Focused Ultrasound Therapy

Outside Approval SquareFocused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with liver tumors. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) enabling liver tumors to be treated without surgery.

The primary options for treatment of liver tumors include surgery, chemotherapy, radiotherapy, localized destruction of the tumor tissue (via radiofrequency ablation, alcohol injection, cryosurgery, or laser photocoagulation), or combination of two or more of these options. The long-term solution for primary liver cancer is often liver transplantation.

Clinical Trials Square

For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost.

Advantages:

  • Focused ultrasound is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
  • Focused ultrasound can reach the desired target without damaging surrounding tissue.
  • Focused ultrasound can enhance the chemotherapy dose for the target, with less impact to the rest of the patient.
  • It can be repeated, if necessary.

Clinical Trials

There is a clinical trial for liver cancer and metastatic liver tumors in pediatric patients and young adults.

A second study involves enhancing drug delivery due to heating the thermosensitive lysosome containing chemotherapy with focused ultrasound.

The Foundation’s Liver and Pancreas Program is working with the medical community to accelerate the research and development of focused ultrasound to treat these deadly cancers.

For a full list of clinical trials, please click here.

See here for a list of treatment sites
See here for a list of laboratory research sites

Regulatory Approval and Reimbursement

A focused ultrasound system has been approved in China, Russia, Europe, and Korea for treatment of liver cancer.

To the best of our knowledge, the use of focused ultrasound to treat liver cancer is not yet widely reimbursed by medical insurance.

Notable Papers

Luo Y, Jiang Y. Comparison of Efficiency of TACE plus HIFU and TACE alone on Patients with Primary Liver Cancer. J Coll Physicians Surg Pak. 2019 May;29(5):414-417. doi: 10.29271/jcpsp.2019.05.414.

Li S, Shi S, Li A, Liu H, Cai L. Diffusion-Weighted Magnetic Resonance Imaging in Assessment of Primary Liver Cancer after HIFU Treatment. J Coll Physicians Surg Pak. 2019 Apr;29(4):305-308. doi: 10.29271/jcpsp.2019.04.305.

Dupre A, Melodelima D, Perol D, Chen Y, Vincenot J, Chapelon JY, Rivoire M. Evaluation of the Feasibility, Safety, and Accuracy of an Intraoperative High-intensity Focused Ultrasound Device for Treating Liver Metastases. J Vis Exp. 2019 Jan 9;(143). doi: 10.3791/57964.

Huang L, Zhou K, Zhang J, Ma Y, Yang W, Ran L, Jin C, Dimitrov DD, Zhu H. Efficacy and safety of high-intensity focused ultrasound ablationfor hepatocellular carcinoma by changing the acoustic environment: microbubble contrast agent (SonoVue) and transcatheter arterial chemoembolization. Int J Hyperthermia. 2019 Jan 22:1-9. doi: 10.1080/02656736.2018.1558290.

Gray MD, Lyon PC, Mannaris C, Folkes LK, Stratford M, Campo L, Chung DYF, Scott S, Anderson M, Goldin R, Carlisle R, Wu F, Middleton MR, Gleeson FV, Coussios CC. Focused Ultrasound Hyperthermia for Targeted Drug Release from Thermosensitive Liposomes: Results from a Phase I Trial. Radiology. 2019 Jan 15:181445. doi: 10.1148/radiol.2018181445.

Wang L, Li L, Wang X, Zhao D, Shan G, Wu X, Wang M, Liu J, Li X. Comparison of Combination Stereotactic Body Radiotherapy Plus High-Intensity Focused Ultrasound Ablation Versus Stereotactic Body Radiotherapy Alone for Massive Hepatocellular Carcinoma. Med Sci Monit. 2018 Nov 18;24:8298-8305. doi: 10.12659/MSM.910735.

Ma B, Liu X, Yu Z. The effect of high intensity focused ultrasound on the treatment of liver cancer and patients' immunity. Cancer Biomark. 2018 Oct 9. doi: 10.3233/CBM-181822. 

Wang L, Li L, Wang X, Zhao D, Shan G, Wu X, Wang M, Liu J, Li X. Comparison of Combination Stereotactic Body Radiotherapy Plus High-Intensity Focused Ultrasound Ablation Versus Stereotactic Body Radiotherapy Alone for Massive Hepatocellular Carcinoma. Med Sci Monit. 2018 Nov 18;24:8298-8305. doi: 10.12659/MSM.910735.

Lyon PC, Gray MD, Mannaris C, Folkes LK, Stratford M, Campo L, Chung DYF, Scott S, Anderson M, Goldin R, Carlisle R, Wu F, Middleton MR, Gleeson FV, Coussios CC. Safety and feasibility of ultrasound-triggered targeted drug delivery of doxorubicin from thermosensitive liposomes in liver tumours (TARDOX): a single-centre, open-label, phase 1 trial. Lancet Oncol. 2018 Aug;19(8):1027-1039. doi: 10.1016/S1470-2045(18)30332-2. Epub 2018 Jul 11.

Paul C. Lyon, Lucy F. Griffiths, Jenni Lee, Daniel Chung, Robert Carlisle, Feng Wu, Mark R. Middleton Email author, Fergus V. Gleeson and Constantin C. Coussios. Clinical trial protocol for TARDOX: a phase I study to investigate the feasibility of targeted release of lyso-thermosensitive liposomal doxorubicin (ThermoDox®) using focused ultrasound in patients with liver tumours. Journal of Therapeutic Ultrasound. 20175:28

Zhai YP1, Wang Y. Effect of the combination treatment of high-intensity focused ultrasound and cryocare knife in advanced liver cancer. J BUON. 2017 Mar-Apr;22(2):495-499.

Wu L, Zhang YS, Ye ML, Shen F, Liu W, Hu HS, Li SW, Wu HW, Chen QH, Zhou WB. Overexpression and correlation of HIF-2α, VEGFA and EphA2 in residual hepatocellular carcinoma following high-intensity focused ultrasound treatment: Implications for tumor recurrence and progression. Exp Ther Med. 2017 Jun;13(6):3529-3534. doi: 10.3892/etm.2017.4428. Epub 2017 May 4.

Click here for additional references from PubMed.

Video courtesy of Insightec.

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