Article

High-intensity focused ultrasound (HIFU) in patients with solid malignancies: evaluation of feasibility, local tumour response and clinical results

Interventional Radiology Unit of European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
La radiologia medica (Impact Factor: 1.37). 02/2011; 116(5):734-48. DOI: 10.1007/s11547-011-0634-4
Source: PubMed

ABSTRACT The purpose of this study was to evaluate the safety and efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for ablation of solid tumours without damaging the surrounding structures.
A specific written informed consent was obtained from every patient before treatment. From September 2008 to April 2009, 22 patients with 29 lesions were treated: nine patients with liver and/or soft-tissue metastases from colorectal carcinoma (CRC), six with pancreatic solid lesions, three with liver and/or bone metastases from breast cancer, one with osteosarcoma, one with muscle metastasis from lung cancer, one with iliac metastasis from multiple myeloma and one with abdominal liposarcoma. The mean diameter of tumours was 4.2 cm. All patients were evaluated 1 day, 1 month and 3 months after HIFU treatment by multidetector computed tomography (MDCT), positron-emission tomography (PET)-CT and clinical evaluation. The treatment time and adverse events were recorded.
All patients had one treatment. Average treatment and sonication times were, respectively, 162.7 and 37.4 min. PET-CT or/and MDCT showed complete response in 11/13 liver metastases; all bone, soft-tissue and pancreatic lesions were palliated in symptoms, with complete response to PET-CT, MDCT or magnetic resonance imaging (MRI); the liposarcoma was almost completely ablated at MRI. Local oedema was observed in three patients. No other side effects were observed. All patients were discharged 1-3 days after treatment.
According to our preliminary experience in a small number of patients, we conclude that HIFU ablation is a safe and feasible technique for locoregional treatment and is effective in pain control.

0 Followers
 · 
201 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Focused ultrasound (FUS) is a modality with rapidly expanding applications across the field of medicine. Treatment of bone lesions with FUS including both benign and malignant tumours has been an active area of investigation. Recently, as a result of a successful phase III trial, magnetic resonance-guided FUS is now a standardised option for treatment of painful bone metastases. This report reviews the clinical applications amenable to treatment with FUS and provides background on FUS and image guidance techniques, results of clinical studies, and future directions. A comprehensive literature search and review of abstracts presented at the recently completed fourth International Focused Ultrasound Symposium was performed. Case reports and older publications revisited in more recent studies were excluded. For clinical studies that extend beyond bone tumours, only the data regarding bone tumours are presented. Fifteen studies assessing the use of focused ultrasound in treatment of primary benign bone tumours, primary malignant tumours, and metastastic tumours meeting the search criteria were identified. For these clinical studies the responders group varied within 91-100%, 85-87% and 64-94%, respectively. Major complications were reported in the ranges 0%, 0-28% and 0-4% for primary benign, malignant and metastatic tumours, respectively. Image-guided FUS is both safe and effective in the treatment of primary and secondary tumours. Additional phase III trials are warranted to more fully define the role of FUS in treatment of both benign and malignant bone tumours.
    International Journal of Hyperthermia 03/2015; DOI:10.3109/02656736.2015.1006690 · 2.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: High-intensity focused ultrasound (HIFU) is an innovative, noninvasive, extracorporeal technique that induces coagulative necrosis of tumor tissue by thermal effects and cavitation. In published studies, HIFU has usually been used as an alternative to surgery, with or without other treatment modalities, to achieve curative tumor ablation or palliative tumor cytoreduction. Neoadjuvant HIFU treatment for primary inoperable malignant fibrous histiocytoma has never been reported, and neoadjuvant radiotherapy, chemoradiation, or chemotherapy is routinely under consideration. This is the first case in which HIFU ablation contributed as a neoadjuvant therapy to facilitate function-sparing resection, not as a replacement for surgery. It suggests that HIFU ablation may have some unique major advantages for treating inoperable huge soft-tissue sarcomas as a neoadjuvant local treatment modality, especially for patients for whom neoadjuvant chemotherapy or radiotherapy is not indicated.
    Journal of Medical Ultrasonics 10/2012; 39(4):259-264. DOI:10.1007/s10396-012-0375-6 · 0.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: As the treatment options for colorectal liver metastases continue to expand, ablation has been integrated into the multidisciplinary management of this disease. Following the success of earlier modalities such as cryotherapy and radiofrequency ablation, more options have emerged, including use of microwaves, irreversible electroporation, laser therapy, and focused ultrasound. Indications have also widened from unresectable disease to include treatment with curative intent, often in combination with surgery and systemic and regional therapies. Randomized evidence is relatively lacking overall, but there are ample retrospective data to support the use of ablation. Good patient selection is important, and the treating clinician must understand the strengths and weaknesses of each modality to ensure safety and maximize efficacy. In this review, we discuss the principles of the more commonly used ablation techniques and summarize the evidence, with emphasis on recent data.
    Current Colorectal Cancer Reports 06/2014; 10(2):239-248. DOI:10.1007/s11888-014-0214-9