Welcome to this month's issue of the Focused Ultrasound Surgery Foundation newsletter, offering the latest developments in focused ultrasound as well as news of the Foundation and its programs.
The Foundation has developed a new brochure to explain the revolutionary potential that focused ultrasound surgery offers and how the Foundation is striving to bring tomorrow's medicine to today's patients. You can download this introduction to MR-guided Focused Ultrasound Surgery (MRgFUS) and the FUS Foundation here.
To keep up with the Foundation's activities and the latest news in the world of Focused Ultrasound Surgery, visit our website at http://www.fusfoundation.org.
Researcher Point of View - King Li, MD, FRCP(C), MBA
Dr. Li is the Chair of Radiology at the Methodist Hospital in Houston, Texas and a prior Associate Director of the National Institutes of Health Clinical Center and the Chief of Radiology for the Imaging Sciences Program. Dr. Li was also on faculty at Stanford University for ten years prior to joining the NIH. A prolific researcher, Dr. Li has published over one hundred scientific articles and contributed to many books. Highly regarded by his peers, Dr. Li has won several research awards as well as received numerous grants from government, industry and private sources.It is commonly accepted that once a therapeutic agent is administered to a subject via biodistribution, therapeutic and side effects are largely dependent on how the therapeutic agent interacts with the different tissues of the subject’s body. Although some work has been done on using chemical or physical means to activate drugs in vivo, such as photodynamic therapy and drug activated gene therapy, a systematic development of “remote controlled drugs” has not been accomplished to date. Similarly, much work has been done to develop a “magic bullet” by using targeting ligands or other technologies to try to home the therapeutic agents to their intended targets, but much less work has been done to modify the targets so that the “bullets” can hit the target more easily.
In our research, we focus on using image guided pulsed high intensity focused ultrasound (pulsed-HIFU) to increase the permeability of tissues to therapeutic agents locally, activate drugs or genesin vivo, and to upregulate targets to facilitate therapeutic agent localization. The long-term goal is to use the combination of image-guided physical energy deposition with smart design of chemical and biologic therapeutic agents to provide spatial and temporal control of delivery, activation and selectivity of therapeutic agents. This should allow us to have therapeutic agents that we can send to the right place at the right time and to have the desired effects on the right cells. We have done many proof-of-concept experiments in mouse models and have achieved very good results. We are working to translate this into larger animals using MR-guided pulsed-HIFU. We have just entered into a research agreement with InSightec, Inc. which should facilitate the translation of this technology into the clinic.
Deadline approaching for CMS request for feedback on MRgFUS payment codes
In a follow-up to a segment in last month's newsletter, the FUSF is providing a template to be used in response to the Center for Medicare and Medicaid's (CMS) proposal to move the MRgFUS treatment of uterine fibroids to a higher paying code.
Although the recommendation the CMS proposed was a great step in the right direction, it failed to fully consider all the costs associated with the treatment that should be covered.
The template prepared by the Foundation can be easily customized by the community and sent to the CMS in order to encourage them to move the MRgFUS procedure into a higher paying code which will allow more patients to benefit from the procedure.
Click here for the template and submission instructions.
Responses must be submitted to the CMS by Sept.14th.
FUSF Nominates Three RPPG Chairs
The FUS Foundation has chosen Chairs for three of its research program planning groups (RPPGs), established to identify key research initiatives for focused ultrasound. The RPPGs will allow the Foundation to initiate studies on its own, bringing together investigators, sites, and funding with the goal of developing new applications for treating patients with MRgFUS.
Dr. King Li of the Methodist Hospital in Houston will chair a group of experts in targeted drug delivery, an important application of focused ultrasound which can be used to thermally activate compounds at a specific site. Liposomal formulations of chemotherapy agents are one example. Other potential research areas include microbubbles and nanotechnology.
Dr. Mario Zuccarello, Professor of Neurosurgery at the University of Cincinatti Medical School, will formulate research priorities for intracerebral hemorrhage, for which limited therapeutic options currently exist. Early research with focused ultrasound has shown promise in its ability to liquefy organized blood clots at depth in tissue.
Dr. Andrei Alexandrov, Professor of Neurology at the University of Alabama, will chair a group looking at the application of focused ultrasound surgery to acute ischemic stroke. Developments in transcranial focused ultrasound together with targeted thrombolytics have the potential to offer powerful, accurate and rapid methods for clearing intravascular clots within the brain.
MRgFUS in the News
New York Times Article on MRgFUS An article featured in the New York Times follows the experiences of one patient as she goes through an MRgFUS treatment of her uterine fibroids. Unfortunately, the patient they chose to report on ended up having a hysterectomy to alleviate her fibroid symptoms in the end. However, the paper that the article references shows that MRgFUS fibroid treatments, when the treatment treats 60% of the fibroid or more, has results that compare very favorably with other leading treatments in a less invasive manner and with a shorter recovery time. Medical Imaging Feature on MRgFUS A good overview of the MRgFUS treatment of uterine fibroids was published in this month's issue of the magazine "Medical Imaging".
In a case report out of Brigham and Women's Hospital, a patient with uterine fibroids and secondary infertility experienced a successful pregnancy after receiving MRgFUS treatment of her fibroids.Improved chemotherapy efficacy when combined with HIFU A clinical study in France suggests that chemotherapy uptake in tissues was improved when combined with high intensity focused ultrasound.
Errata: Dr. Fiona Fennessy's title in last month's newsletter should have read: Assistant Professor of Radiology, Harvard Medical School, staff radiologist Brigham and Women's HospitalWe are always looking for new content of interest to the FUS community, so if you know of any relevant stories that we should be covering, please contact us at .
Focused Ultrasound Surgery Foundation | 230 Court Square, Suite 202 | Charlottesville | VA | 22902