Key Points
- Focused ultrasound continues to gain traction for applications in immunotherapy and cancer treatment, as well as neuromodulation.
- Comprehensive safety protocols and innovative image-guidance methods have been developed to ensure efficacy and minimize risks.
A 2024 review paper published by the Bioeffects Committee of the American Institute of Ultrasound in Medicine (AIUM) in the Journal of Ultrasound in Medicine highlights the significant strides in focused ultrasound over the last decade, building upon the foundational 2012 review. Today, focused ultrasound treatments incorporate state-of-the-art technology to ensure precise and effective noninvasive therapy for a variety of medical conditions.
“The AIUM Bioeffects Committee is increasingly interested in therapeutic ultrasound, particularly given its growing integration into the clinic. An aim for this review was to outline the current state of the field and help the community identify the trajectory of therapeutic ultrasound to improve patient outcomes,” said Kenneth Bader, PhD, an author on the paper.
Ultrasound Modalities and Disease Applications
Focused ultrasound can interact with the body in different ways, producing both mechanical and thermal effects. The following key application areas were discussed in the publication:
- Tissue Ablation: Most clinical applications involve the use of high-intensity focused ultrasound to ablate tissues throughout the body, with recent work targeting aggressive cancers and nervous system diseases. Mechanical ablation (histotripsy) is in clinical testing for liver, kidney, and pancreatic cancers.
- Low-Intensity Pulsed Ultrasound (LIPUS): Clinical trials demonstrate the efficacy of LIPUS for noninvasive deep-brain stimulation, safely altering neural behavior for the potential treatment of conditions such as Alzheimer’s, depression, and epilepsy. LIPUS has also been demonstrated to improve bone healing and is being tested preclinically to trigger genetic changes within cells – a technique called sonogenetics.
- Lithotripsy: Lithotripsy, which uses ultrasound to noninvasively break apart kidney stones, has been standard-of-care since the 1980s. Ultrasound propulsion of kidney stones enhances clearance of the stones with minimal discomfort and no significant adverse effects.
- Immunomodulation: Recent studies reveal focused ultrasound’s potential in modulating inflammatory responses, which could be employed for either tumor treatment or neurodegenerative disease management. Immunomodulation can be achieved with a wide range of ultrasound parameters, including both low- and high-powered mechanical or thermal treatments.
- Other Applications: Advances in other applications of focused ultrasound, such as physical therapy, cosmetic procedures, and drug delivery to the brain and other tissues are also discussed.
Advancements in Technology
- Imaging and Guidance: Image-guided focused ultrasound systems integrate MRI, ultrasound, or neuronavigation to ensure real-time monitoring of procedures. Recent innovations improve imaging accuracy and decrease procedure cost.
- Treatment Testing: Advances in tissue-mimicking materials and computer simulations enable better predictions of treatment outcomes and enhance safety.
Safety Considerations
Focused ultrasound has maintained a strong safety profile while expanding into new disease applications. The implementation of quality assurance protocols, as recommended by the American Association of Physicists in Medicine, ensures device reliability and patient safety. Additionally, the authors emphasized the importance of accurate and consistent reporting of ultrasound treatment parameters to ensure reproducibility.
“Standardized and accurate reporting of treatment parameters is essential to ensure study reproducibility and to monitor potential safety issues,” stated Frédéric Padilla, PhD, the director of the Foundation’s Gene and Cell Therapy Program and a co-author of this paper. “The Foundation has published general treatment reporting guidelines for therapeutic ultrasound, and the International Transcranial Ultrasonic Stimulation Safety and Standards consortium has released specific reporting guidelines for transcranial ultrasound stimulation.”
Conclusion
The 2024 update underscores the transformative potential of focused ultrasound in modern medicine. From its role in noninvasive cancer treatment to emerging applications in neurology and immunotherapy, this modality continues to break new ground. Ongoing clinical trials and technological innovations promise to further expand focused ultrasound’s capabilities, paving the way for safer, more effective patient care.
Read More: For the full paper, see “Overview of Focused Ultrasound Applications and Safety Considerations: 2024 Update” in the Journal of Ultrasound in Medicine.
Image Source: Bader, K.B., Padilla, F., Haworth, K.J., Ellens, N., Dalecki, D., Miller, D.L., Wear, K.A. and (2025), Overview of Therapeutic Ultrasound Applications and Safety Considerations: 2024 Update. J Ultrasound Med. https://doi.org/10.1002/jum.16611