Histotripsy Featured in Special Issue of The International Journal of Hyperthermia

Published:

Key Points

  • The issue includes 12 open-access articles on using focused ultrasound to mechanically destroy tissue.
  • The collection showcases the breadth and depth of the technology across a diverse range of human and veterinary indications.

The Art of Histotripsy: A Focused Ultrasound Application that Has the Potential to Treat from Head to Toe! 

The International Journal of Hyperthermia (IJH) recently published a special issue on histotripsy. Edited by Suzanne LeBlang, MD, the Foundation’s Director of Clinical Relationships, and Timothy J. Ziemlewicz, MD, Professor of Radiology and Director of Abdominal Intervention at the University of Wisconsin–Madison, the issue includes 12 open-access articles. 

“It was quite fortuitous that we started working on this project in 2022 throughout 2023 and the first regulatory approval for a focused ultrasound treatment with histotripsy was approved by the US Food and Drug Administration in 2023,” said Dr. LeBlang. “Histosonics Edison™ system for the treatment of liver tumors was the first approval, with many more applications on the horizon.” 

Histotripsy is an application of focused ultrasound that mechanically destroys cells. It is being evaluated in the body and brain and may play an important role in cancer immunotherapy. The original research articles, review articles, and brief reports in this collection are organized in the following way: 

  • To begin, a review of the spectrum of histotripsy techniques provides insight into the various mechanisms and their potential clinical applications, creating baseline knowledge for those beginning clinical adoption. 
  • Next, focusing on the abdomen, three articles describe preclinical development of abdominal histotripsy, challenges and solutions for aberration of the ultrasound field when delivering ultrasound energy to the abdomen, and the feasibility of pancreas ablation in a swine model. 
  • Two veterinary studies include an article on musculoskeletal applications and a first-in-cat report of the feasibility of histotripsy for the treatment of injection site sarcomas. 
  • For brain applications, one manuscript describes transcranial histotripsy parameters in murine brain tumor models. 
  • In cancer, one article shares preclinical in vivo study insights, a neuroblastoma study examined local tissue effects, and two studies present local and systemic immunologic responses to histotripsy and how histotripsy modulates the tumor microenvironment and improves systemic immune responses. 

“The information in this special edition will provide readers with an overview of histotripsy – from mechanisms of action to preclinical research, clinical research, and future applications, said Dr. Ziemlewicz. “The potential of histotripsy to aid in the treatment of patients with a wide variety of diseases is quite promising.” 

Each of the articles is hyperlinked below, and all of them are open source. 

Histotripsy Techniques 
Review Article: The Histotripsy Spectrum: Differences and Similarities in Techniques and Instrumentation by Randall P. Williams, Julianna C. Simon, Vera A. Khokhlova, Oleg A. Sapozhnikov, and Tatiana D. Khokhlova 

Abdomen 
Review Article: Clinical Translation of Abdominal Histotripsy: A Review of Preclinical Studies in Large Animal Models by Katrina L. Falk, Paul F. Laeseke, Meridith A. Kisting, Annie M. Zlevor, Emily A. Knott, Amanda R. Smolock, Charles Bradley, Eli Vlaisavljevich, Fred T. Lee Jr., and Timothy J. Ziemlewicz 

Review Article: Aberration Correction in Abdominal Histotripsy by Ellen Yeats & Timothy L. Hall 

Article: Ultrasound-Guided Noninvasive Pancreas Ablation Using Histotripsy: Feasibility Study in an In Vivo Porcine Model by Jessica Gannon, Khan Mohammad Imran, Alissa Hendricks-Wenger, Michael Edwards, Hannah Covell, Lauren Ruger, Neha Singh, Margaret Nagai-Singer, Benjamin Tintera, Kristin Eden, Mishal Mendiratta-Lala, Joan Vidal-Jove, David Luyimbazi, Martha Larson, Sherrie Clark-Deener, Sheryl Coutermarsh-Ott, Irving C. Allen, and Eli Vlaisavljevich 

Veterinary 
Article: Investigating Cell Death Responses Associated with Histotripsy Ablation of Canine Osteosarcoma by Alayna N. Hay, Elliana R. Vickers, Manali Patwardhan, Jessica Gannon, Lauren Ruger, Irving C. Allen, Eli Vlaisavljevich,and Joanne Tuohy 

Article: Histotripsy Ablation for the Treatment of Feline Injection Site Sarcomas: A First-in-Cat In Vivo Feasibility Study by Lauren Ruger, Ester Yang, Sheryl Coutermarsh-Ott, Elliana Vickers, Jessica Gannon, Marlie Nightengale, Andy Hsueh, Brittany Ciepluch, Nikolaos Dervisis, Eli Vlaisavljevich, and Shawna Klahn 

Review Article: A Review of the Development of Histotripsy for Extremity Tumor Ablation with a Canine Comparative Oncology Model to Inform Human Treatments by Alayna N. Hay, Lauren Ruger, Andy Hsueh, Elliana Vickers, Shawna Klahn, Eli Vlaisavljevich, and Joanne Tuohy 

Brain 
Article: Transcranial Histotripsy Parameter Study in Primary and Metastatic Murine Brain Tumor Models by Sarah Duclos, Andrew Golin, Adam Fox, Neeraj Chaudhary, Sandra Camelo-Piragua, Aditya Pandey & Zhen Xu 

Cancer 
Review Article: Insights from In Vivo Preclinical Cancer Studies with Histotripsy by Tejaswi Worlikar, Timothy Hall, Man Zhang, Mishal Mendiratta-Lala, Michael Green, Clifford S. Cho, and Zhen Xu 

Article: Histotripsy Induces Apoptosis and Reduces Hypoxia in a Neuroblastoma Xenograft Model by Isabella Iwanicki, Lydia L. Wu, Fernando Flores-Guzman, Rachael Sundland, Paula Viza-Gomes, Rachel Nordgren, Connor S. Centner, Jessica J. Kandel, Mark A. Applebaum, Kenneth B. Bader, and Sonia L. Hernandez 

Brief Report: The Use of Histotripsy as Intratumoral Immunotherapy Beyond Tissue Ablation—the Rationale for Exploring the Immune Effects of Histotripsy by Takuya Osada, Xiaoning Jiang, Yuhang Zhao, Mengyue Chen, Benjamin C. Kreager, Huaiyu Wu, Howuk Kim, Jun Ren, Joshua Snyder, Pei Zhong, Michael A. Morse, and H. Kim Lyerly 

Review Article: Magic Bubbles: Utilizing Histotripsy to Modulate the Tumor Microenvironment and Improve Systemic Anti-Tumor Immune Responses by Khan M. Imran, Anutosh Ganguly, Tamalika Paul, Manali Powar, Eli Vlaisavljevich, Clifford S. Cho, and Irving C. Allen 

See ‘The Art of Histotripsy’