April 2025 Meeting Roundup

Key Points

Six recent conferences featured focused ultrasound presentations.
Use the links below to access the meeting programs and abstract information.

Society of Interventional Radiology (SIR)

SIR 2025 was held March 29–April 1 in Nashville, Tennessee. With an increasing number of focused ultrasound procedures gaining regulatory approvals, interventional radiologists are embracing the technology, participating in research, and supporting commercialization across a variety of clinical applications. Two companies, HistoSonics and TULSA-PRO by Profound Medical, participated in SIR as exhibitors.

Suzanne LeBlang, MD, the Foundation’s director of clinical relationships, attended the conference. “The histotripsy presentations covered many different areas, including procedural follow-up imaging, a safety analysis, early patient outcomes, and ongoing preclinical studies.” said Dr. LeBlang. “Beyond histotripsy, the presentations also covered prostate cancer and renal artery denervation.”

The 13 presentations of interest, by mechanism of action, included the following:

Histotripsy (9)

Hepatic Tumor Histotripsy: Procedural and Follow-Up Imaging Characteristic by Tarub S. Mabud, MD, MS, from New York University Grossman School of Medicine
Histotripsy of the Stomach Wall During Hepatic Histotripsy in an Acute Swine Model by Meridith Kisting, MA, from Carle Illinois College of Medicine
The First International Experience with Histotripsy: A Safety Analysis of 230 Cases by Emily A. Knott from the Cleveland Clinic Lerner College of Medicine
Noninvasive is Persuasive: Indications and Clinical Evidence for Noninvasive Solid Tumor Ablation using Histotripsy or High Intensity Focused Ultrasound by Warren A. Campbell, IV, MD, PhD, from the University of Virginia School of Medicine and Mina S. Makary, MD, from The Ohio State University Wexner Medical Center
New Ablation Techniques: Boom or Bust? – Histotripsy by Nadine Abi-Jaoudeh, MD, FSIR, from the University of California
Do We Really Need Histotripsy for Liver Cancers? by Timothy J. Ziemlewicz, MD, from the University of Wisconsin Hospital and Clinics and Siddharth Padia, MD, from the David Geffen School of Medicine at UCLA
The Effect of Implanted Metal Objects on Histotripsy Treatments: A Phantom Study by Katrina Falk, MS, from the University of Wisconsin-Madison
Early Patient Outcomes After Liver Tumor Histotripsy by Tarub S. Mabud, MD, MS, from New York University Grossman School of Medicine
Does Histotripsy of Central Liver Tumors Cause Biliary Ductal Injuries? A study in a Live Porcine Survival Model and Early Human Clinical Experience by Allison Couillard, MD, from the University of Wisconsin Hospitals and Clinics
Poster 117 Application of Histotripsy to Disrupt Chronic Deep Vein Thrombosis in Pre-Clinical Testing by Kevin Zhao, MS, from the Department of Radiology at the University of Chicago

Prostate Ablation (2)

AI-Assisted Prostate Segmentation Module for MRI-Guided Transurethral Ultrasound (TULSA) Treatment Planning: Multi-Reader Multi-Case Study and Initial Real-World Experience by Steven S. Raman, MD, FSIR, from UCLA
MR-Guided Transurethral Ultrasound Ablation (TULSA) with Dose Escalation to MRI-Visible Prostate Cancer Lesions by Joseph J. Busch, Jr., MD, from the Busch Center

Renal Denervation (2)

Renal Denervation Has Resurfaced – What IRs Need to Know by Lindsay Machan, MD, FSIR, from the University of British Columbia, Canada
Renal Artery Denervation by Focused Ultrasound and Radiofrequency Ablation by Marc Sapoval, MD, PhD, from Hôpital Européen Georges-Pompidou

The content from SIR 2025 is available on demand, and CME credit is offered.

Next: SIR 2026 will be held April 11–15 in Toronto.

American Institute of Ultrasound in Medicine (AIUM)

The AIUM 2025 annual convention was held March 29 through April 1 in Orlando, Florida. Ali Rezai, MD, executive chair and director of the West Virginia University Rockefeller Neuroscience Institute, gave a keynote presentation titled, “Focused Ultrasound: Breaking Barriers in Neurotherapeutics.” He shared how soundwave therapies are offering groundbreaking solutions to combating two of society’s most challenging medical conditions. The presentation, and Dr. Rezai’s work, were summarized nicely in an Aunt Minnie article.

Additional presentations and posters of interest to the community, which can be found by searching the abstracts page, include the following:

Low-Intensity Focused Ultrasound (LIFU) as a Novel Therapeutic Approach for Neurotransmitter Activated Systemic Hormonal Surge (NASHS): Redefining Anxiety Management by Karen Nussbaumer, BS, RDMS, RVT, from the Academy of Diagnostic and Osteopathic Medicine (ADOM)
Application of Histotripsy to Disrupt Chronic Deep Vein Thrombosis in Pre-Clinical Testing by Erik Saucedo, Osman Ahmed, Jonathan Paul, Mikin Patel, and Kenneth Bader from the University of Chicago
Use of Low-Amplitude Pulses to Improve Histotripsy Efficiency when Treating S. Aureus Biofilms on Surgical Mesh by Timothy Bigelow, Andrew Petersen, and Huaiqing Wu from Iowa State University
Dynamic In Vitro Assessment of Subharmonic-Aided Pressure Estimation Sensitivity Using Monodisperse and Polydisperse Microbubbles by Ga Won Kim, Hailee Mayer, Nirmal Patel, Ankit Patel, Wim Van Hoeve, Flemming Forsberg, and John Eisenbrey from Thomas Jefferson University, Drexel University, Northeast Ohio Medical University, and Solstice Pharmaceuticals B.V.

Next: AIUM 2026 will take place May 27–30 in Philadelphia.

European Conference on Interventional Oncology (ECIO)

ECIO 2025 was held April 13–16 in Rotterdam, the Netherlands. High-intensity focused ultrasound was included in a “highlight topics” session on IO Treatments for Localized Prostate Cancer presented by Prof. Jurgen Fütterer.

Prof. Joan Vidal-Jové also presented a satellite symposium for HistoSonics on Histotripsy for the Treatment of Liver Tumors: Mechanism of Action and Early Clinical Experience.

The content listed above (and more) is now available on demand.

Next: ECIO 2026 is scheduled to take place April 26–30 in Basel, Switzerland.

Society of Biological Psychiatry (SOBP)

SOBP held its 2025 annual meeting in Toronto from April 24–26. The theme was Artificial Intelligence and Mental Health: A New Landscape for Research and Practice.

Posters of interest to the focused ultrasound community include the following:

F135 Transcranial Focused Ultrasound Neuromodulation Elicits Functional Connectivity Changes in Depression by Daniel Feldman, Tom Riis, Sarah Kwon, Lily Vonesh, Vincent Koppelmans, Jan Kubanek, and Brian Mickey
F152 Subjective Reports Following Direct Non-Invasive Neuromodulation of Anterior Cingulate Cortex by Brandon Cooper, Thomas S. Riis, Daniel Feldman, Akiko Okifuji, Jan Kubanek, and Brian J. Mickey
F292 Transcranial Ultrasound Stimulation of the Right Globus Pallidus in Schizophrenia: A Randomized Sham-Controlled Pilot Study by Wei Qi, Michele Santacatterina, Spencer Brinker, Alon Gilad, Gillian Capichioni, Fumika Ando, Francisco Castellanos, Shy Shoham, and Donald C. Goff

Next: SOBP 2026 will be held April 30–May 2 in New York, NY.

American Association of Neurological Surgeons (AANS)

The 2025 annual meeting of AANS was held April 25–28 in Boston. This year’s theme, Power of One, Impact of Many, celebrated the individual contributions that collectively advance the field of neurosurgery.

Julie Pilitsis, MD, PhD, MBA, chair and professor of Neurosurgery at the University of Arizona, co-chaired a session titled “Neuromodulation for Novel Indications,” which explored the role of various neuromodulation techniques and targets for novel clinical indications and discussed early outcomes and future directions. She provided the comments (in italics) on the presentations below that she attended.

The “Nuances in Neuromodulation for Movement Disorders and Psychiatry” session included the following presentations:

Updates on Neuromodulation for Movement Disorder by Emily Lehmann Levin, MD, FAANS, from the University of Michigan
Applications of MRgFUS: Thalamotomy and Pallidotomy by Rees Cosgrove, FRCSC, FAANS, from Brigham and Women’s Hospital
Ethics of Neuromodulation for Psychiatric Indications by Clement Hamani, MD, from Sunnybrook Research Institute
Early Feasibility Study of Intracalvarial Prefrontal Cortical Stimulation in Severe Treatment-Resistant Depression by Jon T. Willie, MD, PhD, FAANS, from Washington University in St. Louis School of Medicine. This presentation did not include focused ultrasound, but it is exciting preliminary work exploring the tolerability of long-term stimulation through a site where all but the inner table has been removed. Similar strategies could be used for implantable focused ultrasound.

The following electronic posters were presented:

A Novel Device for Quantifying Improvement in Tremor During Focused Ultrasound Thalamotomy by Andrew E. Toader, medical student at Lake Erie College of Osteopathic Medicine
Assessment of Barriers in Access to Focused Ultrasound Ablation for Essential Tremor by Nicole A. Silva, MD, resident physician at UNC- Chapel Hill. Patients in this study waited on average 10.6 years prior to receiving focused ultrasound because they did not know it was available. The study also showed that quality of life metrics may vary between men and women.
Bidirectional Interaction of Frailty and HIFU Outcomes in Essential Tremors. Frailty Impacts Outcomes and Successful HIFU Thalamotomy Reduces Frailty by Mostafa Mohamed Ismail, MD, fellow at OHSU. In many patients, frailty metrics were improved post-HIFU. Care should be taken in patients with preoperatively high frailty scores as their risk/benefit ratio may change.
Burning Mouth Syndrome Following Focused Ultrasound Thalamotomy in Essential Tremor Patients by Beck Shafie, BS, medical student at OHSU. The authors reported that approximately 1% of their patients with ET developed burning mouth syndrome post-HIFU and suggest discussing this potential complication during the consent process.
Cavitations During MRgFUS Thalamotomy for Tremor Do Not Prevent Satisfactory Tremor Outcomes by Julia Mueller, BS, medical student at Rush University Medical Center. Treatments with cavitations were associated with a lower SDR, higher maximum sonications, and similar results than those without cavitations.
Direct Targeting of the Ventrointermediate Nucleus During Magnetic Resonance Guided Focused Ultrasound Thalamotomy by James L. Cahill, BA, medical student at Oregon Health and Science University. Direct targeting with FGATIR may have benefit for improving outcomes in ET, although the cohort size in this group was much smaller than in the indirect targeting group.
Effectiveness of Low-intensity Focused Ultrasound in Improving Drug Delivery to the Chronic Spinal Cord Injury by Disrupting the Blood-spinal Cord Barrier by Abdul Ghaith, MD, PhD, postdoctoral neurosurgery research fellow at Johns Hopkins University. In rats with spinal cord injury, LIFU to open the blood-spinal cord barrier resulted in increased permeability, decreased vascular density, less scarring, and improved function. This was one of the best studies on focused ultrasound, in my opinion.
Focused Ultrasound Enhances Drug Delivery and Prolongs Survival in a Mouse Model of Diffuse Midline Glioma by Nina Yoh, MD, resident at Columbia University. Combining LIFU with a SMARCA4 inhibitor in mice with diffuse midline glioma resulted in improved longevity.
Focused Ultrasound in the Treatment of Epilepsy: Current Applications and Future Directions by Benjamin Succop, MD, neurosurgery resident physician at Duke University
Focused Ultrasound Neuromodulation for Psychiatric Disorders: A Review of Clinical Applications by Dillan Prasad, MS, medical student at Feinberg School of Medicine
Impact of Low Skull Density Ratio on Outcomes of Magnetic Resonance Guided Focused Ultrasound by Shikha Singh, BS, medical student at the University of Pennsylvania Perelman School of Medicine
MRgFUS Thalamotomy versus DBS for Medically-refractory Essential Tremor: A Case Report by Stephen C. Harward, II, MD, PhD, neurosurgeon at Duke University Department of Neurosurgery
MRI-Guided High-intensity Focused Ultrasound Thalamotomy for Recurrent Tremor: Case Series and Retargeting with DTR Deterministic Tractography and Computerized Stereotactic Atlases by Alexander Fleisher, student at Columbia University
Physical Therapy Outcomes Following Unilateral Focused Ultrasound Thalamotomy for Essential Tremor and Tremor-Dominant Parkinson’s Disease: A Retrospective Analysis by Stephen C. Harward, II, MD, PhD, neurosurgeon at the Duke University Department of Neurosurgery
Predictive Modelling of Cranial MRI-Guided Focused Ultrasound Efficiency by Graham Winston, MD, resident in the Department of Neurological Surgery at Weill Cornell Medicine
Pre-treatment with Bisphosphonates Does Not Change Sonication Parameters in Focused Ultrasound Thalamotomy by Beck Shafie, BS, medical student at OHSU
Proprioceptive and Postural Outcomes Following Magnetic Resonance Guided Focused Ultrasound Thalamotomy for Essential Tremor: A Case Report by Stephen C. Harward, II, MD, PhD, neurosurgeon at Duke University Department of Neurosurgery
Reappraisal of Radiofrequency Lesioning for Movement Disorders and Neurosurgical Team Management for Post-MR-Guided Focused Ultrasound Follow-up by Hiroki Toda, MD, PhD, director of the Tazuke Kofukai Medical Research Institute Kitano Hospital
Safety and Efficacy of Sequential Bilateral Focused Ultrasound Thalamotomy for Essential Tremor (ET) by Beck Shafie, BS, medical student at OHSU. The authors describe 11 patients who underwent staged focused ultrasound for ET with treatments approximately one year apart and showed similar adverse effect profiles with the second treatment.
Safety of Restarting Antiplatelet or Anticoagulant Medications in the Perioperative Period of MR-Guided Focused Ultrasound (MRgFUS) Procedures by Erik Werheim, MD, PGY-1 (Preliminary) General Surgery at Northwell Health
Technical Nuances of MRgFUS Thalamotomy Focusing on Sonication Frequency by Yoshito Sugita, MD, deputy chief of Neurosurgery at Medical Research Institute Kitano Hospital
Thermal Neuromodulation Technique Optimization of Focused Ultrasound Ablation for Essential Tremor: A Single-institution Experience by Nicole A. Silva, MD, resident physician at UNC- Chapel Hill. In order to continue to optimize the safety of focused ultrasound for ataxia in ET, investigators should carefully denote their sonication parameters and results intra-procedure and serially thereafter.
Variation in Skull Density Ratio (SDR) When Planning Bilateral Magnetic Resonance-guided Focused Ultrasound by Lucinda Chiu, MD, neurosurgical resident at Rush University Medical Center. There may be variability in SDR depending on the bone kernel used.

Search the full schedule or the E-posters for key words or diseases and conditions.

Next: AANS 2026 is scheduled for May 1–4 in San Antonio, Texas. The Foundation thanks Dr. Pilitsis for assistance with this report.

American Association of Cancer Research (AACR)

AACR 2025 took place April 25–30 in Chicago. With a theme of Unifying Cancer Science and Medicine: A Continuum of Innovation for Impact, the largest oncology meeting in the world attracted more than 20,000 attendees.

The proceedings of the meeting are published in the April 15, 2025, supplement issue of the journal Cancer Research, and this issue is searchable by key word or disease area.

A group of students from the Allen and Tuohy laboratories at Virginia Tech, including Manali Powar, Tamalika Paul, Carley Elliott, Cassandra Poole, Ny Luong, and Elliana (Elli) Vickers attended AACR and presented their work.

“It was exciting to share our focused ultrasound studies with the cancer community,” said Elliana (Elli) Vickers, a PhD candidate in Translational Biology, Medicine, & Health at Virginia Tech. “There was a lot of interest in focused ultrasound technologies and how they fit into the cancer treatment spectrum. Overall, it was an amazing conference and learning experience for all of us! I look forward to continuing to a be a part of the AACR community and sharing focused ultrasound with the cancer research community.”

“I had a great time presenting our research on histotripsy combined with immunotherapy as a potential therapeutic approach for spontaneous osteosarcoma in pet dogs,” said Ny Luong, a PhD student in the Tuohy laboratory. “Several attendees I spoke with were intrigued by the use of histotripsy in a veterinary setting and appreciated the translational relevance of our canine model. It was exciting to see strong interest in how focused ultrasound fits into the cancer treatment landscape, especially when combined with immunotherapy.”

The following abstracts will be of interest to the focused ultrasound community. Additional notes (in italics) were generously provided by Tamalika Paul, a PhD candidate in the Department of Biomedical Sciences and Pathobiology at Virginia Tech.

2524: Lipid-based nanoparticles for the theranostic treatment of brain tumors using focused ultrasound by Paul Cressey, Chris Payne, Amelia Claxton, Benedetta Arno, Christopher Ireson, Maral Amrahli, David Thurston, Antonios Pouliopoulos, Maya Thanou. This study looked at drug-based treatment of glioblastoma tumors in a murine model. Focused ultrasound and microbubble cavitation were used to transiently open the tight junctions between cells that make up the blood-brain barrier, allowing for more effective drug delivery. The authors designed an activated liposome system to carry drugs into the tumor. They found that tumor volume decreased, and survival significantly increased when focused ultrasound delivered their drug-loaded lipid nanoparticles into the tumor compared to free drug treatment alone. This study demonstrates that focused ultrasound can successfully enhance drug delivery past the blood-brain barrier in the case of brain tumors.
3271: Targeted cancer therapy using a novel recombinant il-24s/il-15 chimeric fusion cytokine by Amit Kumar, Padmanabhan Mannangatti, Swadesh K. Das, Paul B. Fisher. This study aimed to characterize the transcriptional changes induced by Kaposi’s sarcoma–associated herpesvirus (KSHV) infection in guinea pigs, aiming to establish a small animal model for studying KSHV-associated pathologies. KSHV is linked to human cancers, including Kaposi’s sarcoma and primary effusion lymphoma. Current animal model organisms, mostly mice, have limitations due to species barriers and poor virus replication. Guinea pigs are genetically closer to humans than mice and present a promising alternative for translation—methods: Guinea pig fibroblasts were infected with KSHV. RNA was isolated, and RNA-seq was performed to analyze gene expression changes using enrichment analysis. Data was validated using RT-qPCR and visualized via microscopy and bioinformatics pipelines to compare with human (MRC5) and guinea pig JH4. Key findings: They identified differentially expressed genes during KSHV infection in guinea pig cells. Many key immune related transcription factors were significantly affected. KSHV genes, like vIRFs and several ORFs, were expressed, confirming active infection. Viral infection triggered changes in innate immune pathways. Fluorescence microscopy showed nuclear localization of KSHV proteins. Guinea pig transcriptional profiles showed overlap with human responses to KSHV infection. Functional similarities validate the potential of the guinea pig as a preclinical model. Overall, the conclusion was that they were a promising model for studying KSHV-host interactions, especially for testing antiviral therapies and vaccine strategies.
3466: Bubble therapy: Histotripsy ablation of pancreatic tumors in an in vivo murine model affects the tumor microenvironment and increases systemic anti-tumor immunity by Tamalika Paul, Victor Lopez, Cora Youngs, Carley Elliott, K.M Imran, Tyler Moore, Manali Powar, Benjamin Tintera, Eli Vlaisavljevich, Irving Coy Allen. In this study, the authors demonstrated that histotripsy ablation of pancreatic tumors effectively reduced the tumor diameter in the directly treated tumor and the untreated contralateral tumor, suggesting a systemic anti-tumor effect consistent with an abscopal-like response. The flow cytometry data indicated alterations in the immune cell population, demonstrating that histotripsy activated the adaptive immunity, further emphasizing the transformation of the cold tumor microenvironment to the hot tumor microenvironment, which is essential to sensitize pancreatic tumors to immunotherapy. The data establish histotripsy as a potent local and systemic immune modulator in pancreatic cancer. Histotripsy enhances antigen presentation, stimulates anti-tumor immunity, and combines with immunotherapeutics for improved clinical outcomes. The resulting immune modulation highlights histotripsy’s potential as a therapeutic modality, particularly in combination with immunotherapies, to enhance treatment efficacy and achieve durable anti-tumor responses in pancreatic cancer.
3527: Low-intensity pulsed focused ultrasound, with microbubbles and immune adjuvants, promotes CNS epitope spreading, improving CAR T cell therapy for heterogeneous brain tumors by Marco Gallus, Akane Yamamichi, Victor Andres. Arrieta, Atsuro Saijo, Lan Phung, Pavlina Chuntova, Su Phyu, Jeffrey Haegelin, Aishi Zhao, Haoyu Long, Senthilnath Lakshmanachetty, Takahide Nejo, Kaori Okada, Li Chen, Karl Habashy, Andrew Gould, Christina Amidei, Catalina Lee Chang, Roger Stupp, Michael Canney, Adam M. Sonabend, Hideho Okada. This poster presents a compelling strategy to address the challenge of antigenic heterogeneity in malignant brain tumors, particularly glioblastoma, by combining low-intensity pulsed focused ultrasound (LIPU) with microbubbles to transiently open the blood-brain barrier. This process allows central nervous system (CNS)-derived antigen presenting cells (APCs) to access peripheral lymphoid tissues, facilitating T cell priming and spreading epitope. These mechanisms are critical for improving the efficacy of CAR T cell therapies against tumors with mixed antigen expression. Using novel glial-specific major histocompatibility complex (MHC) transgenic mice, this study demonstrated that pairing LIPU with immune adjuvants poly-ICLC and IL-2 enhances CNS-specific immune responses and significantly improves CAR T cell–mediated tumor control. This work stands out for its mechanistic rigor and translational relevance, particularly its use of glioblastoma patient–derived blood samples compared to chimera bone marrow (BM) chimera mice. However, it does raise questions about clinical implementation, such as individual patient variability in immune response and long-term immune surveillance within the CNS. Additional research questions include how this strategy could be combined with immune checkpoint inhibitors, which biomarkers might be predictive of response or helpful in monitoring treatment efficacy, and whether the current approach retains efficacy in CNS tumors with inherently low immunogenicity.
3948: Enhancing immune checkpoint delivery to diffuse midline glioma (DMG) using focused ultrasound by Amelia Claxton; Paul Cressey; David Thurston; Esther Hulleman; Antonios Pouliopoulos; Darren Hargrave; Maya Thanou. The objective of the research was to improve the delivery of therapeutic antibodies to diffuse midline glioma (DMG) by using focused ultrasound combined with nanodroplets to open the blood-brain barrier. DMG is a fatal pediatric brain tumor with poor treatment options due to the intact BBB, which limits drug delivery. Focused ultrasound plus microbubbles have shown promise in opening the BBB for better drug delivery. This study investigated the use of focused ultrasound plus nanodroplets (NDs) to enhance antibody delivery. The researchers developed a mouse model of DMG using mDMG-3.3 (K27M mutant) cells implanted in the brainstem, designed perfluoropentane-based NDs that vaporize under ultrasound to open the BBB, monitored BBB opening using passive cavitation detection and MRI, and delivered fluorescently-labeled antibodies after focused ultrasound to assess antibody penetration. The focused ultrasound plus NDs successfully opened the BBB in the mouse DMG model, and the combination significantly improved the delivery of the antibody to tumor regions. BBB opening and IgG delivery correlated with the strength of cavitation signals. This study used MRI to confirm enhanced delivery without causing excessive tissue damage.
4688: Focused ultrasound for the treatment of osteosarcoma in a canine comparative oncology model: Findings from veterinary clinical trials by Elliana Vickers, Alayna Hay, Lauren Ruger, Ny Luong, Sheryl Coutermarsh-Ott, Gregory Daniel, Steven Soliman, Gunjan Malhotra, Timothy Ziemlewicz, Adam Maxwell, Eli Vlaisavljevich, and Joanne Tuohy. In this study, researchers used histotripsy to treat pet dogs with naturally occurring bone tumors. The cancer was targeted over multiple sessions to treat at least 50% of the tumor. Of nine dogs treated, six received long-term follow up. The study suggests that histotripsy could be a promising noninvasive option for managing bone cancer, especially as a limb-sparing treatment in dogs, and could eventually reduce or replace the need for amputation in some cases. Fractionated treatments safely ablated large tumor volumes. Future research will investigate improving treatment precision and exploring combinations with immunotherapy to boost effectiveness.
5844: Initial findings on the immunomodulatory effects of histotripsy combined with N-dihydrogalactochitosan in a comparative oncology model of canine osteosarcoma by Ny Luong, Alayna Hay, Elliana Vickers, Samuel S. Lam, Wei R. Chen, Eli Vlaisavljevich, Joanne Tuohy. This study demonstrated N-dihydrogalactochitosan (GC) as a novel immunostimulant for enhancing systemic immune responses when delivered intratumorally after histotripsy. Researchers evaluated the safety, feasibility, and immunomodulatory effects of combining histotripsy with GC in pet dogs with spontaneous osteosarcoma (a type of bone cancer). Study dogs received focused ultrasound histotripsy treatments using a 700 kHz system delivering 500–750 pulses per point. After the final histotripsy treatment, GC was injected directly into the tumors under ultrasound guidance, with the amount adjusted based on tumor size. These early results suggest that combining histotripsy with GC effectively activates the immune system and could become a promising new strategy for treating primary tumors and osteosarcoma metastases. The combination therapy was well tolerated in the patients, and an increase in immune cells and specific changes in T-cell behavior were observed.