- Last Updated: November 30, 2016
Liver cancer is the fifth most common malignancy worldwide, with an annual incidence of more than 550,000. Primary liver cancer tends to occur in previously damaged livers, as in cases of viral hepatitis, alcohol abuse, and obesity.
The liver is the second most common site for metastases. The worldwide annual incidence of liver metastases is 2 million. Common sources of liver metastases are colorectal, breast, and lung cancer.
Traditional treatment options 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. For secondary liver cancer, surgical resection is the gold standard and it is curative for suitable patients (about 20%).
Focused Ultrasound Treatment
Focused ultrasound is a completely non-invasive way to thermally destroy tumors in the liver. Using focused ultrasound in conjunction with image guidance, the physician directs a focused beam of acoustic energy to heat and destroy the targeted tumor tissue. This technique could offer patients who are not candidates for surgery a non-invasive, low-morbidity, single treatment with a short recovery time.
Focused ultrasound is currently approved to treat liver cancer in Europe and China, with tens of thousands of patients treated to date. These procedures have been done using ultrasound guidance, as either a stand-alone treatment or in combination with chemotherapy.
There are no clinical trials currently underway for the treatment of liver tumors 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.
Regulatory Approval and Reimbursement
A focused ultrasound system has been approved in China and in Europe 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.
There are many international sites which are treating liver cancer using the equipment manufacturered by Chongquing Haifu Technology. Click here to see a list of treatment sites.
Gélat P, Ter Haar G, Saffari N. A comparison of methods for focusing the field of a HIFU array transducer through human ribs. Phys Med Biol. 2014 May 27;59(12):3139-3171.
Jean-Francois Aubry, Kim Pauly, Chrit Moonen, Gail ter Haar, Mario Ries, Rares Salomir, Sham Sokka, Kevin Sekins, Yerucham Shapira, Fangwei Ye, Heather Huff-Simonin, Matt Eames, Arik Hananel, Neal Kassell, Alessandro Napoli, Joo Hwang, Feng Wu, Lian Zhang, Andreas Melzer, Young-sun Kim, Wladyslaw M Gedroyc. The road to clinical use of high-intensity focused ultrasound for liver cancer: technical and clinical consensus. Journal of Therapeutic Ultrasound 2013, 1:13; 2013 Aug 1.
Orsi F, Arnone P, Chen WZ, Zhang LA. High intensity focused ultrasound ablation: A new therapeutic option for solid tumors. J Cancer Res Ther 2010 Oct-Dec;6(4):414-20.
Li YY, Sha WH, Zhou YJ, Nie YQ. Short and long term efficacy of high intensity focused ultrasound therapy for advanced hepatocellular carcinoma. J Gastroenterol Hepatol 2007 Dec 22(12):2148-54.
Illing RO, Kennedy JE, Wu F, ter Haar GR, Protheroe AS, Friend PJ, Gleeson FV, Cranston DW, Phillips RR, Middleton MR. 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 Oct 17;93(8):890-5.
Wu F, Wang ZB, Chen WZ, Zou JZ, Bai J, Zhu H, Li KQ, Xie FL, Jin CB, Su HB, Gao GW. Extracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience. Ultrasound Med Biol 2004 Feb;30(2):245-60.
Click here for additional references from PubMed.
Video courtesy of InSightec