation by increasing the tissue temperature in a tight focal region and has been successfully used as a new technique of tumor treatment or to stop bleeding in clinical applications. The main challenges of this technique are: adjusting the location of HIFU thermal ablation exactly at the region of interest, and controlling the level of thermal ablation. Several imaging methods have been proposed to monitor HIFU-induced thermal lesions such as X-ray, MRI and ultrasound imaging. Currently, ultrasound imaging techniques that are clinically used for monitoring HIFU treatment are standard pulse-echo B-mode ultrasound imaging, ultrasound temperature estimation, and elastography-based methods. This study was carried on ex vivo animal tissue samples. Backscattered radio frequency (RF) signals were acquired in real-time including before, during and after HIFU treatment. In this study, first we estimate the dynamic changes in the acoustical, mechanical and statistical parameters of the tissue resulted from HIFU exposures with three different acoustic powers. Then, we use these parameters to detect the induced HIFU thermal lesions and monitor the treatment process. By estimating the standard deviation of the studied parameters along acquired RF data frames, we show that there are significant changes in the tissue properties during the HIFU treatment.
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Zhu, Xue-Qiang, Pei Lu, Zhong-Lin Xu, Qiang Zhou, Jun Zhang, Zhi-Biao Wang, and Feng Wu. "Alterations in Immune Response Profile of Tumor-Draining Lymph Nodes after High-Intensity Focused Ultrasound Ablation of Breast Cancer Patients." Cells 10, no. 12 (November 29, 2021): 3346. http://dx.doi.org/10.3390/cells10123346.
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Previous studies have revealed that high-intensity focused ultrasound (HIFU) ablation can trigger an antitumor immune response. The aim of this study was to investigate immune response in tumor-draining lymph nodes (TDLNs) after HIFU treatment. Forty-eight female patients with biopsy-confirmed breast cancer were divided into a control group and an HIFU group. In the control group, 25 patients underwent modified radical mastectomy, but 23 patients in the HIFU group received HIFU ablation of primary cancer, followed by the same operation. Using HE and immunohistochemical staining, the immunologic reactivity pattern and immune cell profile were assessed in paraffin-embedded axillary lymph nodes (ALNs) in all patients. The results showed that ALNs presented more evident immune reactions in the HIFU group than in the control group (100% vs. 64%). Among the ALNs, 78.3% had mixed cellular and humoral immune response, whereas 36% in the control group showed cellular immune response. The numbers of CD3+, CD4+, NK cell, and activated CTLs with Fas ligand+, granzyme+ and perforin+ expression were significantly higher in the ALNs in the HIFU group. It was concluded that HIFU could stimulate potent immune response and significantly increase T cell, activated CTLs and NK cell populations in the TDLNs of breast cancer.
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Sofuni, Atsushi, Yasutsugu Asai, Takayoshi Tsuchiya, Kentaro Ishii, Reina Tanaka, Ryosuke Tonozuka, Mitsuyoshi Honjo, et al. "Novel Therapeutic Method for Unresectable Pancreatic Cancer—The Impact of the Long-Term Research in Therapeutic Effect of High-Intensity Focused Ultrasound (HIFU) Therapy." Current Oncology 28, no. 6 (November 20, 2021): 4845–61. http://dx.doi.org/10.3390/curroncol28060409.
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High-intensity focused ultrasound (HIFU) is a novel advanced therapy for unresectable pancreatic cancer (PC). HIFU therapy with chemotherapy is being promoted as a novel method to control local advancement by tumor ablation. We evaluated the therapeutic effects of HIFU therapy in locally advanced and metastatic PC. PC patients were treated with HIFU as an optional local therapy and systemic chemotherapy. The FEP-BY02 (Yuande Bio-Medical Engineering) HIFU device was used under ultrasound guidance. Of 176 PC patients, 89 cases were Stage III and 87 were Stage IV. The rate of complete tumor ablation was 90.3%, while that of symptom relief was 66.7%. The effectiveness on the primary lesions were as follows: complete response (CR): n = 0, partial response (PR): n = 21, stable disease (SD): n = 106, and progressive disease (PD): n = 49; the primary disease control rate was 72.2%. Eight patients underwent surgery. The median survival time (MST) after diagnosis for HIFU with chemotherapy compared to chemotherapy alone (100 patients in our hospital) was 648 vs. 288 days (p < 0.001). Compared with chemotherapy alone, the combination of HIFU therapy and chemotherapy demonstrated significant prolongation of prognosis. This study suggests that HIFU therapy has the potential to be a novel combination therapy for unresectable PC.
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Siedek, Florian, Sin Yuin Yeo, Edwin Heijman, Olga Grinstein, Grischa Bratke, Carola Heneweer, Michael Puesken, Thorsten Persigehl, David Maintz, and Holger Grüll. "Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU): Overview of Emerging Applications (Part 2)." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 191, no. 06 (January 10, 2019): 531–39. http://dx.doi.org/10.1055/a-0817-5686.
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Background High-intensity focused ultrasound (HIFU) allows noninvasive heating of deep-seated tissues. Guidance under magnetic resonance imaging (MR-HIFU) offers spatial targeting based on anatomical MR images as well as MR-based near-real-time temperature maps. Temperature feedback allows delivery of a well-defined thermal dose enabling new applications such as the ablation of malignant tissue. Methods Peer-reviewed publications on MR-HIFU were studied and are summarized in this review. Literature was restricted to applications in oncology. Results Several MR-HIFU-based applications for the treatment of malignant diseases are currently part of clinical trials or translational research. Recent trials regarding the treatment of prostate cancer with MR-HIFU have already shown this to be a safe and patient-friendly method. For the treatment of breast cancer and malignancies within abdominal organs, MR-HIFU has been applied so far only in proof of concept studies. Conclusion MR-HIFU is currently being investigated for the ablative treatment of malignant tissue in a variety of oncological applications. For example, the transrectal as well as transurethral ablation of prostate cancer using MR-HIFU was shown to be a patient-friendly, safe alternative to other local treatment options with low side effects. Key points: Citation Format
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Chung, Sae Rom, Jung Hwan Baek, Chong Hyun Suh, Young Jun Choi, and Jeong Hyun Lee. "Efficacy and safety of high-intensity focused ultrasound (HIFU) for treating benign thyroid nodules: a systematic review and meta-analysis." Acta Radiologica 61, no. 12 (March 22, 2020): 1636–43. http://dx.doi.org/10.1177/0284185120909339.
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Background High-intensity focused ultrasound (HIFU) is an emerging thermal ablation technique that has been successfully applied to various benign thyroid nodules. Purpose To evaluate the efficacy and safety of HIFU for the treatment of benign thyroid nodules. Material and Methods The Ovid-MEDLINE and EMBASE databases were searched up to 9 July 2018 for studies describing the use of HIFU to treat benign thyroid nodules. We included studies that have outcomes with sufficient detail to evaluate the volume reduction rate (VRR). The pooled proportions of VRR ≥50% and pooled VRR at one, three, and six months after HIFU were assessed using random-effects modeling. Heterogeneity among studies was determined using Chi-square statistics for pooled estimates and the inconsistency index I2. Results Seven studies were included in the systematic review and four in the meta-analysis. The pooled VRR at one, three, and six months after HIFU were 17.59 (95% confidence interval [CI] 12.56–22.62), 48.93 (95% CI 42.20–55.66), and 60.43 (95% CI 51.88–68.98). The pooled proportions of VRR ≥50% at six months after HIFU were 75% (95% CI 53–89; I2=73.6%). There were no major complications of HIFU. Conclusion HIFU may be a safe and effective treatment modality for benign thyroid nodules, especially for small nodules.
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Feng, Sui, Yingjie Qu, Yuquan Meng, and Jinjin Zheng. "Use thermophysical property to quantify state of HIFU treatment for VLS." E3S Web of Conferences 185 (2020): 03045. http://dx.doi.org/10.1051/e3sconf/202018503045.
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The aim of this study is to evaluate the performance of ADT methods in grading the effectiveness of HIFU treatment for VLS. High-intensity focused ultrasound has been identified as a promising treatment modality for vulvar lichen sclerosus, a common inflammatory disorder associated with an increased risk of developing vulvar carcinoma. With small probe on extensive VLS parts, the therapy was sometimes uneven, thus the total doses of HIFU machine couldn’t indicate the curative effect at each part. The current therapeutic effect was based on symptoms and skin appearance after 3 months, which was time-consuming. Until now, there has been no immediate quantitative assessment method of HIFU therapeutic response for VLS. In our study, active dynamic IR thermal (ADT) was scheduled to undergo HIFU therapy before and after treatment. The thermal time constant was calculated based on ADT images measured both before and after HIFU treatment. In the result of pig phantom measurements, with each part approximately the same thermal time constant before HIFU treatment, the change of thermal time constant was strictly positively associated with HIFU dose onto each part. This study demonstrates the clinical potential of ADT in fast and effective quantify state of HIFU treatment for VLS.
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Ge, Hui-Yu, Li-Ying Miao, Jin-Rui Wang, Liu-Lin Xiong, Fang Yan, Cui-Shan Zheng, Jian-Wen Jia, Li-Gang Cui, and Wen Chen. "Correlation between Ultrasound Reflection Intensity and Tumor Ablation Ratio of Late-Stage Pancreatic Carcinoma in HIFU Therapy: Dynamic Observation on Ultrasound Reflection Intensity." Scientific World Journal 2013 (2013): 1–10. http://dx.doi.org/10.1155/2013/852874.
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The minimally invasive high-intensity focused ultrasound (HIFU) therapy is thermal ablation treatment for late-stage pancreatic carcinoma with widely recognized safety and effectiveness, but there are currently no instant assessment methods for its ablation effect. It is vital to find a real-time high-sensitive assessment method. This research aims to dynamically observe the variation rules of ultrasound reflection intensity, analyze the correlation between ultrasound reflection intensity and tumor ablation ratio, and find out the value of ultrasound reflection intensity in prognosis of HIFU ablation effect. HIFU intermittent therapies were retrospectively analyzed for 31 subjects with late-stage pancreatic carcinoma from March 2007 to December 2009 in the study. The variation rules of the ultrasound reflection intensity during HIFU therapy were summarized and the correlation between ultrasound reflection intensity and tumor ablation ratio was analyzed based on the tumor ablation ratio indicated by CT scanning. The conclusion is that variation of ultrasound reflection intensity can be used for initial assessment of tumor ablation in HIFU therapy and early prognosis of overall HIFU ablation, providing important clinical basis for improving safety and effectiveness of HIFU therapy. Ultrasound can work as a real-time imaging instrument for observation of HIFU ablation effect in treating late-stage pancreatic carcinoma.
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Zhou, P., M. Fu, J. Bai, Z. Wang, and F. Wu. "Immune response after high-intensity focused ultrasound ablation for H22 tumor." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 21169. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.21169.
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21169 Background: Previous results have shown that high intensity focused ultrasound (HIFU) ablation can potentially activate a host anti-tumor immunity. This study was to investigate whether acoustic cavitaion may enhance host immune responses after HIFU treatment for solid malignancy, and to explore the potential mechanisms regarding the enhanced anti-tumor immunity. Methods: (1) Tumor cell vaccine preparation: H22 cells were irradiated with HIFU (0.8MHz, 1050W/cm2, 90s); H22 cells were heated for one hour in 65°C water bath. (2) Animal study: 150 KM mice were randomly divided into three groups: control group, thermal group, and HIFU group. Each group had 50 mice for immune experiments. By using hypodermic injection, the mice in thermal group and HIFU group received either 0.2ml heat-treated H22 vaccine or 0.2ml HIFU-treated H22 vaccine in the left flank of each mouse. Those in control group received only injection with same amount of saline solution. The vaccination times were 4 sessions, once a week for 4 consecutive weeks. One week after last vaccination, each mouse was challenged with H22 tumor cells. All mice were followed up to observe the long-term survival in each group, and peripheral blood was collected to detect changes in T lymphocytes and their subsets by flow cytometry technique. Results: The tumor incidences and 6-week survival rates were observed 100% and 88% of mice in control group, 72.5% and 40% in thermal group, and 42.5% and 14% in HIFU group respectively. Compared to the values in either control group or thermal group, there was a significant decrease of tumor incidences and 6-week survival rates in HIFU group. The volume of tumor was obviously lower in HIFU group, and a significant difference was observed between HIFU group and thermal group or control group. Compared to the values in control group, there were a significant increase of CD4+ levels and CD4+/CD8+ ratio, and a significant decrease of CD8+ level in both HIFU group and thermal group. Conclusions: Antitumor immune response could be enhanced after HIFU ablation for H22 implanted tumor in mice, and acoustic cavitation could play an important role to stimulate host antitumor immune system. No significant financial relationships to disclose.
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Byun, Kyung-A., Hyoung Moon Kim, Seyeon Oh, Sosorburam Batsukh, Sangsu Lee, Myungjune Oh, Jeongwoo Lee, et al. "High-Intensity Focused Ultrasound Increases Facial Adipogenesis in a Swine Model via Modulation of Adipose-Derived Stem Cell Cilia." International Journal of Molecular Sciences 25, no. 14 (July 12, 2024): 7648. http://dx.doi.org/10.3390/ijms25147648.
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Decreased medial cheek fat volume during aging leads to loss of a youthful facial shape. Increasing facial volume by methods such as adipose-derived stem cell (ASC) injection can produce facial rejuvenation. High-intensity focused ultrasound (HIFU) can increase adipogenesis in subcutaneous fat by modulating cilia on ASCs, which is accompanied by increased HSP70 and decreased NF-κB expression. Thus, we evaluated the effect of HIFU on increasing facial adipogenesis in swine (n = 2) via modulation of ASC cilia. Expression of CD166, an ASC marker, differed by subcutaneous adipose tissue location. CD166 expression in the zygomatic arch (ZA) was significantly higher than that in the subcutaneous adipose tissue in the mandible or lateral temporal areas. HIFU was applied only on the right side of the face, which was compared with the left side, where HIFU was not applied, as a control. HIFU produced a significant increase in HSP70 expression, decreased expression of NF-κB and a cilia disassembly factor (AURKA), and increased expression of a cilia increasing factor (ARL13B) and PPARG and CEBPA, which are the main regulators of adipogenesis. All of these changes were most prominent at the ZA. Facial adipose tissue thickness was also increased by HIFU. Adipose tissue volume, evaluated by magnetic resonance imaging, was increased by HIFU, most prominently in the ZA. In conclusion, HIFU increased ASC marker expression, accompanied by increased HSP70 and decreased NF-κB expression. Additionally, changes in cilia disassembly and length and expression of adipogenesis were observed. These results suggest that HIFU could be used to increase facial volume by modulating adipogenesis.
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Su, Shengchen, Yanping Wang, Eric M. Lo, Patrick Tamukong, and Hyung L. Kim. "High-intensity focused ultrasound ablation increases lymphocyte infiltration in mouse prostate tumor." Journal of Immunology 210, no. 1_Supplement (May 1, 2023): 245.17. http://dx.doi.org/10.4049/jimmunol.210.supp.245.17.
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Abstract Introduction and Objective: High-Intensity Focused Ultrasound (HIFU) is an FDA-approved procedure for the treatment of localized prostate cancer. HIFU destroys tumor tissue by noninvasively delivering ultrasonic energy, which rapidly heats the targeted tissue. Prostate cancer has few tumor-infiltrating lymphocytes, which are required for antitumor immunity. The objective of this study was to determine if HIFU activates antitumor immunity and increases lymphocyte infiltration into the tumor. Methods: RM1 tumors were grown on the flanks of syngeneic C57BL/6J mice and one tumor was treated with HIFU. Contralateral tumor growth was monitored, and tumors were collected at the end of the study to assess immune cell infiltration. Tumor infiltrating lymphocytes were assess by flow cytometry. Results: When one tumor was treated with HIFU, the growth of the contralateral (untreated) tumor decreased when the contralateral tumor was the same tumor type but not when it was a different tumor type. HIFU increased CD4 +and CD8 +lymphocyte infiltration into the contralateral (untreated) tumor. Depletion studies confirmed that the antitumor immune effect of HIFU is CD4 +and CD8 +lymphocyte dependent. Conclusions: In preclinical models, HIFU generates an antitumor immune response capable of suppressing the growth of mouse prostate tumors. The antitumor immune effect of HIFU is CD4 +and CD8 +lymphocyte dependent. Future studies should investigate mouse models of metastatic prostate cancer, where cytoreductive prostate tumor ablation can be combined with systemic immunotherapies to generate robust antitumor immunity. Homer and Gloria Harvey Family Chair Fund in urologic oncology in honor of Stuart Friedman, M.D.
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Oh, Seyeon, Do-Young Rhee, Sosorburam Batsukh, Kuk Hui Son, and Kyunghee Byun. "High-Intensity Focused Ultrasound Increases Collagen and Elastin Fiber Synthesis by Modulating Caveolin-1 in Aging Skin." Cells 12, no. 18 (September 14, 2023): 2275. http://dx.doi.org/10.3390/cells12182275.
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Caveolin-1 (Cav-1) induces cellular senescence by reducing extracellular signal-regulated kinase (ERK)1/2 phosphorylation and activating p53 via inhibition of mouse double minute 2 homolog (MDM2) and sirtuin 1 (Sirt1), promoting cell cycle arrest and decreasing fibroblast proliferation and collagen synthesis. High-intensity focused ultrasound (HIFU) treatment increases collagen synthesis, rejuvenating skin. Using H2O2-induced senescent fibroblasts and the skin of 12-month-old mice, we tested the hypothesis that HIFU increases collagen production through Cav-1 modulation. HIFU was administered at 0.3, 0.5, or 0.7 J in the LINEAR and DOT modes. In both models, HIFU administration decreased Cav-1 levels, increased ERK1/2 phosphorylation, and decreased the binding of Cav-1 with both MDM2 and Sirt1. HIFU administration decreased p53 activation (acetylated p53) and p21 levels and increased cyclin D1, cyclin-dependent kinase 2, and proliferating cell nuclear antigen levels in both models. HIFU treatment increased collagen and elastin expression, collagen fiber accumulation, and elastin fiber density in aging skin, with 0.5 J in LINEAR mode resulting in the most prominent effects. HIFU treatment increased collagen synthesis to levels similar to those in Cav-1-silenced senescent fibroblasts. Our results suggest that HIFU administration increases dermal collagen and elastin fibers in aging skin via Cav-1 modulation and reduced p53 activity.
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Shaw, C. J., G. R. ter Haar, I. H. Rivens, D. A. Giussani, and C. C. Lees. "Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery." Journal of The Royal Society Interface 11, no. 95 (June 6, 2014): 20140029. http://dx.doi.org/10.1098/rsif.2014.0029.
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High-intensity focused ultrasound (HIFU) is a non-invasive technology, which can be used occlude blood vessels in the body. Both the theory underlying and practical process of blood vessel occlusion are still under development and relatively sparse in vivo experimental and therapeutic data exist. HIFU would however provide an alternative to surgery, particularly in circumstances where serious complications inherent to surgery outweigh the potential benefits. Accordingly, the HIFU technique would be of particular utility for fetal and placental interventions, where open or endoscopic surgery is fraught with difficulty and likelihood of complications including premature delivery. This assumes that HIFU could be shown to safely and effectively occlude blood vessels in utero . To understand these mechanisms more fully, we present a review of relevant cross-specialty literature on the topic of vascular HIFU and suggest an integrative mechanism taking into account clinical, physical and engineering considerations through which HIFU may produce vascular occlusion. This model may aid in the design of HIFU protocols to further develop this area, and might be adapted to provide a non-invasive therapy for conditions in fetal medicine where vascular occlusion is beneficial.
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Du, Zhiyu, Pisong Yan, Qiang Luo, Dan Zhang, and Yu Zhang. "Keratorefractive Effect of High Intensity Focused Ultrasound Keratoplasty on Rabbit Eyes." Journal of Ophthalmology 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/5260531.
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Purpose. To evaluate high intensity focused ultrasound (HIFU) as an innovation and noninvasive technique to correct presbyopia by altering corneal curvature in the rabbit eye.Methods. Eighteen enucleated rabbit eyes were treated with a prototype HIFU keratoplasty. According to the therapy power, these eyes were divided three groups: group 1 (1 W), group 2 (2 W), and group 3 (3 W). The change in corneal power was quantified by a Sirius Scheimpflug camera. Light microscopy (LM) and transmission electron microscopy (TEM) were performed to determine the effect on the corneal stroma.Results. In the treated eyes, the corneal curvature increases from 49.42 ± 0.30 diopters (D) and 48.00 ± 1.95 D before procedure to 51.37 ± 1.11 D and 57.00 ± 1.84 D after HIFU keratoplasty application in groups 1 and 3, respectively. The major axis and minor axis of the focal region got longer when the powers of the HIFU got increased; the difference was statistically significant (p<0.05). LM and TEM showed HIFU-induced shrinkage of corneal stromal collagen with little disturbance to the underlying epithelium.Conclusions. We have preliminarily exploited HIFU to establish a new technique for correcting presbyopia. HIFU keratoplasty will be a good application prospect for treating presbyopia.
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MacDonell, Jacquelyn, Niravkumar Patel, Sebastian Rubino, Goutam Ghoshal, Gregory Fischer, E. Clif Burdette, Roy Hwang, and Julie G. Pilitsis. "Magnetic resonance–guided interstitial high-intensity focused ultrasound for brain tumor ablation." Neurosurgical Focus 44, no. 2 (February 2018): E11. http://dx.doi.org/10.3171/2017.11.focus17613.
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Currently, treatment of brain tumors is limited to resection, chemotherapy, and radiotherapy. Thermal ablation has been recently explored. High-intensity focused ultrasound (HIFU) is being explored as an alternative. Specifically, the authors propose delivering HIFU internally to the tumor with an MRI-guided robotic assistant (MRgRA). The advantage of the authors’ interstitial device over external MRI-guided HIFU (MRgHIFU) is that it allows for conformal, precise ablation and concurrent tissue sampling. The authors describe their workflow for MRgRA HIFU delivery.
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Liu, Li, and Jian Sun. "A Study of Temperature Measurement Technique of High Intensity Focusing Ultrasonic Therapy." Applied Mechanics and Materials 201-202 (October 2012): 521–24. http://dx.doi.org/10.4028/www.scientific.net/amm.201-202.521.
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High intensity focused ultrasound (HIFU) is the fourth brand-new and efficient means to cure tumour acknowledged by the medical field. China is one of countries applying HIFU to clinical oncotherapy earliest in the world. However, a considerable part of HIFU equipments which have been put on the market leave unused because accidental injuries such as ambustion to the body surface, tumour tissue residues in the target section or damages to normal tissues are often caused in HIFU clinical treatment. In the thesis, temperature measurement technique of high-intensity focusing ultrasonic therapy is introduced; features and existing problems of two methods (ultrasound and MRI) which are usually used at home and abroad to guide and monitor HIFU treatment are focally analyzed and illustrated.
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Yao, Yuanzhi, Ke Yang, Yang Cao, Xuan Zhou, Jinshun Xu, Jianxin Liu, Qi Wang, Zhigang Wang, and Dong Wang. "Comparison of the synergistic effect of lipid nanobubbles and SonoVue microbubbles for high intensity focused ultrasound thermal ablation of tumors." PeerJ 4 (February 22, 2016): e1716. http://dx.doi.org/10.7717/peerj.1716.
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Microbubbles (MBs) are considered as an important enhancer for high intensity focused ultrasound (HIFU) treatment of benign or malignant tumors. Recently, different sizes of gas-filled bubbles have been investigated to improve the therapeutic efficiency of HIFU thermal ablation and reduce side effects associated with ultrasound power and irradiation time. However, nanobubbles (NBs) as an ultrasound contrast agent for synergistic therapy of HIFU thermal ablation remain controversial due to their small nano-size in diameter. In this study, phospholipid-shell and gas-core NBs with a narrow size range of 500–600 nm were developed. The synergistic effect of NBs for HIFU thermal ablation was carefully studied both in excised bovine livers and in breast tumor models of rabbits, and made a critical comparison with that of commercial SonoVue microbubbles (SonoVue MBs). In addition, the pathological changes of the targeted area in tumor tissue after HIFU ablation were further investigated. Phosphate buffer saline (PBS) was used as the control. Under the same HIFU parameters, the quantitative echo intensity of B-mode ultrasound image and the volume of coagulative necrosis in lipid NBs groups were significantly higher and larger than that in PBS groups, but could not be demonstrated a difference to that in SonoVue MBs groups bothex vivoandin vivo. These results showed that the synergistic effect of lipid NBs for HIFU thermal ablation were similar with that of SonoVue MBs, and further indicate that lipid NBs could potentially become an enhancer for HIFU thermal ablation of tumors.
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Cheong, Clarissa Wei Shuen, Joy Xin Yi Au, Ming Yann Lim, Ernest Weizhong Fu, Hao Li, and Jereme Yijin Gan. "The efficacy and safety of high-intensity focused ultrasound in the treatment of benign thyroid nodules: A systematic review and meta-analysis from 1990 to 2021." Annals of the Academy of Medicine, Singapore 51, no. 2 (February 23, 2022): 101–8. http://dx.doi.org/10.47102/annals-acadmedsg.2021260.
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Introduction: To date, there have only been 2 systematic reviews, and 1 systematic review and meta-analysis on high-intensity focused ultrasound (HIFU) for benign thyroid nodules. The present systematic review and meta-analysis seeks to evaluate the efficacy and safety of HIFU in the treatment of benign thyroid nodules. Methods: PubMed, Embase and Cochrane databases were searched for relevant studies from 1990 to 2021. Nine studies were included in the systematic review and 6 in the meta-analysis. Pooled volume reduction rates (VRRs) at 3, 6 and 24 months after HIFU were assessed. Results: This systematic review and meta-analysis showed that pooled VRRs at 3, 6, and 24 months after HIFU were 42.14 (95% confidence interval [CI] 28.66–55.62, I2=91%), 53.51 (95% CI 36.78–70.25, I2=97%) and 46.89 (95% CI 18.87–74.92, I2=99%), respectively. There was significant heterogeneity in the pooled VRRs at 3, 6 and 24 months after HIFU. No studies recorded complete disappearance of the nodules. Common side effects included pain, skin changes and oedema. There were no major complications except for transient vocal cord paralysis and voice hoarseness (0.014%) and transient Horner syndrome (0.5%). Conclusion: HIFU may be an effective and safe alternative treatment modality for benign thyroid nodules. Larger clinical trials with longer follow-up are needed to evaluate the effectiveness of HIFU in treating benign thyroid nodules. Keywords: Benign thyroid nodule, HIFU, high-intensity focused ultrasound, meta-analysis, minimally invasive technique, MITT, systematic review
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Medeiros, Enderson, Renata Rezende Naves Oliveira, Fernanda Dorneles De Morais, and Xisto Sena Passos. "Uso de ultrassom focalizado de alta intensidade para o tratamento de melasma." Brazilian Journal of Health Review 6, no. 6 (November 22, 2023): 29224–37. http://dx.doi.org/10.34119/bjhrv6n6-205.
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Objetivo - Descrever o funcionamento da tecnologia ultrassom focalizado de alta intensidade (HIFU) no tratamento do melasma. Métodos – Revisão narrativa centrada na aplicação da tecnologia HIFU no tratamento de melasma. Os critérios de inclusão visaram abordar a etiologia, diagnóstico e tratamento do melasma, bem como a contribuição do HIFU para essa condição. Resultados- O melasma tem causas relacionadas à genética, exposição solar, influência hormonal e inflamação cutânea. Os métodos diagnósticos incluem lâmpada de Wood, dermoscopia, histopatologia e inteligência artificial. Os tratamentos eficazes incluem protetores solares, cremes clareadores e terapias combinadas. A tecnologia HIFU como um procedimento não invasivo, geralmente livre de dor e com rápida recuperação, utiliza ondas sonoras de alta frequência para gerar calor ou ablação nas camadas profundas da pele, poupando a superfície. No contexto do melasma, o HIFU pode seletivamente destruir as células produtoras de melanina na camada superficial da pele, reduzindo a hiperpigmentação. Quatro estudos, incluindo um com cobaias e três com humanos, avaliaram o HIFU como uma opção de tratamento para melasma. Dois deles focaram na segurança do procedimento em humanos, e um explorou resultados em pacientes de fototipos de pele III e IV. Todos estudos apresentaram resultados positivos e promissores. Não foram encontrados protocolos específicos relacionando o uso da tecnologia HIFU para melasma. Conclusão- Embora promissor, a eficácia do HIFU no tratamento do melasma carece de evidências robustas, especialmente em outros fototipos de pele. Pesquisas futuras com amostras mais representativas são necessárias para avaliar a eficácia e segurança desse tratamento.
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Shen, Hua-Ping, Jian-Ping Gong, and Guo-Qing Zuo. "Role of High-Intensity Focused Ultrasound in Treatment of Hepatocellular Carcinoma." American Surgeon 77, no. 11 (November 2011): 1496–501. http://dx.doi.org/10.1177/000313481107701140.
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About 70 per cent of patients with hepatocellular carcinoma are diagnosed at intermediate or advanced stages, and most of them are technically unresectable. As a novel, emerging therapeutic modality, high intensity focused ultrasound (HIFU) has a great potential for tumor treatment. In this review, principle of HIFU technique is introduced, and an overview of clinical applications and limitations of HIFU for HCC treatment, as well as prospects for future development, is provided. Consequently, HIFU has been considered a safe and feasible procedure for HCC treatment.
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Su, Shengchen, Yanping Wang, Eric M. Lo, and Hyung L. Kim. "Abstract 3845: High-intensity focused ultrasound ablation increases tumor specific lymphocytes in prostate cancer." Cancer Research 84, no. 6_Supplement (March 22, 2024): 3845. http://dx.doi.org/10.1158/1538-7445.am2024-3845.
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Abstract The treatment of localized prostate cancer has been revolutionized by High-Intensity Focused Ultrasound (HIFU), an FDA-approved procedure. Thermal HIFU achieves the destruction of tumor tissue through the noninvasive delivery of ultrasonic energy, causing rapid heating of the targeted area. Given that prostate cancer typically exhibits a low presence of tumor-infiltrating lymphocytes crucial for antitumor immunity, this study aimed to investigate whether HIFU has the potential to activate antitumor immunity and enhance lymphocyte infiltration within the tumor. RM1 tumors were implanted on the flanks of syngeneic C57BL/6J mice, with one tumor subjected to HIFU treatment. The growth of the contralateral tumor was monitored, and at the end of the study, tumors were collected to evaluate immune cell infiltration. Blood samples were obtained from patients both before and after prostatectomy or HIFU treatment. Peripheral blood mononuclear cells (PBMCs) were then isolated to analyze the immune cell population. In murine experiments, the application of HIFU to one tumor resulted in a reduction in the growth of the contralateral (untreated) tumor, specifically when the contralateral tumor was of the same type, but not when it was a different tumor type. Notably, HIFU led to an augmented infiltration of CD4+ and CD8+ lymphocytes into the contralateral (untreated) tumor. Depletion studies further affirmed that the antitumor immune response triggered by HIFU relies on CD4+ and CD8+ lymphocytes. In human subjects, HIFU was observed to elevate the CD4+ and CD8+ lymphocyte populations in PBMCs. HIFU induces a potent antitumor immune response that effectively inhibits the progression of murine prostate tumors. This immune response is contingent upon CD4+ and CD8+ lymphocytes. HIFU demonstrates significant promise in activating antitumor immune responses in patients diagnosed with prostate cancer. Subsequent research endeavors should delve into models of metastatic prostate cancer, exploring the potential synergy of cytoreductive prostate tumor ablation with systemic immunotherapies to elicit a robust and comprehensive antitumor immune response. Citation Format: Shengchen Su, Yanping Wang, Eric M. Lo, Hyung L. Kim. High-intensity focused ultrasound ablation increases tumor specific lymphocytes in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3845.
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Bui, Ngoc Thang, Thi My Tien Nguyen, Gebremedhin Yonatan Ataklti, Quoc Cuong Bui, Tran Thanh Nam Dinh, Duc Tri Phan, Sumin Park, Jaeyeop Choi, Thi Thu Ha Vu, and Junghwan Oh. "Design of a High-Power Multilevel Sinusoidal Signal and High-Frequency Excitation Module Based on FPGA for HIFU Systems." Electronics 10, no. 11 (May 29, 2021): 1299. http://dx.doi.org/10.3390/electronics10111299.
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High-intensity focused ultrasound (HIFU) is a noninvasive therapy that uses focused ultrasound to treat a part of the tissue; high temperatures can damage tissues by heat. HIFU has many applications in the field of surgery and aesthetics and is used increasingly in everyday life. In this article, we discuss the mainboard design that controls the HIFU system with the ability to create a multistep sine wave compatible with many different applications. The signal used to trigger the transducer is a sinusoidal signal with a frequency adjustable from 0.1 to 3 MHz. In addition, the power supplied to the HIFU transducer is also controlled easily by the configuration parameters installed in the control circuit board. The proposed control and design method generates a voltage signal that doubles the supply voltage, thereby reducing the current on the MOSFET. The hardware design is optimized for a surface-mounted device-type MOSFET without the need for an external heat sink. In tests, we conducted a harmonious combination of two output signals to activate the same HIFU probe. The results showed that the energy transferred to the HIFU transducer increased by 1.5 times compared to a single channel. This means that the HIFU treatment time is reduced when using this method, with absolutely no changes in the system structure.
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Ikink, Marlijne E., Johanna M. M. van Breugel, Gerald Schubert, Robbert J. Nijenhuis, Lambertus W. Bartels, Chrit T. W. Moonen, and Maurice A. A. J. van den Bosch. "Volumetric MR-Guided High-Intensity Focused Ultrasound with Direct Skin Cooling for the Treatment of Symptomatic Uterine Fibroids: Proof-of-Concept Study." BioMed Research International 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/684250.
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Objective.To prospectively assess the safety and technical feasibility of volumetric magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation with direct skin cooling (DISC) during treatment of uterine fibroids.Methods.In this proof-of-concept study, eight patients were consecutively selected for clinical MR-HIFU ablation of uterine fibroids with the use of an additional DISC device to maintain a constant temperature (T≈20°C) at the interface between the HIFU table top and the skin. Technical feasibility was verified by successful completion of MR-HIFU ablation. Contrast-enhanced T1-weighted MRI was used to measure the treatment effect (nonperfused volume (NPV) ratio). Safety was evaluated by recording of adverse events (AEs) within 30 days’ follow-up.Results.All MR-HIFU treatments were successfully completed in an outpatient setting. The median NPV ratio was 0.56 (IQR [0.27–0.72]). Immediately after treatment, two patients experienced coldness related discomfort which resolved at the same day. No serious (device-related) AEs were reported. Specifically, no skin burns, cold injuries, or subcutaneous edema were observed.Conclusion.This study showed that it is safe and technically feasible to complete a volumetric MR-HIFU ablation with DISC. This technique may reduce the risk of thermal injury to the abdominal wall during MR-HIFU ablation of uterine fibroids. This trial is registered withNTR4189.
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Shee, Kevin, William Pace, Andrew W. Liu, Janet E. Cowan, Samuel L. Washington, Matthew R. Cooperberg, Katsuto Shinohara, Peter Carroll, and Hao Nguyen. "Determining optimal patient selection for high-intensity focused ultrasound (HIFU) for prostate cancer: Results from a single-institution cohort." Journal of Clinical Oncology 43, no. 5_suppl (February 10, 2025): 362. https://doi.org/10.1200/jco.2025.43.5_suppl.362.
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362 Background: High-intensity focused ultrasound (HIFU) uses magnetic resonance imaging (MRI) and transrectal ultrasound to target areas affected by prostate cancer (PCa). HIFU has moderate PCa control outcomes with little impact on sexual or urinary side effects, but there is concern for disease recurrence and need for salvage treatment. Here we share institutional biopsy-proven recurrence and treatment failure outcomes following HIFU and identify clinicodemographic factors associated with adverse outcomes. Methods: All men who underwent robotic HIFU (Focal One) in 2021-2023 at the University of California, San Francisco and underwent 1-year post-procedure MRI-fusion biopsy were included. The primary outcome was treatment failure, defined as salvage treatment or metastases. Secondary outcomes were in-field recurrence, defined as Gleason Grade 2 (≥GG2) in the same region of HIFU treatment, overall recurrence, defined as ≥GG2 diagnosed anywhere in the prostate, and change in urinary and sexual function by International Prostate Symptom Score (IPSS) and Sexual Health Inventory for Men (SHIM) scores, respectively. Cox Proportional Hazards regression models and multivariable logistic regression and were used to estimate associations between clinical characteristics and outcome events. Results: Of 133 men who underwent HIFU, 110 had post-HIFU biopsy follow-up at median (IQR) of 12.5 (12-14) months. 18 (16%) had treatment failure, and median (IQR) time from recurrence to salvage treatment for 16 men was 3.5 (2-5) months. Cox proportional hazard regression showed pre-HIFU PSA to be associated with the risk of treatment failure (HR 1.14; 95% CI 1.05-1.24; p<0.01). Additional modeling comparing clinically relevant PSA groupings (<6, 6-10, and >10) revealed a significant association between treatment failure and PSA >10 (HR 5.35; 95% CI 1.54-18.57; p<0.01), but not PSA 6-10 (HR 1.94; 95% CI 0.53-7.06). In-field and overall recurrence on 1-year biopsy was 42% and 50%, respectively. On logistic regression analysis, pre-HIFU Gleason Grade of 3 or greater (≥GG3) was associated with a higher likelihood of in-field recurrence (OR, 3.11; 95% CI, 1.13-8.56), and both ≥GG3 (OR 3.07; 95% CI 1.04-9.10, p=0.04) and higher PSA (OR 1.20; 95% CI 1.05-1.37; p<0.01) were associated with a higher likelihood of overall recurrence. No significant differences were found for IPSS and SHIM scoring groups before and after HIFU. Conclusions: Treatment failure rate was 16%, and in-field and overall recurrence rates on biopsy one year after HIFU were 42% and 50%, respectively. Higher pre-HIFU PSA was associated with treatment failure and overall recurrence on biopsy, and ≥GG3 was associated with in-field and overall recurrence on biopsy. These findings emphasize the importance of careful patient selection for HIFU, which has potential for modest cancer control with minimal side effects in the appropriate PCa patient.
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Solovov, V. A., and A. A. Tyurin. "Treatment of prostate cancer by high-intensity ultrasound ablation and radical prostatectomy: a comparative analysis of long-term oncological results." Experimental and Сlinical Urology 17, no. 4 (December 25, 2024): 50–55. https://doi.org/10.29188/2222-8543-2024-17-4-50-55.
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Introduction. To compare oncological efficacy of long-term follow-up of high-intensity focused ultrasound ablation (HIFU) and radical prostatectomy (RP) in the treatment of patients with prostate cancer. Materials and methods. A comparative retrospective analysis included the results of treatment of 150 patients who underwent RP with 194 patients who received HIFU therapy in the period from 2008 to 2010 in the Samara Regional Clinical Oncology Center. To compare the oncological efficacy of both treatments, overall survival, cancer-specific survival, and recurrence-free survival were assessed. Biochemical recurrence was diagnosed based on ASTRO/Phoenix criteria. Statistical analysis used a one-dimensional logarithmic rank test, the Kaplan-Meier method. Results. The mean follow-up time in the RP and HIFU groups were 14,5 and 15,2 years, respectively. The 15-year overall, cancer-specific, and disease-free survival rates were 28,3%, 77,7%, 53,7% in the RP group and 48,0%, 79,4%, 69,8% in the HIFU group, respectively. Prognostic factors were PSA level before treatment, Gleason score. The results of HIFU therapy compared with RP demonstrated comparable cancer-specific and disease-free survival rates. Conclusion. HIFU therapy may be an alternative treatment for patients with PCa low and intermediate risk progression according to D'Amico. Patients with high-risk progression should be informed about possible repeat HIFU sessions and/or adjuvant treatment. In long-term follow-up, HIFU therapy compared to RP has shown a higher overall survival with comparable values of cancer-specific and relapse-free survival in the treatment of patients with prostate cancer.
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Vespasiani, G., A. D. Asimakopoulos, E. Finazzi Agrò, and G. Virgili. "High-intensity focused ultrasound and prostate cancer: technology, state of the art and future." Urologia Journal 75, no. 4 (October 2008): 199–206. http://dx.doi.org/10.1177/039156030807500401.
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Background. The potential applications of the high-intensity focused ultrasound (HIFU) as a minimally invasive therapy of the localized prostate cancer explain the growing interest of the urologic community towards this technique. HIFU has been assessed for its role in the treatment of localized prostate cancer in patients who otherwise would not have benefited from surgery, and in local recurrences after radiation failure. Methods. Relevant information on HIFU treatment was identified through a literature search of published studies. Results. High biochemical efficacy, excellent tumor local control and favorable mid- and long-term oncological data with a low morbidity rate have been shown in many series of patients. Conclusions. Although HIFU is a recent and emerging technology, it has been well studied and developed to a point that HIFU will undoubtedly be an effective alternative to radiation therapy.
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Pasticier, Gilles, Sebastien Crouzet, Marc Colombel, Olivier Rouviere, Muriel Rabilloud, Jean-Yves Chapelon, Florence Mege-Lechevallier, Helene Tonoli-Catez, Xavier Martin, and Albert Gelet. "Radical prostatectomy versus high intensity-focused ultrasound for localized prostate cancer: A matched-pair comparison." Journal of Clinical Oncology 33, no. 7_suppl (March 1, 2015): 74. http://dx.doi.org/10.1200/jco.2015.33.7_suppl.74.
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74 Background: Radical prostatectomy is the gold standard treatment for localized prostate cancer. HIFU is a treatment option with promising outcomes. No randomized study is available to compare those techniques. The goal of the study was to evaluate the oncologic outcome of patients treated with HIFU and radical prostatectomy by using a matched pair analysis to compare the 2 groups. Methods: A total of 710 patients treated between 2000 and 2005 were prospectively followed in our institutional database and matched to a 1:1 basis following know prognostic variables: prostate-specific antigen (PSA) level, Gleason score, and clinical stage. After matching, 588 patients (294 in each group) were further analysed. The starts of salvage external beam radiotherapy (S-EBRT) or definitive palliative androgen deprivation therapy (ADT) were primary endpoints. Other endpoints were overall, cancer specific and metastasis free survival rates: The survival rates were calculated with Kaplan-Meier estimate Results: The seven years S-EBRT free survival rate was significantly lower after HIFU than after RP (62% versus 78%, p=0.001). The palliative androgen deprivation free rate at nine years was not significantly different between HIFU and RP (86% versus 87%, p=0.271). At nine years the overall, cancer specific and metastasis free survival rates were similar: 89%, 97%, 94 % and 89%, 97% and 97% for HIFU and RP respectively (p=0.186, 0.312, 0.107). Conclusions: Matched pair comparison of HIFU and RP has shown a higher rate of S-EBRT for HIFU. At 9 years, the rate of patients who need palliative ADT, the overall cancer specific and metastasis free survival rates were not significantly different between HIFU and RP.
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Lemmens, Valery E. P. P., and Olav G. J. M. van Aubel. "High-intensity focussed ultrasound (HIFU) als salvagebehandeling van recidiverend prostaatcarcinoom: stand van zaken wetenschap en praktijk. Een review van systematische reviews." Tijdschrift voor Urologie 10, no. 8 (May 19, 2020): 156–64. http://dx.doi.org/10.1007/s13629-020-00291-x.
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SamenvattingEr verschijnen steeds meer oorspronkelijke studies naar de veiligheid en effectiviteit van HIFU als salvagebehandeling van een lokaal recidief van het prostaatcarcinoom (Pca). Ook verschenen recentelijk meerdere systematische reviews (SR’s) over dit onderwerp. Deze review van SR’s geeft inzicht in de huidige stand van wetenschap en praktijk ten aanzien van salvage-HIFU van een lokaal recidiverend Pca. De meest recente en tevens grootste SR toont bij een lokaal recidief na bestraling geen verschil in overleving tussen HIFU en salvage radicale prostatectomie of salvagebestraling. De morbiditeit na salvage-HIFU was lager dan na een salvage radicale prostatectomie. In verband met de hoge morbiditeit bij een salvage radicale prostatectomie wordt deze zelden uitgevoerd. HIFU als salvagebehandeling kan daarom worden gezien als een veelbelovend alternatief. Dit geldt zeker voor patiëntengroepen bij wie leeftijd, ziektestadium en wens van de patiënt in de richting wijzen van afzien van agressievere therapieën, en bij wie het risico op bijwerkingen en vermindering van de kwaliteit van leven te hoog wordt geacht. De huidige evidence geeft voldoende aanleiding om, in afwachting van studies met hogere bewijskracht, HIFU als salvagebehandeling aan te bieden in plaats van androgeendeprivatietherapie, dan wel niet te behandelen.
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An, Chih Yu, Jia Hao Syu, Ching Shiow Tseng, and Chih-Ju Chang. "An Ultrasound Imaging-Guided Robotic HIFU Ablation Experimental System and Accuracy Evaluations." Applied Bionics and Biomechanics 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/5868695.
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In recent years, noninvasive thermal treatment by using high-intensity focused ultrasound (HIFU) has high potential in tumor treatment. The goal of this research is to develop an ultrasound imaging-guided robotic HIFU ablation system for tumor treatment. The system integrates the technologies of ultrasound image-assisted guidance, robotic positioning control, and HIFU treatment planning. With the assistance of ultrasound image guidance technology, the tumor size and location can be determined from ultrasound images as well as the robotic arm can be controlled to position the HIFU transducer to focus on the target tumor. After the development of the system, several experiments were conducted to measure the positioning accuracy of this system. The results show that the average positioning error is 1.01 mm with a standard deviation 0.34, and HIFU ablation accuracy is 1.32 mm with a standard deviation 0.58, which means this system is confirmed with its possibility and accuracy.
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Zhou, Yufeng. "High-Intensity Focused Ultrasound Treatment for Advanced Pancreatic Cancer." Gastroenterology Research and Practice 2014 (2014): 1–11. http://dx.doi.org/10.1155/2014/205325.
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Pancreatic cancer is under high mortality but has few effective treatment modalities. High-intensity focused ultrasound (HIFU) is becoming an emerging approach of noninvasively ablating solid tumor in clinics. A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success. The principle, mechanism, and clinical outcome of HIFU were introduced first. All 3022 clinical cases of HIFU treatment for the advanced pancreatic cancer alone or in combination with chemotherapy or radiotherapy in 241 published papers were reviewed and summarized for its efficacy, pain relief, clinical benefit rate, survival, Karnofsky performance scale (KPS) score, changes in tumor size, occurrence of echogenicity, serum level, diagnostic assessment of outcome, and associated complications. Immune response induced by HIFU ablation may become an effective way of cancer treatment. Comments for a better outcome and current challenges of HIFU technology are also covered.
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Kim, Jin Il. "Therapeutic effectiveness of high-intensity focused ultrasound (HIFU) ablation in patients with unresectable hepatocellular carcinoma." Journal of Clinical Oncology 42, no. 3_suppl (January 20, 2024): 490. http://dx.doi.org/10.1200/jco.2024.42.3_suppl.490.
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490 Background: High-intensity focused ultrasound (HIFU) ablation is a new therapeutic method for treatment of solid tumor. To determine the efficacy and safety of HIFU, we report our experience for local therapy of primary or metastatic hepatocellular carcinoma (HCC). Methods: From January 2015 to December 2022, forty- eight patients with unresectable HCC underwent single or two therapeutic sessions of HIFU under general anesthesia. Ten patients with liver metastasis from colon cancer and three patients with liver metastasis from stomach cancer were included. We used HIFU, ultrasound-guided extracorporeal system (HIFU Technology Company, Chongqing, China). Thirty-three patients received transarterial embolization before HIFU. Thirteen patients were treated with chemotherapy before HIFU. Technical effectiveness per patient and per masses was assessed according to clinical findings and MR imaging at follow-up. Complications were also recorded. Results: We treated total 78 tumors in 48 patients. The tumor size ranged from 1.3 cm to 12 cm in diameter. Small (< 3 cm), intermediate (3-5 cm) and large tumors (>5 cm) are 44, 24 and 10 patients, respectively. Average procedure time was 4 hours 10 minutes with 68 minutes treatment time. We made the artificial pleural effusion to get treatment field in 25 patients. Mean follow-up period was 52 weeks. For the technical effectiveness per patient as follows: complete ablation with no evidence of recurrence on follow up in 18%, apparent complete ablation of target mass with progression of new lesions on follow up in 29%, recurrence after apparent complete ablation in 26%, and incomplete ablation at 2 week follow up in 27%. Average post-procedure hospital day was 5.4 days. No severe complication except mild right upper quadrant pain was observed after treatment. Conclusions: HIFU is an effective and safe treatment option for local image-guided tumor ablation in patients with unresectable HCC. Although further study is necessary, these results show that HIFU may be helpful in treating unresectable HCC.
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Choi, Yongwhan, Hyounkoo Han, Sangmin Jeon, Hong Yeol Yoon, Hyuncheol Kim, Ick Chan Kwon, and Kwangmeyung Kim. "Deep Tumor Penetration of Doxorubicin-Loaded Glycol Chitosan Nanoparticles Using High-Intensity Focused Ultrasound." Pharmaceutics 12, no. 10 (October 15, 2020): 974. http://dx.doi.org/10.3390/pharmaceutics12100974.
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The dense extracellular matrix (ECM) in heterogeneous tumor tissues can prevent the deep tumor penetration of drug-loaded nanoparticles, resulting in a limited therapeutic efficacy in cancer treatment. Herein, we suggest that the deep tumor penetration of doxorubicin (DOX)-loaded glycol chitosan nanoparticles (CNPs) can be improved using high-intensity focused ultrasound (HIFU) technology. Firstly, we prepared amphiphilic glycol chitosan-5β-cholanic acid conjugates that can self-assemble to form stable nanoparticles with an average of 283.7 ± 5.3 nm. Next, the anticancer drug DOX was simply loaded into the CNPs via a dialysis method. DOX-loaded CNPs (DOX-CNPs) had stable nanoparticle structures with an average size of 265.9 ± 35.5 nm in aqueous condition. In cultured cells, HIFU-treated DOX-CNPs showed rapid drug release and enhanced cellular uptake in A549 cells, resulting in increased cytotoxicity, compared to untreated DOX-CNPs. In ECM-rich A549 tumor-bearing mice, the tumor-targeting efficacy of intravenously injected DOX-CNPs with HIFU treatment was 1.84 times higher than that of untreated DOX-CNPs. Furthermore, the deep tumor penetration of HIFU-treated DOX-CNPs was clearly observed at targeted tumor tissues, due to the destruction of the ECM structure via HIFU treatment. Finally, HIFU-treated DOX-CNPs greatly increased the therapeutic efficacy at ECM-rich A549 tumor-bearing mice, compared to free DOX and untreated DOX-CNPs. This deep penetration of drug-loaded nanoparticles via HIFU treatment is a promising strategy to treat heterogeneous tumors with dense ECM structures.
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Tang, Fei, Qin Zhong, Tingting Ni, Yanping Chen, Yuncong Liu, Jing Wu, Zhiyu Feng, Xiaokai Lu, Shisheng Tan, and Yu Zhang. "Salvage high-intensity focused ultrasound for residual or recurrent cervical cancer after definitive chemoradiotherapy." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): e17524-e17524. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e17524.
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e17524 Background: Approximately 30%-65% of patients have residual disease or subsequent recurrence after completion of chemoradiotherapy (CRT) treatment. The treatment of residual/recurrent cervical cancer in previously irradiated field is challenging and generally associated with a poor prognosis. Local treatments such as salvage surgery and re-irradiation are usually traumatic and have limited efficacy. High intensity focused ultrasound (HIFU) treatment can directly ablate solid tumors without damaging neighboring healthy tissue. However, the HIFU studies for these patients are limited. Over 10 years of experience gained with the management of HIFU in cervical cancer patients with residual disease or recurrence after CRT is reported here. Methods: 153 patients with residual or recurrent cervical cancer in previously irradiated field who received HIFU treatment between 2010 and 2021 were retrospectively analyzed. Adverse effects, survival benefit, and factors affecting prognosis were given particular attention. Results: A total of 36 patients (23.5%) achieved a partial response following HIFU treatment and 107 patients (69.9%) had stable disease. The objective response and disease control rates were 23.5% and 93.5%, respectively. The median progression-free survival (mPFS) and median overall survival (mOS) were 17.0 months and 24.5 months, respectively. Moreover, patients with lesions ≥ 1.40 cm before HIFU treatment and a shrinkage rate ≥ 30% after treatment had a higher mPFS and mOS, and patients with lesions ≤ 1.00 cm after HIFU treatment had a higher mPFS (P < 0.05). All of the treatment-related adverse events were limited to minor complications, which included skin burns, abdominal pain and vaginal discharge. Conclusions: Many cervical cancer patients have few efficacious treatment options following chemoradiotherapy. This study demonstrates that HIFU treatment is likely a preferred option that can safely improve the local control rate and extend survival.
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Shaw, Caroline J., Ian Rivens, John Civale, Kimberley J. Botting, Beth J. Allison, Kirsty L. Brain, Y. Niu, Gail ter Haar, Dino A. Giussani, and Christoph C. Lees. "Maternal and fetal cardiometabolic recovery following ultrasound-guided high-intensity focused ultrasound placental vascular occlusion." Journal of The Royal Society Interface 16, no. 154 (May 2019): 20190013. http://dx.doi.org/10.1098/rsif.2019.0013.
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High-intensity focused ultrasound (HIFU) is a non-invasive method of selective placental vascular occlusion, providing a potential therapy for conditions such as twin–twin transfusion syndrome. In order to translate this technique into human studies, evidence of prolonged fetal recovery and maintenance of a healthy fetal physiology following exposure to HIFU is essential. At 116 ± 2 days gestation, 12 pregnant ewes were assigned to control ( n = 6) or HIFU vascular occlusion ( n = 6) groups and anaesthetized. Placental blood vessels were identified using colour Doppler ultrasound; HIFU-mediated vascular occlusion was performed through intact maternal skin (1.66 MHz, 5 s duration, in situ I SPTA 1.8–3.9 kW cm −2 ). Unidentifiable colour Doppler signals in targeted vessels following HIFU exposure denoted successful occlusion. Ewes and fetuses were then surgically instrumented with vascular catheters and transonic flow probes and recovered from anaesthesia. A custom-made wireless data acquisition system, which records continuous maternal and fetal cardiovascular data, and daily blood sampling were used to assess wellbeing for 20 days, followed by post-mortem examination. Based on a comparison of pre- and post-treatment colour Doppler imaging, 100% (36/36) of placental vessels were occluded following HIFU, and occlusion persisted for 20 days. All fetuses survived. No differences in maternal or fetal blood pressure, heart rate, heart rate variability, metabolic status or oxygenation were observed between treatment groups. There was evidence of normal fetal maturation and no evidence of chronic fetal stress. There were no maternal injuries and no placental vascular haemorrhage. There was both a uterine and fetal burn, which did not result in any obstetric or fetal complications. This study demonstrates normal long-term recovery of fetal sheep from exposure to HIFU-mediated placental vascular occlusion and underlines the potential of HIFU as a potential non-invasive therapy in human pregnancy.