KoreaMed Synapse
 
About Synapse
Overview
Help
Disclaimer
Advanced Search
 
 
   
       Journal List > Korean J Radiol > v.9(4); Aug 2008
  |    |  Full-text      |    |  
Korean J Radiol. 2008 Aug;9(4):291-302.
Published online 2008 August 20.  doi: 10.3348/kjr.2008.9.4.291.
Copyright © 2008 The Korean Radiological Society
High-Intensity Focused Ultrasound Therapy: an Overview for Radiologists
Young-sun Kim, MD,1 Hyunchul Rhim, MD,1 Min Joo Choi, PhD,2,3 Hyo Keun Lim, MD,1 and Dongil Choi, MD1
1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
2Department of Biomedical Engineering, College of Medicine, Cheju National University, Jeju-si 690-716, Korea.
3Medical Physics Department, GSST & Division of Medical Imaging, Medical School, King's College London, University of London, UK.

Address reprint requests to: Hyunchul Rhim, MD, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. Tel. (822) 3410-2507, Fax. (822) 3410-2559, Email: rhimhc@skku.edu
Received October 20, 2007; Accepted December 28, 2007.

Abstract

High-intensity focused ultrasound therapy is a novel, emerging, therapeutic modality that uses ultrasound waves, propagated through tissue media, as carriers of energy. This completely non-invasive technology has great potential for tumor ablation as well as hemostasis, thrombolysis and targeted drug/gene delivery. However, the application of this technology still has many drawbacks. It is expected that current obstacles to implementation will be resolved in the near future. In this review, we provide an overview of high-intensity focused ultrasound therapy from the basic physics to recent clinical studies with an interventional radiologist's perspective for the purpose of improving the general understanding of this cutting-edge technology as well as speculating on future developments.

Keywords: Interventional procedures, technology, Ultrasound (US), therapeutic, Ultrasound (US), focused, High-intensity focused ultrasound (HIFU).
References
1. Wood RW,Loomis AL. The physical and biological effects of high frequency sound waves of great intensity. Philos Mag 1927;4:417.
2. Feril LB Jr,Kondo T. Biological effects of low intensity ultrasound: the mechanism involved, and its implications on therapy and on biosafety of ultrasound. J Radiat Res 2004;45:479–489.
3. Lynn JG,Zwemer RL,Chick AJ,Miller AF. A new method for the generation and use of focused ultrasound in experimental biology. J Gen Physiol 1942;26:179–193.
4. Fry WJ,Barnard JW,Fry FJ,Brennan JF. Ultrasonically produced localized selective lesions in the central nervous system. Am J Phys Med 1955;34:413–423.
5. Fry FJ. Precision high intensity focusing ultrasonic machines for surgery. Am J Phys Med 1958;37:152–156.
6. Fry WJ,Fry FJ. Fundamental neurological research and human neurosurgery using intense ultrasound. IRE Trans Med Electron 1960;ME-7:166–181.
7. Madersbacher S,Pedevilla M,Vingers L,Susani M,Marberger M. Effect of high-intensity focused ultrasound on human prostate cancer in vivo. Cancer Res 1995;55:3346–3351.
8. Dalecki D. Mechanical bioeffects of ultrasound. Annu Rev Biomed Eng 2004;6:229–248.
9. American institute of ultrasound in medicine, bioeffects committee. Bioeffects consideration of the safety of diagnostic ultrasound. J Ultrasound Med 1988;7:S1–S38.
10. Crocker MJ. Encyclopedia of acoustics. 1st ed. New York: John Wiley & Sons; 1997. pp. 6.
11. Nyborg WL. Mechanisms for bioeffects of ultrasound relevant to therapeutic applications. In: Wu J,Nyborg WLEmerging therapeutic ultrasound. 1st ed. Singapore: World Scientific Publishing; 2006. pp. 5-67.
12. ter Haar GR. Therapeutic application of ultrasound. Prog Biophys Mol Biol 2007;93:111–129.
13. ter Haar GR. Therapeutic and surgical applications. In: Hill CR,Bamber JC,ter Haar GRPhysical principles of medical ultrasound. 2nd ed. West Sussex: John Wiley & Sons; 2004. pp. 407-456.
14. Vaezy S,Andrew M,Kaczkowski P,Crum L. Image-guided acoustic therapy. Annu Rev Biomed Eng 2001;3:375–390.
15. Hynynen K,McDannold N. MRI-guided focused ultrasound for local tissue ablation and other image-guided interventions. In: Wu J,Nyborg WLEmerging therapeutic ultrasound. 1st ed. Singapore: World Scientific Publishing; 2006. pp. 167-218.
16. ter Haar GR. Ultrasonic biophysics. In: Hill CR,Bamber JC,ter Haar GRPhysical principles of medical ultrasound. 2nd ed. West Sussex: John Wiley & Sons; 2004. pp. 348-406.
17. Kennedy JE,ter Haar GR,Cranston D. High intensity focused ultrasound: surgery of the future?. Br J Radiol 2003;76:590–599.
18. Crocker MJ. Encyclopedia of acoustics. 1st ed. New York: John Wiley & Sons; 1997. pp. 1727.
19. Biological Effects of Ultrasound: Mechanisms and Clinical Implications, NCRP Report #74. National Council on Radiation Protection and Measurements (NCRP); 1983.
20. Leslie TA,Kennedy JE. High-intensity focused ultrasound principles, current uses, and potential for the future. Ultrasound Q 2006;22:263–272.
21. Clement GT. Perspectives in clinical uses of high-intensity focused ultrasound. Ultrasonics 2004;42:1087–1093.
22. ter Haar GR. High intensity focused ultrasound for the treatment of tumors. Echocardiography 2001;18:317–322.
23. ter Haar GR,Robertson D. Tissue destruction with focused ultrasound in vivo. Eur Urol 1993;23:S8–S11.
24. Bush NL,Rivens I,ter Haar GR,Bamber JC. Acoustic properties of lesions generated with an ultrasound therapy system. Ultrasound Med Biol 1993;19:789–801.
25. Vaezy S,Martin R,Crum L. High intensity focused ultrasound: a method of hemostasis. Echocardiography 2001;18:309–315.
26. Poliachik SL,Chandler WL,Mourad PD,Bailey MR,Bloch S,Cleveland RO,et al. Effect of high-intensity focused ultrasound on whole blood with and without microbubble contrast agent. Ultrasound Med Biol 1999;25:991–998.
27. Tachibana S,Koga K. Ultrasound boosting effect to thrombolysis. Blood Vessel 1981;12:450–453.
28. Tachibana S. Vibration for boosting fibrinolytic effect of urokinase. Thromb Haemost 1981;46 Suppl.:211A.
29. Tachibana K,Tachibana S. The use of ultrasound for drug delivery. Echocardiography 2001;18:323–328.
30. Alexandrov AV,Molina CA,Grotta JC,Garami Z,Ford SR,Alvarez-Sabin J,et al. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. New Eng J Med 2004;351:2170–2178.
31. Liu Y,Yang H,Sakanishi A. Ultrasound: mechanical gene transfer into plant cells by sonoporation. Biotechnol Adv 2006;24:1–16.
32. Miller DL,Pislaru SV,Greenleaf JE. Sonoporation: mechanical DNA delivery by ultrasonic cavitation. Somat Cell Mol Genet 2002;27:115–134.
33. Jolez FA,Hynynen K. Magnetic resonance image-guided focused ultrasound surgery. Cancer J 2002;8:S100–S112.
34. Hynynen K,McDannold N,Clement G,Jolesz FA,Zadicario E,Killiany R,et al. Pre-clinical testing of a phased array ultrasound system for MRI-guided noninvasive surgery of the brain? A primate study. Eur J Radiol 2006;59:149–156.
35. Hynynen K,McDannold N,Vykhodtseva N,Jolez FA. Noninvasive MR imaging-guided focal opening of the blood-brain barrier in rabbits. Radiology 2001;220:640–646.
36. Yu T,Wang G,Hu K,Ma P,Bai J,Wang Z. A microbubble agent improves the therapeutic efficiency of high intensity focused ultrasound: a rabbit kidney study. Urol Res 2004;32:14–19.
37. Kaneko Y,Maruyama T,Takegami K,Watanabe T,Mitsui H,Hanajiri K,et al. Use of a microbubble agent to increase the effects of high intensity focused ultrasound on liver tissue. Eur Radiol 2005;15:1415–1420.
38. Hanajiri K,Maruyama T,Kaneko Y,Mitsui H,Watanabe S,Sata M,et al. Microbubble-induced increase in ablation of liver tumors by high-intensity focused ultrasound. Hepatol Res 2006;36:308–314.
39. Tachibana K,Tachibana S. Albumin microbubble echo-contrast material as an enhancer for ultrasound accelerated thrombolysis. Circulation 1995;92:1148–1150.
40. Molina CA,Ribo M,Rubiera M,Montaner J,Santamarina E,Delgado-Mederos R,et al. Microbubble administration accelerates clot lysis during continuous 2-MHz ultrasound monitoring in stroke patients treated with intravenous tissue plasminogen activator. Stroke 2006;37:425–429.
41. Hwang JH,Brayman AA,Reidy MA,Matula TJ,Kimmey MB,Crum LA. Vascular effects induced by combined 1-MHz ultrasound and microbubble contrast agent treatments in vivo. Ultrasound Med Biol 2005;31:553–564.
42. Zderic V,Brayman AA,Sharar SR,Crum LA,Vaezy S. Microbubble-enhanced hemorrhage control using high intensity focused ultrasound. Ultrasonics 2006;45:113–120.
43. McDannold NJ,Vykhodtseva NI,Hynynen K. Microbubble contrast agent with focused ultrasound to create brain lesions at low power levels: MR imaging and histologic study in rabbits. Radiology 2006;241:95–106.
44. Hynynen K,McDannold N,Vykhodtseva N,Jolesz FA. Non-invasive opening of BBB by focused ultrasound. Acta Neurochi Suppl 2003;86:555–558.
45. Rabkin BA,Zderic V,Vaezy S. Hyperecho in ultrasound images of HIFU therapy: involvement of cavitation. Ultrasound Med Biol 2005;31:947–956.
46. Rabkin BA,Zderic V,Crum LA,Vaezy S. Biological and physical mechanisms of HIFU-induced hyperecho in ultrasound images. Ultrasound Med Biol 2006;32:1721–1729.
47. Qian ZW,Xiong L,Yu J,Shao D,Zhu H,Wu X. Noninvasive thermometer for HIFU and its scaling. Ultrasonics 2006;44S:E31–E35.
48. Souchon R,Rouviere O,Gelet A,Detti V,Srinivasan S,Ophir J,et al. Visualisation of HIFU lesion using elastography of the human prostate in vivo: preliminary results. Ultrasound Med Biol 2003;29:1007–1015.
49. Hindman JC. Proton resonance shift of water in the gas and liquid states. J Chem Phys 1996;44:4582–4592.
50. Blana A,Walter B,Rogenhofer S,Wieland WF. High-intensity focused ultrasound for the treatment of localized prostate cancer: 5-year experience. Urology 2004;63:297–300.
51. Uchida T,Ohkusa H,Yamashita H,Shoji S,Nagata Y,Hyodo T,et al. Five years experience of transrectal high-intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer. Int J Urol 2006;13:228–233.
52. Poissonnier L,Chapelon JY,Rouviere O,Curiel L,Bouvier R,Martin X,et al. Control of prostate cancer by transrectal HIFU in 227 patients. Eur Urol 2007;51:381–387.
53. Gelet A,Chapelon JY,Poissonnier L,Bouvier R,Rouviere O,Curiel L,et al. Local recurrence of prostate cancer after external beam radiotherapy: early experience of salvage therapy using high-intensity focused ultrasonography. Urology 2004;63:625–629.
54. Stewart EA,Rabinovici J,Tempany CM,Inbar Y,Regan L,Gostout B,et al. Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids. Fertil Steril 2006;85:22–29.
55. Hindley J,Gedroyc WM,Regan L,Stewart E,Tempany C,Hynynen K,et al. MRI guidance of focused ultrasound therapy of uterine fibroid: early results. AJR Am J Roentgenol 2004;183:1713–1719.
56. Smart OC,Hindley JT,Regan L,Gedroyc WG. Gonadotrophin-releasing hormone and magnetic-resonance-guided ultrasound surgery for uterine leiomyomata. Obstet Gynecol 2006;108:49–54.
57. Wu F,Wang ZB,Zhu H,Chen WZ,Zou JZ,Bai J,et al. Extracorporeal high intensity focused ultrasound treatment for patients with breast cancer. Breast Cancer Res Treat 2005;92:51–60.
58. Furusawa H,Namba K,Thomsen S,Akiyama F,Bendet A,Tanaka C,et al. Magnetic resonance-guided focused ultrasound surgery of breast cancer: reliability and effectiveness. J Am Coll Surg 2006;203:54–63.
59. Kennedy JE,Wu F,ter Haar GR,Gleeson FV,Phillips RR,Middleton MR,et al. High-intensity focused ultrasound for the treatment of liver tumors. Ultrasonics 2004;42:931–935.
60. Wu F,Wang ZB,Chen WZ,Zhu H,Bai J,Zou JZ,et al. Extracorporeal high intensity focused ultrasound ablation in the treatment of patients with large hepatocellular carcinoma. Ann Surg Oncol 2004;11:1061–1069.
61. Wu F,Wang ZB,Chen WZ,Zou JZ,Bai J,Zhu H,et al. Advanced hepatocellular carcinoma: treatment with high-intensity focused ultrasound ablation combined with transcatheter arterial embolization. Radiology 2005;235:659–667.
62. Wu F,Wang ZB,Zhu H,Chen WZ,Zou JZ,Bai J,et al. Feasibility of US-guided high-intensity focused ultrasound treatment in patients with advanced pancreatic cancer: initial experience. Radiology 2005;236:1034–1040.
63. Wu F,Wang ZB,Chen WZ,Bai J,Zhu H,Qiao TY. Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy. J Urol 2003;170:2237–2240.
64. Wu F,Wang ZB,Chen WZ,Wang W,Gui Y,Zhang M,et al. Extracorporeal high intensity focused ultrasound ablation in the treatment of 1038 patients with solid carcinomas in China: an overview. Ultrason Sonochem 2004;11:149–154.
65. Kratzik C,Schatzl G,Lackner J,Marberger M. Transcutaneous high-intensity focused ultrasonography can cure testicular cancer in solitary testis. Urololgy 2006;67:1269–1273.
66. Ram Z,Cohen ZR,Harnof S,Tal S,Faibel M,Nass D,et al. Magnetic resonance imaging-guided, high-intensity focused ultrasound for brain tumor therapy. Neurosurgery 2006;59:949–956.
67. Li JJ,Xu GL,Gu MF,Luo GY,Rong Z,Wu PH,et al. Complications of high intensity focused ultrasound in patients with recurrent and metastatic abdominal tumors. World J Gastroenterol 2007;13:2747–2751.
68. Mougenot C,Salomir R,Palussiere J,Grenier N,Moonen CT. Automatic spatial and temporal temperature control for MR-guided focused ultrasound using fast 3D MR thermometry and multispiral trajectory of the focal point. Magn Reson Med 2004;52:1005–1015.
69. de Senneville BD,Mougenot C,Moonen CT. Real-time adaptive method for treatment of mobile organs by MRI-controlled high-intensity focused ultrasound. Magn Reson Med 2007;57:319–330.