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Mechanisms of Action

Where the focused ultrasound beams converge, there are 30 identified mechanisms of action – or bioeffects – that enable the technology to treat multiple medical disorders. Learn more about the more advanced mechanisms of action below.

Focused ultrasound is a platform technology that can interact with the body in a number of different ways. It can produce both mechanical and thermal energy, and may deliver this energy through either high or low pressure waves. These various focused ultrasound applications induce a wide range of bioeffects on the treated tissue. Some effects like tissue destruction and clot lysis are permanent, while others such as blood-brain barrier opening and neuromodulation are transitory and reversible. Multiple types of ultrasound applications may produce the same bioeffect, further enhancing focused ultrasound’s versatility in the treatment of disease.

Current research related to the various mechanisms of action is also available in Chapter 3 in the 2024 State of the Field Report.

Mechanisms of Action:

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Tissue Destruction

Tissue Destruction

Sonodynamic therapy

Sonodynamic therapy involves using ultrasound to activate cytotoxic drugs – medications that are designed to kill or damage cells – to cause targeted cell death.

Tissue Destruction

Histotripsy

Histotripsy involves using the mechanical energy of the ultrasound to create microshockwaves and disrupt cell membranes without heat.

Tissue Destruction

Thermal Ablation

Thermal ablation involves heating tissue to cause cell death. 

Drug Delivery

Drug Delivery

Drug delivery

Focused ultrasound can be used to enhance the local delivery of drugs, immune or stem cells, immunotherapeutics, genes, and nanoparticles.

Drug Delivery

Blood-brain barrier opening

Focused ultrasound can be used to increase the permeability of the blood-brain barrier – a protective layer of tightly joined cells that line the blood vessels of the brain to prevent harmful toxins from entering. This technique is noninvasive and temporary, enabling the delivery of beneficial drugs to the brain in higher concentrations.

Drug Delivery

Increased vascular permeability

Focused ultrasound can increase the permeability of the blood vessels, which allows drugs to enter tissue in higher concentrations.

Immunomodulation

Immunomodulation

Hyperthermia

Focused ultrasound can cause a mild temperature elevation that increases delivery of blood and drugs in the bloodstream to the targeted region.

Immunomodulation

Immunomodulation

Focused ultrasound can trigger an increased immune response to a treated tumor.

Immunomodulation

Immune cell trafficking

Focused ultrasound can cause the release of cytokines that can attract immune cells to the targeted tissue.

Neuromodulation

Neuromodulation

Neuromodulation

Neuromodulation involves using ultrasound to stimulate or block neural activity without damaging the nerves.

Other

Other

Vasoconstriction

Focused ultrasound can cause blood vessels to narrow, reducing blood flow, temporarily or long-term.

Other

Stem cell trafficking

Focused ultrasound is capable of enhancing the homing, penetration, and retention of stem cells at a targeted site.

Other

Liquid biopsy

Focused ultrasound can enhance the release of cancer antigens, cells, and DNA into the blood stream to allow for cancer diagnosis and monitoring.

Other

Hemostasis

Focused ultrasound can be used to stop blood flow.

Other

Cardiac pacing

Focused ultrasound can be used to trigger contraction of the heart.

Other

Angiogenesis

Focused ultrasound interacts with endothelial cells to induce angiogenesis – the process through which new blood vessels form from pre-existing vessels.

Other

Radiosensitization

Focused ultrasound can increase the delivery of oxygen to tumors and enhance their metabolic rate, thereby making them more susceptible to radiotherapy.

Other

Chemosensitization

Treating tumors with focused ultrasound can make them more susceptible to chemotherapy.

Other

Vasodilation

Focused ultrasound can be used to increase the volume of blood flowing through a targeted region.

Other

Clot lysis

Focused ultrasound can be used to destroy targeted blood clots, or sensitize them to drug treatments.