Topic
High-intensity focused ultrasound
About: High-intensity focused ultrasound is a research topic. Over the lifetime, 2493 publications have been published within this topic receiving 52529 citations.
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TL;DR: For decades high-intensity focused ultrasound has promised to deliver the ultimate objective — truly non-invasive tumour ablation, but only now, with recent improvements in imaging, has this objective finally emerged as a real clinical possibility.
Abstract: Traditionally, surgery has been the only cure for many solid tumours. Technological advances have catalysed a shift from open surgery towards less invasive techniques. Laparoscopic surgery and minimally invasive techniques continue to evolve, but for decades high-intensity focused ultrasound has promised to deliver the ultimate objective - truly non-invasive tumour ablation. Only now, however, with recent improvements in imaging, has this objective finally emerged as a real clinical possibility.
1,133 citations
TL;DR: The principle of operation of high intensity focused ultrasound, a treatment modality enabling non-invasive tissue heating and ablation for numerous applications, and numerous extra-corporeal, transrectal and interstitial devices have been described here to optimise application-specific treatment delivery.
Abstract: High intensity focused ultrasound (HIFU) is gaining rapid clinical acceptance as a treatment modality enabling non-invasive tissue heating and ablation for numerous applications. HIFU treatments are usually carried out in a single session, often as a day case procedure, with the patient either fully conscious, lightly sedated or under light general anaesthesia. A major advantage of HIFU over other thermal ablation techniques is that there is no necessity for the transcutaneous insertion of probes into the target tissue. The high powered focused beams employed are generated from sources placed either outside the body (for treatment of tumours of the liver, kidney, breast, uterus, pancreas and bone) or in the rectum (for treatment of the prostate), and are designed to enable rapid heating of a target tissue volume, while leaving tissue in the ultrasound propagation path relatively unaffected. Given the wide-ranging applicability of HIFU, numerous extra-corporeal, transrectal and interstitial devices have been designed to optimise application-specific treatment delivery. Their principle of operation is described here, alongside an overview of the physical mechanisms governing HIFU propagation and HIFU-induced heating. Present methods of characterising HIFU fields and of quantifying HIFU exposure and its associated effects are also addressed.
610 citations
TL;DR: Recent technological development suggests that HIFU is likely to play a significant role in future surgical practice, according to a literature review of recent advances made in the field.
Abstract: For 50 years, high intensity focused ultrasound (HIFU) has been a subject of interest for medical research. HIFU causes selective tissue necrosis in a very well defined volume, at a variable distance from the transducer, through heating or cavitation. Over the past decade, the use of HIFU has been investigated in many clinical settings. This literature review aims to summarize recent advances made in the field. A Medline-based literature search (1965-2002) was conducted using the keywords "HIFU" and "high intensity focused ultrasound". Additional literature was obtained from original papers and published meeting abstracts. The most abundant clinical trial data comes from studies investigating its use in the treatment of prostatic disease, although early research looked at applications in neurosurgery. More recently horizons have been broadened, and the potential of HIFU as a non-invasive surgical tool has been demonstrated in many settings including the treatment of tumours of the liver, kidney, breast, bone, uterus and pancreas, as well as conduction defects in the heart, for surgical haemostasis, and the relief of chronic pain of malignant origin. Further clinical evaluation will follow, but recent technological development suggests that HIFU is likely to play a significant role in future surgical practice.
605 citations
01 Jan 2003
TL;DR: High intensity focused ultrasound (HIFU) has been widely used for non-invasive, targeted treatment of cancer in many clinical settings as mentioned in this paper. But the potential of HIFU as a noninvasive surgical tool has not yet been explored.
Abstract: For 50 years, high intensity focused ultrasound (HIFU) has been a subject of interest for medical research. HIFU causes selective tissue necrosis in a very well defined volume, at a variable distance from the transducer, through heating or cavitation. Over the past decade, the use of HIFU has been investigated in many clinical settings. This literature review aims to summarize recent advances made in the field. A Medline-based literature search (1965-2002) was conducted using the keywords ''HIFU'' and ''high intensity focused ultrasound''. Additional literature was obtained from original papers and published meeting abstracts. The most abundant clinical trial data comes from studies investigating its use in the treatment of prostatic disease, although early research looked at applications in neurosurgery. More recently horizons have been broadened, and the potential of HIFU as a non-invasive surgical tool has been demonstrated in many settings including the treatment of tumours of the liver, kidney, breast, bone, uterus and pancreas, as well as conduction defects in the heart, for surgical haemostasis, and the relief of chronic pain of malignant origin. Further clinical evaluation will follow, but recent technological development suggests that HIFU is likely to play a significant role in future surgical practice. The quest continues for a reliable and minimally-invasive alternative to open surgery. The endoscopic revolution is well underway and there is much research activity in other fields such as laser, radiofrequency, cryo-, thermo- and brachy-therapies. Lithotripsy is now an established treat- ment for stone disease, but currently, the only non-invasive modalities in mainstream use for cancer treatment are chemotherapy and radiotherapy, both of which carry significant side-effect profiles. High intensity focused ultrasound (HIFU) has the potential to provide the clinician with another truly non- invasive, targeted treatment option. Its scope is not, however, limited to the direct treatment of cancers. It may also be used in a palliative setting for relief of chronic pain of malignant origin, for haemostasis, or even for the treatment of cardiac conduction or congenital anomalies.
587 citations
TL;DR: Therapeutic applications of ultrasound predate its use in imaging, but useful therapeutic effects are now being demonstrated clinically, the mechanisms by which they occur are often not well understood.
Abstract: Therapeutic applications of ultrasound predate its use in imaging. A range of biological effects can be induced by ultrasound, depending on the exposure levels used. At low levels, beneficial, reversible cellular effects may be produced, whereas at high intensities instantaneous cell death is sought. Therapy ultrasound can therefore be broadly divided into "low power" and "high power" applications. The "low power" group includes physiotherapy, fracture repair, sonophoresis, sonoporation and gene therapy, whereas the most common use of "high power" ultrasound in medicine is probably now high intensity focused ultrasound. Therapeutic effect through the intensity spectrum is obtained by both thermal and non-thermal interaction mechanisms. At low intensities, acoustic streaming is likely to be significant, but at higher levels, heating and acoustic cavitation will predominate. While useful therapeutic effects are now being demonstrated clinically, the mechanisms by which they occur are often not well understood.
558 citations