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Meeting Report: 183rd Meeting of Acoustical Society of America (ASA) 2022

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Key Points The 183rd meeting of the Acoustical Society of America took place in Nashville, Tennessee, from December 5–9, 2022. All abstracts are searchable on the meeting planning tool or in the PDF of the open access program. The Foundation thanks Kevin J. Haworth, PhD, Schott Schoen, Jr., PhD, Adam Maxwell, PhD, and Eli Vlaisavljevich, PhD, for assistance in writing this meeting report. The 183rd meeting of the Acoustical Society of America (ASA) took place in Nashville, Tennessee, from December 5–9, 2022. Dozens of abstracts were presented in the field of biomedical acoustics (BA) during the meeting, and joint sessions were held with the physical acoustics (PA), computational acoustics (CA), and signal processing acoustics (PA) technical committees. A broad range of topics were covered, and the material extended from fundamental science investigation to translational bench studies, preclinical studies, and in-human investigations in both imaging and therapeutic ultrasound. The sessions relevant to focused ultrasound are listed below. All abstracts are available in a searchable PDF of the open access program or by using the searchable online meeting planning tool. During the open BA Technical Committee meeting on Wednesday evening, several senior researchers, including Larry Crum, Christy Holland, and Mark Schafer, noted that the content of the meeting was excellent in its scope and depth. The range of invited speakers included great talks from both well-established members of the field and early-career speakers (such as Harriet Lea-Banks of Sunnybrook Research Institute and Dongwoon Hyun from Stanford). The early-career speakers introduced some fascinating new topic areas in ultrasound and provided a refreshing influx of new ideas and concepts. It was a reminder of how bright the future is for this research community and an inspiration for further research. The following presentations were particularly notable: 2aBAb6. “Volatile nanodroplets for neurological applications” (Lea-Banks, Sunnybrook Research Institute) discussed delivery of pentobarbital to specific regions of the brain without disruption of the blood-brain barrier and having specific anesthetic effects to those limited regions. 2pBAb3. “Fibrin-targeted phase shift microbubbles outperform fibrin-targeted microbubbles for the treatment of microvascular obstruction” (Pacella, University of Pittsburgh) discussed results from a series of investigations into the use of nanodroplets plus ultrasound to increase perfusion after acute myocardial infarction. Bench, small animal, and large animal model studies were used with an excellent interplay in how each informed the observations of the others. 3aBA1. “Acoustic droplet vaporization for nonthermal ablation of brain tumors” (Porter, University of Texas at Austin) discussed a series of studies performing mechanical ablation in the rat brain and the improved localization and more thorough treatment when nanodroplets were used as contrast nucleation agents. A special session titled “Detection and quantification of bubble activity in therapeutic ultrasound” was held on Thursday. This session opened with Brian Fowlkes from the University of Michigan providing a summary of the outcomes of the Fall 2021 joint AIUM/FUSF workshop on this topic, as well as current efforts through IEC and other bodies to develop standards. This was followed by presentations in specific areas of cavitation detection and characterization by optical imaging, Doppler, MRI, and passive mapping. A brief panel discussion then outlined considerations for standardizing measurements. Panelists generally agreed that measurements should be guided by application. When possible, it may be valuable to use relative measurements rather than absolute measurement values for the sake of simplicity. Panelists indicated that the technologies to perform at least relative measurements have been well-developed, but the processing and quantities derived from instruments that are specific to each application need further consensus. An afternoon session further highlighted new research areas, including optical and acoustic characterization of histotripsy, tissue permeabilization, biofilm removal, drug delivery, and lithotripsy. New techniques for thermal characterization and computational modeling of microbubble clusters were also presented. During Friday’s 5aBA session, there were several presentations that were relevant to the focused ultrasound community, including abstracts that directly considered focused ultrasound transducers and considerations for characterizing transducer with holography. 5aBA2. “In vivo thermal ablation control using three-dimensional echo decorrelation imaging in swine liver” (Ghahramani, University of Cincinnati) examined the correlation between 3D acoustic correlation images and ablated regions in porcine liver toward controlled ablative treatment. 5aBA3. “The impact of the central opening on nonlinear effects in ultrasound fields generated by Sonalleve V1 and V2 MR-HIFU systems” (V. Khokhlova, University of Washington and Moscow State University) compared the focal patterns and capabilities of the Sonalleve MR-HIFU V1 and V2 systems and described the HIFU-Beam simulation software, which allows time domain nonlinear simulation of annular arrays and layered media. 5aBA4. “Palpating particles using the acoustic radiation force: A new approach to magnetic particle imaging” (Zarcone, Vanderbilt University) proposed using acoustic radiation force to induce motion for magnetic particle imaging. 5aBA5. “Characterizing the steering performance of a diagnostic-therapeutic ultrasound array using measured and synthesized holograms” (Williams, University of Washington and Moscow State University) described the use of holography to characterize the surface of a linear ultrasound array with interleaving measurements to conserve time. 5aBA6. “The use of acoustic holography for simultaneous characterization of various focus steering configurations in ultrasound fields generated by multi-element phased arrays” (V. Khokhlova, University of Washington) performed harmonic and time domain holograms for annular therapeutic focused ultrasound transducers. 5aBA7. “A pipeline to enable large-scale generation of diverse 2D cardiac synthetic ultrasound recordings corresponding to healthy and heart failure virtual patients” (Burman, Katholieke Universiteit Leuven) described the use of augmentation tools for the generation of realistic myocardial velocity profiles toward the generation of large ultrasound training sets for machine learning. 5aBA8. “Contrast-enhanced ultrasound to detect active bleeding” (Schoen, Jr., Harvard Medical School and Massachusetts General Hospital) described methods and in vitro models used to establish the feasibility of microbubbles to assist with the detection of hemorrhage. 5aBA9. “Effect of acoustic output on fetal ultrasound color Doppler performance” (Huber, Duke University) described the setting of as low as reasonably achievable (ALRA) for Doppler ultrasound in neonatal imaging. 5aBA10. “Exploring the benefits of spatial and temporal block-wise filtering architectures” (Weeks, Vanderbilt University) which evaluated the use of spatial and temporal block-wise filtering ...
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Meeting Report: Congress of Neurological Surgeons (CNS) 2022

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Key Points The 2022 Annual Meeting of the Congress of Neurological Surgeons (CNS), “Neurosurgery Connected,” was held October 8–12, 2022, in San Francisco. The conference included discussions of focused ultrasound for movement disorders and for brain and spine tumors. All abstracts are available on the CNS 2022 app. The 2022 Annual Meeting of the Congress of Neurological Surgeons (CNS), “Neurosurgery Connected,” was held October 8–12, 2022, in San Francisco. In one of the Saturday symposia, “Controversies in Movement Disorder Surgery,” Experts debated hot topics within the movement disorder community, including: What is the optimal technique: Deep Brain Stimulation (DBS) vs. High Intensity Focused Ultrasound (HIFU)? The session included case presentations and discussion of complication avoidance or management. Course directors were Sharona Ben-Haim and André Machado, and faculty included Kara Beasley, Casey H. Halpern, Erika A. Petersen, Francisco A. Ponce, Tejas Sankar, and Jason M. Schwalb. A session titled, “Intraprocedural Delivery of Adjuvant Treatments for Brain and Spine Tumors,” included microbubbles plus focused ultrasound. Its description stated, “Tumor surgeons are becoming increasingly involved with delivery of adjuvant treatment during their procedures.” The session highlighted recent advances in intraoperative radiation therapy, microbubble ultrasound, and laser interstitial thermal therapy (LITT) for spinal tumors. The session was moderated by Nancy A. Oberheim Bush and Tiffany R. Hodges. Faculty included Isabelle Germano (intraoperative radiation therapy), Christopher Cifarelli (microbubble ultrasound), Francesco DiMeco (LITT), and Claudio Tatsui (oral abstract presentations). Five abstracts that may be of interest to the focused ultrasound community are listed below. The full text for these abstracts can be accessed by by downloading the CNS app (search “Congress of Neurological Surgeons” and look for the “Neurosurgery Connected” tagline). Cerebral Ischemia165. Intra-arterial Mitochondria as Treatment for Cerebral Ischemia after Thrombectomy by M. Yashar S. Kalani, Pedro Norat, Michael Robert Levitt, Melanie Walker, Jennifer Sokolowski, Petr Tvridk, and Richard Price Thermal Ablation Effects209. What Happens to Brain Outside the Thermal Ablation Zones? An Assessment of Needle-based Therapeutic Ultrasound in Survival Swine by Benjamin Szewczyk, Phillip Johansen, Matthew Tarasek, Zahabiya Campwala, Rachel Trowbridge, Zhanyue Zhao, Zachary T. Olmsted, Chitresh Bhushan, Eric Fiveland, Goutam Ghoushal, Tamas Heffter, Farid Tavakkolmoghaddam, Charles Bales, Yang Wang, Dhruv Kool Rajamani, Katie Gandomi, Christopher Nycz, Erin Jeannotte, Shweta Mane, Julia Nalwalk, Clif Burdette, Gregory S. Fischer, Desmond Yeo, Jiang Qian, and Julie G. Pilitsis Glioblastoma381. Repeated Opening of the Blood-brain Barrier with the Skull-Implantable SonoCloud-9 (SC9) Device: Phase 1 Trial of Nab-paclitaxel and SC9 in Recurrent Glioblastoma by Adam M. Sonabend, Andrew Gould, Yu Luan, Ye Hou, Le Chen, Mikoto Kobayashi, Brandyn Castro, Daniel Zhang, Farida Korobova, Christina Amidei, Mark William Youngblood, John Patrick Bebawy, Benjamin P. Liu, Craig Horbinski, Carole Desseaux, Irene Helenowski, Hui Zhang, Miguel Muzzio, Feng Yue, Michael Canney, and Roger Stupp Essential Tremor853. Voxel-Based Analysis of Lesion and Edema in MR-Guided Focused Ultrasound Thalamotomy for Essential Tremor by Patrick Ng, Alfredo Morales Pinzon, Fardad Behzadi, Michele Cavallari, Andrzej Marciniak, Grégory Bliault, Kezia Irene, Clément Nicolas-Graffard, Sarah Blitz, Melissa Ming Jie Chua, David J. Segar, Bruno Madore, Matthew N. DeSalvo, Thomas Tourdias, Manoj Saranathan, Jason White, Nathan McDannold, Charles R.G. Guttmann, and G. Rees Cosgrove Infiltrating Gliomas874. Direct Visualization of Planned Resection Volumes with Microbubble-Enhanced MR-Guided Focused Ultrasound Blood-Brain Barrier Opening and Sodium Fluorescein in Infiltrating Gliomas by Abdul-Kareem Ahmed, Pavlos Anastasaidis, Dheeraj Gandhi, and Graeme Woodworth To see the full text of all abstracts, download the free CNS App from your app store. See the Meeting Program Book >
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Meeting Report: Radiological Society of North America (RSNA) 2022

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Key Points The RSNA 108th Scientific Assembly and Annual Meeting was held in Chicago from November 27 through December 1, 2022. Focused ultrasound—related abstracts addressed histotripsy, tumor ablation, and several indications, including bone, brain, musculoskeletal, pancreatic cancer, prostate cancer, and uterine fibroids. RSNA’s 108th Scientific Assembly and Annual Meeting was held in Chicago from November 27 through December 1, 2022. There were at least 26 focused ultrasound–related abstracts, wherein attendees presented their research on histotripsy, tumor ablation, and several medical indications, including bone, brain, musculoskeletal, pancreatic cancer, prostate cancer, and uterine fibroids. The 26 abstracts and on demand educational content that may be of interest to the focused ultrasound community are listed below by topic area. Use the RSNA Online Planner tool to search and read the full text for each presentation. BoneMR-guided High Intensity Focused Ultrasound (MRgHIFU) in the Treatment of Bone Metastases: Safety of Sensitive Structures within 1 cm from Target Lesion by Valerio D’Agostino, MD (poster) Safety of MR-guided High Intensity Focused Ultrasound (MRgHIFU) in the Treatment of Osteoid Osteoma in Proximity of Sensitive Structures by Valerio D’Agostino, MD (oral presentation) BrainUltra High-Field MRI (7T) of the Thalamic Ventral Intermediate Nucleus (VIM) to Validate 3T Diffusion Tractography and 3T Anatomical Targeting for MR-Guided Focused Ultrasound (MRgFUS) of Essential Tremor (ET) by Brynmor Jones, FRCR, MRCP (oral presentation) How Diffusion Tensor Imaging Enables Direct Targeting for Focused Ultrasound Surgery by Hiroki Hori (on demand educational content) HistotripsyImpact of Non-invasive Histotripsy on Liver Tumor Treatment in a Rat Hepatocellular Carcinoma Model by Man Zhang, MD, PhD (oral presentation) Histotripsy Treatment of Veins as a Mechanism of Endothelial Damage by Amanda R. Smolock, MD, PhD (poster) A Phantom for Assessing Histotripsy Treatment Zones on Both Ultrasound and X-ray Imaging by Ayca Z. Kutlu, MD (poster) History of Histotripsy: Bench to Clinical Translation by Nathan E. Loudon, MD (on demand educational content) MusculoskeletalIn Vitro US-Triggered Drug Release from Polymer Film Pocket by Selin Isguven (poster) MSK Interventions: How I Do It by Matthew D. Bucknor, MD (on demand educational content) Pancreatic CancerFolfirinox plus High Intensity Focused Ultrasound for Pancreatic Ductal Adenocarcinoma: A Prospective Single Center Phase II Trial by Dong Ho Lee, MD (oral presentation) Synergistic Anticancer Effect of Pulsed Focused Ultrasound with Ultrasound-Sensitive Nanoparticle IMP301 on Pancreas Cancer Xenograft Model by Soojin Kim, MD (poster) ProstateAssessing Temporal Changes in Multi-parametric MRI and Analyzing MR Thermometry Parameters in Patients with Prostate Cancer Treated by Transurethral Ultrasound Ablation (TULSA): A Four-year Follow-up Study by Ali Bassir, MD (oral presentation) A Pilot Study of68Ga-PSMA11 and68Ga-RM2 PET/MRI for Evaluation of Prostate Cancer Response to High Intensity Focused Ultrasound (HIFU) Therapy by Heying Duan, MD (poster) Customized MR-guided Transurethral Ultrasound Ablation (TULSA) for Treatment of Localized Prostate Cancer and Concurrent Benign Prostate Hyperplasia: A Single Centre Retrospective Analysis of One Hundred Patients by Leonhard Steinmeister, MD (poster) MRI-Guided Focused Ultrasound (MRgFUS) Ablation for Localized Intermediate-Risk Prostate Cancer – Results of a Phase II Trial by Sangeet Ghai, MD (poster) Focal MRI-Guided Transurethral Ultrasound Ablation (TULSA) in Men with Prostate Cancer: Lessons Learned in 60+ Patients by Daniel N. Costa, MD (on demand educational content) MRI Guided Transurethral Ultrasound Ablation (TULSA) of Prostate: Initial Experience at Wellspan Hospital by Edward Steiner, MD (on demand educational content) Post-Treatment Prostatic Cancer: How to Perform an Adequate Imaging Evaluation by Vivien Bonadio, MD (on demand educational content) Minimally Invasive Image-Guided Treatment of Primary, Recurrent, and Metastatic Prostate Cancer by Daniel A. Adamo, MD (on demand educational content) Minimally Invasive Prostate Cancer Treatments – An Update by Riddhi M. Borse, MD (on demand educational content) Tumor AblationLow-Power MRgFUS Tumor Ablation upon Controlled Accumulation of Magnetic Nanoparticles by Cascade-Activated DNA Cross Linkers by Yi Zhu (poster) Uterine FibroidsDeep Learning Based Automatic Segmentation of the Uterus on T2-Weighted MRI for Volumetry in Patients with Uterine Fibroids Before and After High-Intensity Focused Ultrasound Therapy by Maike Theis, MSc (oral presentation) The Role of Boosting Algorithms in Machine Learning in Predicting the Treatment Outcome of High-Intensity Focused Ultrasound Ablation of Uterine Fibroids: Most Informative Perfusion MRI Features by Bilgin Keserci, PhD (poster) The Role of Machine Learning Algorithms in Predicting the Treatment Outcome of High-Intensity Focused Ultrasound Ablation of Uterine Fibroids with an Immediate Nonperfused Volume Ratio of at least 90% by Bilgin Keserci, PhD (poster) Magnetic Resonance Guided Focused Ultrasound (MRgFUS) for Treatment of Uterine Fibroids: Patient Selection, Contraindications and Operative Execution by Monica Mattone, MD (on demand educational content) See the Meeting Website > Search the RSNA Online Planner Tool >
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Meeting Report: Society of Neuro-Oncology (SNO) Annual Meeting and Education Day

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Key Points SNO held its 27th annual meeting and education day November 16-20, 2022. Investigators presented abstracts on using focused ultrasound to treat brain metastases and recurrent glioblastoma. Focused ultrasound—enhanced liquid biopsy was discussed with other researchers in the liquid biopsy session. Devices from Insightec, Carthera, and Cordance Medical were represented. SNO held its 27th Annual Meeting and Education Day in Tampa Bay, Florida, from November 16–20, 2022. With an in-person attendance of 2,500, the conference broke its previous attendance record. Along with the Foundation, many other nonprofits and patient advocacy organizations that support brain tumor research were represented, which created productive networking and collaboration opportunities. Suzanne LeBlang, MD, the Foundation’s Director of Clinical Relationships, attended many sessions at SNO and said, “Overall, I was impressed by the number of studies presented by focused ultrasound researchers. New research efforts clearly show the potential of this incisionless technology to combat brain tumors with numerous mechanisms of action.” At the liquid biopsy meeting, Dr. LeBlang presented an update on the state of the field of focused ultrasound–enhanced liquid biopsy for brain tumors and how focused ultrasound blood-brain barrier opening in and around a brain tumor could enhance the quantity and perhaps quality of analytes detected in the peripheral blood. Investigators presented abstracts and posters on using focused ultrasound to treat glioblastoma, primary brain tumors, and brain metastases with blood-brain barrier opening as well as sonodynamic therapy as the mechanisms of action. Focused ultrasound—enhanced liquid biopsy, a mechanism of action that has the potential to make a big impact in brain cancer diagnosis and treatment, and drug delivery approaches were also presented. Hideho Okada, MD, PhD, from the University of California, San Francisco, presented “Immunotherapy for Patients with IDH-Mutant LGG,” a keynote lecture and mentioned that focused ultrasound has the potential to enhance chimeric antigen receptor (CAR) T cell delivery. Each abstract is listed below. The full text for each abstract can be found by searching the ID number on SNO’s program website. CTNI-10 – Randomized pivotal study of blood-brain barrier (BBB) disruption using Exablate Model 4000 with standard of care (SOC) therapy in non-small cell lung cancer (NSCLC) brain metastases: LIMITLESS trial (Multiple medical centers, Insightec) poster presented by Manmeet S. Ahluwalia CTNI-13 – A first-in-human phase 0/1 trial of 5-Aminolevulinic Acid Sonodynamic Therapy (5-ALA SDT) in recurrent glioblastoma (Barrow Neurological Institute and Ivy Brain Tumor Center) oral abstract presented by Nader Sanai CTNI-20 – Results of a phase 1/2 clinical trial of blood-brain barrier (BBB) opening with the SonoCloud-9 implantable ultrasound device in recurrent glioblastoma patients receiving IV carboplatin (Multiple medical centers, Carthera) poster presented by Michael Canney CTNI-37 – Repeated opening of the blood-brain barrier with the skull-implantable SonoCloud-9 (SC9) device: Phase 1 trial of nab-paclitaxel and SC9 in recurrent glioblastoma (multiple medical centers, Carthera) oral abstract presented by Adam Sonabend CTNI-46 – Pivotal study to evaluate safety and efficacy of Exablate model 4000 using microbubble resonators to temporarily mediate blood-brain barrier disruption for liquid biopsy in glioblastoma (LIBERATE) (Multiple medical centers, Insightec) poster presented by Manmeet S. Ahluwalia CTNI-64 – Focused ultrasound mediated blood-brain barrier penetrance to enable cell-free DNA (cfDNA) as a liquid biopsy in recurrent primary brain tumors (Memorial Sloan Kettering Cancer Center and Cordance Medical) – poster presented by Ryan Dittamore DDEL-10 – Ultrasound-enhanced drug delivery in humans alters endothelial phenotype and perturbs the ultrastructure of the blood-brain barrier (Northwestern University, Carthera) poster presented by Andrew Gould DDEL-13 – Ultrasound-enhanced delivery of liposomal doxorubicin across the blood brain barrier induces an IFN-g phenotype in microglia, macrophages, and T cells and improves response to PD-1 blockade in gliomas (Northwestern University, IIT Research Institute, Carthera) poster presented by Victor A. Arrieta See the Meeting Website >
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Focused Ultrasound for Pancreatic Cancer: Trial Results Prove Safety, Initial Efficacy

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Key Points The data from an initial clinical trial in Korea were critical for establishing safety, preliminary efficacy, and the protocol parameters for a larger study. Jae Young Lee, MD, PhD, used the ultrasound-guided Alpinion focused ultrasound device plus standard-of-care chemotherapy to decrease tumor size in patients with pancreatic cancer. A phase II clinical trial is now underway in Korea and nearing its enrollment goal. Early, proof-of-concept safety data and the protocol parameters from a pancreatic cancer focused ultrasound plus chemotherapy clinical trial have now been published. This small, 9-participant clinical trial, which completed enrollment in 2019, was critical for establishing safety, preliminary efficacy, and the protocol parameters for the phase II clinical trial that is now underway. All participants were pathologically diagnosed with unresectable pancreatic cancer. Jae Young Lee, MD, PhD, professor of Radiology and president at Seoul National University Medical Research Center in Korea, is the principal investigator for both (phase I and II) studies. He and his team are using the ultrasound-guided Alpinion focused ultrasound device and standard-of-care chemotherapy regimens to address pancreatic cancer that is unresectable (which is the case in about 80% of patients with pancreatic cancer). “Pancreatic cancer typically presents with a dense fibrous stroma and low vascularity, which limits drug delivery and efficacy,” said Dr. Lee in the publication. “Therefore, there is an urgent need to develop new treatment options to enhance drug delivery.” Dr. Lee hypothesizes that focused ultrasound can weaken the tumor’s dense stroma to allow chemotherapy to penetrate the cancer cells. As published in European Radiology, the nine participants in the phase I study were assigned to one of three predefined treatment intensity groups (low, intermediate, or high) for six combined treatments of focused ultrasound plus nab-paclitaxel plus gemcitabine chemotherapy. Although it was primarily a safety study, after treatment, the team also measured changes in tumor size, tumor response, tumor marker levels, patient-reported outcomes, and survival. The treatments were safe, and participants experienced no adverse effects. Tumor size decreased more than 15% in seven of the nine participants at both the immediate and 3-month follow-up computed tomography scans. Tumor marker levels decreased in all participants. The intermediate intensity treatment was the most effective, with this group showing the largest decreases in tumor size (more than 30%) and tumor markers plus a significant improvement in survival (p < 0.05). “A key point of the proof-of-concept study is that the Seoul National team showed that they were able to access the patients’ tumors and treat them without complications,” said Tim Meakem, MD, the Foundation’s Chief Medical Officer. “This was not a small issue to solve, because accessing the pancreas with focused ultrasound has been challenging. Some efforts to treat similar patients using MRI guidance have been difficult, simply due to the size and access limitations of the MRI. Dr. Lee used ultrasound guidance for this procedure, which avoided these issues. The safety and initial efficacy of this project were well received by his colleagues, and almost all of the participants for the phase II study have already been enrolled.” The phase II, 60-participant study is being funded by the Focused Ultrasound Foundation. For phase II, the team is using a FOLFIRINOX regimen of chemotherapy. Dr. Lee presented interim phase II results at the 8th International Symposium on Focused Ultrasound. See the Video > See European Radiology > Related StoriesPancreatic Cancer Clinical Trial Begins in Korea October 2021 Research Awards Update: 15 Projects Initiated in the First Six Months of 2021 September 2021
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Clinical Trial of Sonodynamic Therapy for Glioblastoma Begins in Milan Call for Manuscripts: Special Collection on Histotripsy Meeting Report: International Bubble Conference 2022 Meeting Report: European Society for Hyperthermic Oncology (ESHO) 2022 Cleveland Clinic’s Comprehensive Review of Focused Ultrasound Brain Treatments