Please wait a minute...
Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front Med Chin    2010, Vol. 4 Issue (3) : 294-302    https://doi.org/10.1007/s11684-010-0092-8
REVIEW
High-intensity focused ultrasound tumor ablation: Review of ten years of clinical experience
Lian ZHANG1, Zhi-Biao WANG1,2,3()
1. Clinical Center for Tumor Therapy of 2nd Hospital of Chongqing University of Medical Sciences, Chongqing 400010, China; 2. State Key Laboratory, Department of Biomedical Engineering, Chongqing University of Medical Sciences, Chongqing 400037, China; 3. National Engineering and Research Center for Ultrasound Medicine, Chongqing 401121, China
 Download: PDF(390 KB)   HTML
 Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks
Abstract

High-intensity focused ultrasound (HIFU) is a technique to destroy tissue at depth within the body, selectively and without harming overlying and adjacent structures within the path of the beam because the ultrasonic intensity at the beam focus is much higher than that outside of the focus. Diagnostic ultrasound is the first imaging modality used for guiding HIFU ablation. In 1997, a patient with osteosarcoma was first successfully treated with ultrasound imaging-guided HIFU in Chongqing, China. Over the last decade, thousands of patients with uterine fibroids, liver cancer, breast cancer, pancreatic cancer, bone tumors, and renal cancer have been treated with ultrasound imaging-guided HIFU. Based on several research groups’ reports, as well as our ten-year clinical experience, we conclude that this technique is safe and effective in treating human solid tumors. HIFU is a promising technique. Most importantly, HIFU offers patients another alternative when those patients have no other treatment available.

Keywords high-intensity focused ultrasound (HIFU)      ultrasound imaging-guided HIFU (USgHIFU)      magnetic resonance imaging-guided HIFU (MRgHIFU)     
Corresponding Author(s): WANG Zhi-Biao,Email:zhibiaowang@haifu.com.cn   
Issue Date: 05 September 2010
 Cite this article:   
Lian ZHANG,Zhi-Biao WANG. High-intensity focused ultrasound tumor ablation: Review of ten years of clinical experience[J]. Front Med Chin, 2010, 4(3): 294-302.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-010-0092-8
https://academic.hep.com.cn/fmd/EN/Y2010/V4/I3/294
Fig.1  Model JC focused ultrasound tumor therapeutic system manufactured by Chongqing Haifu (HIFU) Technology Co., Ltd., Chongqing, China
Fig.2  PET-CT from a patient with iliac metastasis from multiple myeloma. (a) Pretreatment PET-CT image showing positive of the tumor; (b) one month posttreatment, PET-CT image showing negative of the tumor. Courtesy of Dr. Franco Orsi from the European Institute of Oncology, Milan, Italy. PET: positron emission tomography; CT: computed tomography.
Fig.3  Real-time ultrasonography and contrast-enhanced MR images from a patient with pancreatic cancer. (a) Real-time ultrasound image before HIFU treatment reveals a hypoechoic lesion; (b) real-time ultrasound image during HIFU treatment shows massive gray-scale change in the tumor; (c) pretreatment contrast-enhanced MRI shows perfusion in the tumor (arrow); (d) one month after HIFU treatment, contrast-enhanced MRI shows the treated tumor with no enhancement (arrow). MRI: magnetic resonance imaging; HIFU: high-intensity focused ultrasound.
Fig.4  Contrast-agent-enhanced MRI from a patient with uterine fibroids. (a) Pretreatment image showing the fibroid with enhancement (arrow). (b) One month posttreatment, MRI showing the fibroid shrunk with no enhancement (arrow). MRI: magnetic resonance imaging.
1 Lynn J G, Zwemer R L, Chick A J, Miller A E. A new method for the generation and use of focused ultrasound in experiment biology. J Gen Physiol , 1942, 26(2): 179–193
doi: 10.1085/jgp.26.2.179
2 Wang Z B, Wu F, Wang Z L, Zhang Z, Zou J Z, Liu C, Liu Y G, Cheng G, Du Y H, He Z C, Gu M L, Wang Z G, Feng R. Targeted damage effects of high intensity focused ultrasound (HIFU) on liver tissues of Guizhou Province miniswine. Ultrason Sonochem , 1997, 4(2): 181–182
doi: 10.1016/S1350-4177(97)00028-X
3 Hynynen K, Pomeroy O, Smith D N, Huber P E, McDannold N J, Kettenbach J, Baum J, Singer S, Jolesz F A. MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast: a feasibility study. Radiology , 2001, 219(1): 176–185
4 Wu F, Wang Z B, Zhu H, Chen W Z, Zou J Z, Bai J, Li K Q, Jin C B, Xie F L, Su H B. Feasibility of US-guided high-intensity focused ultrasound treatment in patients with advanced pancreatic cancer: initial experience. Radiology , 2005, 236(3): 1034–1040
doi: 10.1148/radiol.2362041105
5 Wu F, Wang Z B, Chen W Z, Wang W, Gui Y, Zhang M, Zheng G, Zhou Y, Xu G, Li M, Zhang C, Ye H, Feng R. Extracorporeal high intensity focused ultrasound ablation in the treatment of 1038 patients with solid carcinomas in China: an overview. Ultrason Sonochem , 2004, 11(3-4): 149–154
doi: 10.1016/j.ultsonch.2004.01.011
6 Zhang L, Chen W Z, Liu Y J, Hu X, Zhou K, Chen L, Peng S, Zhu H, Zou H L, Bai J, Wang Z B. Feasibility of magnetic resonance imaging-guided high intensity focused ultrasound therapy for ablating uterine fibroids in patients with bowel lies anterior to uterus. Eur J Radiol , 2010, 73(2): 396–403
doi: 10.1016/j.ejrad.2008.11.002
7 Finn H A, Simon M A. Limb-salvage surgery in the treatment of osteosarcoma in skeletally immature individuals. Clin Orthop Relat Res , 1991, 262(262): 108–118
8 Rimner A, Brennan M F, Zhang Z, Singer S, Alektiar K M. Influence of compartmental involvement on the patterns of morbidity in soft tissue sarcoma of the thigh. Cancer , 2009, 115(1): 149–157
doi: 10.1002/cncr.23975
9 Mittermayer F, Krepler P, Dominkus M, Schwameis E, Sluga M, Heinzl H, Kotz R. Long-term followup of uncemented tumor endoprostheses for the lower extremity. Clin Orthop Relat Res , 2001, 388(388): 167–177
doi: 10.1097/00003086-200107000-00024
10 Mroz T E, Joyce M J, Steinmetz M P, Lieberman I H, Wang J C. Musculoskeletal allograft risks and recalls in the United States. J Am Acad Orthop Surg , 2008, 16(10): 559–565
11 Eagan M J, McAllister D R. Biology of allograft incorporation. Clin Sports Med , 2009, 28(2): 203–214 , vii
doi: 10.1016/j.csm.2008.10.009
12 Wu F, Chen W Z, Bai J, Zou J Z, Wang Z L, Zhu H, Wang Z B. Pathological changes in human malignant carcinoma treated with high-intensity focused ultrasound. Ultrasound Med Biol , 2001, 27(8): 1099–1106
doi: 10.1016/S0301-5629(01)00389-1
13 Chen W, Wang Z, Wu F, Zhu H, Zou J, Bai J, Li K, Xie F. High intensity focused ultrasound in the treatment of primary malignant bone tumor. Zhonghua Zhong Liu Za Zhi , 2002, 24(6): 612–615 (in Chinese)
14 Chen W, Zhou K. High-intensity focused ultrasound ablation: a new strategy to manage primary bone tumors. Curr Opin Orthop , 2006, 16(6): 494–500
doi: 10.1097/01.bco.0000183682.00083.a1
16 Wu F, Wang Z B, Chen W Z, Zou J Z, Bai J, Zhu H, Li K Q, Xie F L, Jin C B, Su H B, Gao G W. Extracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience. Ultrasound Med Biol , 2004, 30(2): 245–260
doi: 10.1016/j.ultrasmedbio.2003.10.010
17 Chen W, Zhu H, Zhang L, Li K, Su H, Jin C, Zhou K, Bai J, Wu F, Wang Z. Primary bone malignancy: Effective treatment with high-intensity focused ultrasound ablation. Radiology , 2010, 255(3): 968–978
doi: 10.1148/radiol.10090374
18 Wenzhi C, Rhee S, Wei W, Bai L, Zhou J, Hui Z, Wang Z, Wu F, Li K, Zhou K. Comparison of clinical outcome of osteosarcomas after treatment of surgery and HIFU. In: Proceedings of the 6th International Symposium on Therapeutic Ultrasound , 2006
19 Wu F, Wang Z, Chen W. Pathological study of extracorporeally ablated hepatocellular carcinoma with high-intensity focused ultrasound. Zhonghua Zhong Liu Za Zhi , 2001, 23(3): 237–239 (in Chinese)
20 Wu F, Wang Z B, Chen W Z, Zou J Z, Bai J, Zhu H, Li K Q, Jin C B, Xie F L, Su H B. Advanced hepatocellular carcinoma: treatment with high-intensity focused ultrasound ablation combined with transcatheter arterial embolization. Radiology , 2005, 235(2): 659–667
doi: 10.1148/radiol.2352030916
21 Li Y Y, Sha W H, Zhou Y J, Nie Y Q. Short and long term efficacy of high intensity focused ultrasound therapy for advanced hepatocellular carcinoma. J Gastroenterol Hepatol , 2007, 22(12): 2148–2154
doi: 10.1111/j.1440-1746.2006.04719.x
22 Illing R O, Kennedy J E, Wu F, ter Haar G R, Protheroe A S, Friend P J, Gleeson F V, Cranston D W, Phillips R R, Middleton M R. The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population. Br J Cancer , 2005, 93(8): 890–895
doi: 10.1038/sj.bjc.6602803
23 Zhang L, Zhu H, Jin C, Zhou K, Li K, Su H, Chen W, Bai J, Wang Z. High-intensity focused ultrasound (HIFU): effective and safe therapy for hepatocellular carcinoma adjacent to major hepatic veins. Eur Radiol , 2009, 19(2): 437–445
doi: 10.1007/s00330-008-1137-0
24 Orsi F, Zhang L, Arnone P, Bonomo G, Vigna P D, Monfardini L, Zhou K, Chen W Z, Wang Z B, Veronesi U. High intensity focused ultrasound (HIFU) ablation: Effective and safe therapy for solid tumors at difficult locations. AJR Am J Roentgenol , (in press)
26 Wang X, Sun J. High-intensity focused ultrasound in patients with late-stage pancreatic carcinoma. Chin Med J (Engl) , 2002, 115(9): 1332–1335
27 Wu F, Wang Z B, Cao Y D, Chen W Z, Bai J, Zou J Z, Zhu H. A randomised clinical trial of high-intensity focused ultrasound ablation for the treatment of patients with localised breast cancer. Br J Cancer , 2003, 89(12): 2227–2233
doi: 10.1038/sj.bjc.6601411
28 Wu F, Wang Z B, Cao Y D, Chen W Z, Zou J Z, Bai J, Zhu H, Li K Q, Jin C B, Xie F L, Su H B, Gao G W. Changes in biologic characteristics of breast cancer treated with high-intensity focused ultrasound. Ultrasound Med Biol , 2003, 29(10): 1487–1492
doi: 10.1016/S0301-5629(03)01034-2
29 Wu F, Wang Z B, Cao Y D, Xu Z L, Zhou Q, Zhu H, Chen W Z. Heat fixation of cancer cells ablated with high-intensity-focused ultrasound in patients with breast cancer. Am J Surg , 2006, 192(2): 179–184
doi: 10.1016/j.amjsurg.2006.03.014
30 Wu F, Wang Z B, Zhu H, Chen W Z, Zou J Z, Bai J, Li K Q, Jin C B, Xie F L, Su H B. Extracorporeal high intensity focused ultrasound treatment for patients with breast cancer. Breast Cancer Res Treat , 2005, 92(1): 51–60
doi: 10.1007/s10549-004-5778-7
31 Wu F, Wang Z B, Chen W Z, Bai J, Zhu H, Qiao T Y. Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy. J Urol , 2003, 170(6 Pt 1): 2237–2240
doi: 10.1097/01.ju.0000097123.34790.70
32 Buttram V C Jr, Reiter R C. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril , 1981, 36(4): 433–445
33 Nishiyama S, Saito M, Sato K, Kurishita M, Itasaka T, Shioda K. High recurrence rate of uterine fibroids on transvaginal ultrasound after abdominal myomectomy in Japanese women. Gynecol Obstet Invest , 2006, 61(3): 155–159
doi: 10.1159/000090628
34 M?kinen J, Johansson J, Tomás C, Tomás E, Heinonen P K, Laatikainen T, Kauko M, Heikkinen A M, Sj?berg J. Morbidity of 10 110 hysterectomies by type of approach. Hum Reprod , 2001, 16(7): 1473–1478
doi: 10.1093/humrep/16.7.1473
35 Wang W, Liu W Y, Zhou J M, Xu J M, Gai L H, Huang C J. High-intensity focused ultrasound treatment for symptomatic uterine fibroids: Preliminary results. Zhonghua Chao Sheng Ying Xiang Xue Za Zhi , 2002, 11(3): 161–163 (in Chinese)
36 He H, Lu L, Zhou Y, Nie Y. Clinical study of curing uterine leiomyoma with high intensity focused ultrasound. Zhongguo Xian Dai Yi Xue Za Zhi , 2004, 14(19): 9 (in Chinese)
37 Wang Y, Wang W, Wang L, Wang J, Tang J. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results. Eur J Radiol , 2010Jan28.
doi:10.1016/j.ejrad.2009.12.034
doi: 10.1016/j.ejrad.2009.12.034
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed