Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with kidney tumors. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
How it Works
Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated.
One mechanism is the precise ablation (thermal destruction of tissue), which can be done to completely destroy the target or to partially treat it. Partial treatment is believed to stimulate the patient’s immune response, which may have a broader impact.
Another mechanism is the use of mechanical (non-thermal) histotripsy to destroy the tumor.
A third mechanism is to use focused ultrasound to cause hyperthermia which enables the local release and absorption of a therapeutic that is contained in the blood stream.
Advantages
The primary options for treatment of kidney tumors depend on the type of the tumor, but typical approaches are partial or complete surgical removal. Radiation, arterial embolization or chemotherapy may also be considered.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary. Focused ultrasound can also enhance the chemotherapy dose for the target, with less impact to the rest of the patient.
Clinical Trials
A clinical trial using histotripsy for the treatment of kidney tumors has begun.
There is a clinical trial is using thermally sensitive doxorubicin to treat recurrent or refractory tumors.
A clinical trial is recruiting patients with solid tumors with metastatic lesions, including kidney cancer, at the University of Virginia.
For a full list of kidney tumor clinical trials, please see here.
See a list of treatment sites >
See a list of clinical trials sites >
See a list of laboratory research sites >
Regulatory Approval and Reimbursement
A focused ultrasound system has been approved in China and in Europe for treatment of kidney cancer.
To the best of our knowledge, the use of focused ultrasound to treat kidney cancer is not yet reimbursed by medical insurance.
Notable Papers
Panzone J, Byler T, Bratslavsky G, Goldberg H. Applications of Focused Ultrasound in the Treatment of Genitourinary Cancers. Cancers (Basel). 2022 Mar 17;14(6):1536. doi: 10.3390/cancers14061536.
Motta G, Ferraresso M, Lamperti L, Di Paolo D, Raison N, Perego M, Favi E. Treatment options for localised renal cell carcinoma of the transplanted kidney. World J Transplant. 2020 Jun 29;10(6):147-161. doi: 10.5500/wjt.v10.i6.147.
Khokhlova TD, Schade GR, Wang YN, Buravkov SV, Chernikov VP, Simon JC, Starr F, Maxwell AD, Bailey MR, Kreider W, Khokhlova VA. Pilot in vivo studies on transcutaneous boiling histotripsy in porcine liver and kidney. Sci Rep. 2019 Dec 27;9(1):20176. doi: 10.1038/s41598-019-56658-7.
Di Candio G, Porcelli F, Campatelli A, Guadagni S, Vistoli F, Morelli L. High-Intensity Focused Ultrasonography and Radiofrequency Ablation of Renal Cell Carcinoma Arisen in Transplanted Kidneys: Single-Center Experience With Long-Term Follow-Up and Review of Literature. J Ultrasound Med. 2019 Jan 28. doi: 10.1002/jum.14938.
Magda Abbas A, Constatin-Coussios C, Robin Cleveland O. Patient Specific Simulation of HIFU Kidney Tumour Ablation. Conf Proc IEEE Eng Med Biol Soc. 2018 Jul;2018:5709-5712. doi: 10.1109/EMBC.2018.8513647.
Schade GR, Wang YN, D’Andrea S, Hwang JH, Liles WC, Khokhlova TD. Boiling Histotripsy Ablation of Renal Cell Carcinoma in the Eker Rat Promotes a Systemic Inflammatory Response. Ultrasound Med Biol. 2018 Oct 16. pii: S0301-5629(18)30403-4. doi: 10.1016/j.ultrasmedbio.2018.09.006.
Magda Abbas A, Constatin-Coussios C, Robin Cleveland O. Patient Specific Simulation of HIFU Kidney Tumour Ablation. Conf Proc IEEE Eng Med Biol Soc. 2018 Jul;2018:5709-5712. doi: 10.1109/EMBC.2018.8513647.
Suomi V, Jaros J, Treeby B, Cleveland RO. Full Modeling of High-Intensity Focused Ultrasound and Thermal Heating in the Kidney Using Realistic Patient Models. IEEE Trans Biomed Eng. 2018 Nov;65(11):2660-2670. doi: 10.1109/TBME.2018.2870064. Epub 2018 Sep 13.
Weissenbacher A, Lo Faro L, Boubriak O, Soares MF, Roberts IS, Hunter JP, Voyce D, Mikov N, Cook A, Ploeg RJ, Coussios CC, Friend PJ. Twenty-four-hour normothermic perfusion of discarded human kidneys with urine recirculation. Am J Transplant. 2018 May 14. doi: 10.1111/ajt.14932.
Suomi V, Jaros J, Treeby B, Cleveland R. Full Modelling of High-Intensity Focused Ultrasound and Thermal Heating in the Kidney using Realistic Patient Models. IEEE Trans Biomed Eng. 2017 Jul 28. doi: 10.1109/TBME.2017.2732684.
Click here for additional references from PubMed.
