By Joy Polefrone, PhD, Focal Drug Delivery Program Director
Inspired by the FUS Foundation’s symposia in 2008 and 2010, the Sapienza University of Rome organized the 1st European Symposium on Focused Ultrasound Therapy. Held from September 22-23, the meeting was a great success with more than 200 people present. Program content was excellent and covered current and future applications of both MR-guided and ultrasound-guided focused ultrasound technology. The agenda included three invited presentations by FUS Foundation staff members and spotlighted some of our funded researchers as well.
From my perspective, key takeaways from the meeting included:
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MR-guided focused ultrasound research and development is robust in Europe and is receiving a tremendous amount of government funding, especially in the Netherlands and the United Kingdom
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The field of ultrasound-guided focused ultrasound has advanced solidly and is now being used to treat prostate, thyroid and liver cancer and for pain palliation as well.
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Multi-disciplinary, multi-institutional, public-private collaboration is of great interest – an initial discussion was held to develop a European Working Group to facilitate the adoption of both MR-guided and ultrasound-guided applications.
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The European community holds the FUS Foundation in high regard and has asked us to facilitate the formation of its new Working Group. Further details are now being planned and will be announced in coming months.
Day one highlights:
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Brain applications – Key presentations from the FUS Foundation’s Brain Program described research on intracerebral hemorrhage and essential tremor, given by University of Virginia clinician-researchers Stephen Monteith, MD and W. Jeffrey Elias, MD, respectively.
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Breast cancer – Presenters included researchers from Japan, Italy and Germany, with planned research discussed by the team of Professor Willem Mali, MD at UMC Utrecht.
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Bone tumors – Presentations covered focused ultrasound for pain palliation, back pain, osteoid osteoma, and excitingly, the application of focused ultrasound to achieve tumor control, which was presented by Alessandro Napoli, MD, PhD of La Sapienza.
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Abdominal tumors – Applications in patients were described by leaders in the field, including Wladyslaw Gedroyc, MD from St. Mary’s Hospital who discussed treatment with MR-guided focused ultrasound.
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Technology discussions – Falko Busse of Philips Healthcare discussed the company’s new HIFU platform recently launched at CIRSE (see article above). Franco Orsi, MD of the European Insititute of Oncology in Milan discussed his experience with ultrasound-guided focused ultrasound. The technological challenges and solutions for respiratory gating and motion tracking were presented by Rares Salomir, PhD, of the University of Geneva in Switzerland.
Day two highlights:
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Prostate cancer – Discussions touched on various focused ultrasound modalities and addressed some of the more contentious issues, including treatment of patients with low-risk cancer as well as the basis of focal therapy. Presentations also included an MR-guided approach as well as data from the groups in Italy involved in a treat-and-resect study using this technique.
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Uterine fibroids – Mathias Matzko, MD described his clinical experience with MR-guided FUS in Germany, followed by presentations on efficiency improvement and volumetric ablation from groups in France and Germany respectively. Advances or improvements in treatment were covered, including presentation of treatment results with FUS for adenomyosis and early results on fertility preservation from the team in Spain.
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Drug delivery – Marcel Arditi from Bracco offered a very informative presentation on the many approaches and applications of microbubbles and therapy. Joy Polefrone, PhD of the FUS Foundation, described drug dose painting with the combination of temperature sensitive liposomes and MR-guided HIFU by the team at the NIH. She also discussed the FUS Foundation’s Focal Drug Delivery Program.
FUSF-funded researcher Nathan McDannold, PhD of the Brigham and Women’s Hospital presented exciting results in the use of focused ultrasound combined with microbubbles to safely open the blood brain barrier repeatedly over many weeks in a large animal model. He showed both safety and maintenance of functional capacity, all of which are critical for moving this work into a clinical setting.
Andreas Melzer, MD of Dundee University described a planned approach for treating multiple indications with focused ultrasound and drug delivery using MR-compatible advanced robotics, active beam steering for targeting moving organs and a combination of MR-guided focused ultrasound and PET for molecular imaging guided focal therapy. Such an approach would truly be a treatment suite of the future.
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Organization and networking – An afternoon session centered on adoption and collaborative research projects, with lively discussions around developing a successful center and the utility of a registry for uterine fibroids.