Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with liver tumors. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) enabling liver tumors to be treated without surgery.
The primary options for treatment of liver tumors include surgery, chemotherapy, radiotherapy, localized destruction of the tumor tissue (via radiofrequency ablation, alcohol injection, cryosurgery, or laser photocoagulation), or combination of two or more of these options. The long-term solution for primary liver cancer is often liver transplantation.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost.
- Focused ultrasound is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- Focused ultrasound can enhance the chemotherapy dose for the target, with less impact to the rest of the patient.
- It can be repeated, if necessary.
There is a clinical trial for liver cancer and metastatic liver tumors in pediatric patients and young adults.
A second study involves enhancing drug delivery due to heating the thermosensitive lysosome containing chemotherapy with focused ultrasound.
The Foundation’s Liver and Pancreas Program is working with the medical community to accelerate the research and development of focused ultrasound to treat these deadly cancers.
For a full list of clinical trials, please click here.
Regulatory Approval and Reimbursement
A focused ultrasound system has been approved in China and in Europe for treatment of liver cancer.
To the best of our knowledge, the use of focused ultrasound to treat liver cancer is not yet widely reimbursed by medical insurance.
Ma B, Liu X, Yu Z. The effect of high intensity focused ultrasound on the treatment of liver cancer and patients' immunity. Cancer Biomark. 2018 Oct 9. doi: 10.3233/CBM-181822.
Wang L, Li L, Wang X, Zhao D, Shan G, Wu X, Wang M, Liu J, Li X. Comparison of Combination Stereotactic Body Radiotherapy Plus High-Intensity Focused Ultrasound Ablation Versus Stereotactic Body Radiotherapy Alone for Massive Hepatocellular Carcinoma. Med Sci Monit. 2018 Nov 18;24:8298-8305. doi: 10.12659/MSM.910735.
Lyon PC, Gray MD, Mannaris C, Folkes LK, Stratford M, Campo L, Chung DYF, Scott S, Anderson M, Goldin R, Carlisle R, Wu F, Middleton MR, Gleeson FV, Coussios CC. Safety and feasibility of ultrasound-triggered targeted drug delivery of doxorubicin from thermosensitive liposomes in liver tumours (TARDOX): a single-centre, open-label, phase 1 trial. Lancet Oncol. 2018 Aug;19(8):1027-1039. doi: 10.1016/S1470-2045(18)30332-2. Epub 2018 Jul 11.
Paul C. Lyon, Lucy F. Griffiths, Jenni Lee, Daniel Chung, Robert Carlisle, Feng Wu, Mark R. Middleton Email author, Fergus V. Gleeson and Constantin C. Coussios. Clinical trial protocol for TARDOX: a phase I study to investigate the feasibility of targeted release of lyso-thermosensitive liposomal doxorubicin (ThermoDox®) using focused ultrasound in patients with liver tumours. Journal of Therapeutic Ultrasound. 20175:28
Zhai YP1, Wang Y. Effect of the combination treatment of high-intensity focused ultrasound and cryocare knife in advanced liver cancer. J BUON. 2017 Mar-Apr;22(2):495-499.
Wu L, Zhang YS, Ye ML, Shen F, Liu W, Hu HS, Li SW, Wu HW, Chen QH, Zhou WB. Overexpression and correlation of HIF-2α, VEGFA and EphA2 in residual hepatocellular carcinoma following high-intensity focused ultrasound treatment: Implications for tumor recurrence and progression. Exp Ther Med. 2017 Jun;13(6):3529-3534. doi: 10.3892/etm.2017.4428. Epub 2017 May 4.
Gélat P, Ter Haar G, Saffari N. A comparison of methods for focusing the field of a HIFU array transducer through human ribs. Phys Med Biol. 2014 May 27;59(12):3139-3171.
Jean-Francois Aubry, Kim Pauly, Chrit Moonen, Gail ter Haar, Mario Ries, Rares Salomir, Sham Sokka, Kevin Sekins, Yerucham Shapira, Fangwei Ye, Heather Huff-Simonin, Matt Eames, Arik Hananel, Neal Kassell, Alessandro Napoli, Joo Hwang, Feng Wu, Lian Zhang, Andreas Melzer, Young-sun Kim, Wladyslaw M Gedroyc. The road to clinical use of high-intensity focused ultrasound for liver cancer: technical and clinical consensus. Journal of Therapeutic Ultrasound 2013, 1:13; 2013 Aug 1.
Orsi F, Arnone P, Chen WZ, Zhang LA. High intensity focused ultrasound ablation: A new therapeutic option for solid tumors. J Cancer Res Ther 2010 Oct-Dec;6(4):414-20.
Click here for additional references from PubMed.
Video courtesy of Insightec.