Focused Ultrasound Therapy
Focused ultrasound is an early-stage, non-invasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with lung cancer. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces a variety of therapeutic effects that could potentially enable lung cancer to be treated without incisions or radiation.
Some challenges in using focused ultrasound to treat lung cancer include the movement of the lungs with respiration, the air spaces in the lungs which disrupt the energy deposition and the limitations based on rib coverage of the target. Efforts are underway to address all of these concerns, including the use of one lung filling (OLF), where the patient is ventilated using the non-cancerous lung, and the lung with cancer is filled with saline prior to treatment.
A recent, isolated case was reported in a scientific meeting where a metastatic cancer located in the anterior portion of the lung was treated with focused ultrasound. This treatment did not require OLF. See the discussion of this case >
Potential advantages as compared to current treatments:
- Focused ultrasound is non-invasive and therefore has reduced risk for infection and blood clots, and potential for shorter recovery times.
- Precise targeting minimizes damage to non-targeted healthy tissue.
- No ionizing radiation, enabling repeat treatment if necessary.
- Treatment can be a complement to drug therapy, enabling enhanced delivery of chemotherapy or immunotherapy to tumors, with lower doses of drugs and minimal toxicity.
- May potentially induce an anti-tumor immune response.
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of lung tumors.
Preclinical Laboratory Studies
Early-stage preclinical studies suggest that focused ultrasound may play a beneficial role in the treatment of lung cancer. Recent feasibility studies have shown that focused ultrasound can be an effective, minimally invasive way to destroy tumors in the lung, with the potential to target only the tumor with minimal risk of damage to the surrounding tissues. Focused ultrasound would provide a more precise alternative to radiofrequency ablation and offers potential side effects that are significantly more tolerable than those of chemotherapy and radiation therapy. More studies are needed to further establish the safety and efficacy of this treatment modality before research can progress to the clinical stages.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for lung tumor is not yet approved by regulatory bodies or covered by medical insurance companies.
Documentation of human treatment: https://www.youtube.com/watch?v=Wtr25ypcQlU
Wolfram F, Lesser TG. A simulation study of the HIFU ablation process on lung tumours, showing consequences of atypical acoustic properties in flooded lung. Z Med Phys. 2018 Jul 20. doi: 10.1016/j.zemedi.2018.06.002.
Zhang T, Chen L, Zhang S, Xu Y, Fan Y, Zhang L. Effects of high-intensity focused ultrasound on cisplatin-resistant human lung adenocarcinoma in vitro and in vivo. Acta Biochim Biophys Sin (Shanghai). 2017 Dec 1;49(12):1092-1098. doi: 10.1093/abbs/gmx107.
Wolfram F, Dietrich G, Boltze C, Jenderka KV, Lesser TG. Effects of HIFU induced cavitation on flooded lung parenchyma. J Ther Ultrasound. 2017 Aug 7;5:21. doi: 10.1186/s40349-017-0099-6. eCollection 2017.
Wang Z, Qiao R, Tang N, Lu Z, Wang H, Zhang Z, Xue X, Huang Z, Zhang S, Zhang G, Li Y. Active targeting theranostic iron oxide nanoparticles for MRI and magnetic resonance-guided focused ultrasound ablation of lung cancer. Biomaterials. 2017 May;127:25-35. doi: 10.1016/j.biomaterials.2017.02.037. Epub 2017 Mar 1.
Lesser TG, Schubert H, Gullmar D, Reichenbach JR, Wolfram F. One-lung flooding reduces the ipsilateral diaphragm motion during mechanical ventilation. Eur J Med Res. 2016 Mar 8;21:9.
Wolfram F, Reichenbach JR, Lesser TG. An ex vivo human lung model for ultrasound-guided high-intensity focused ultrasound therapy using lung flooding. Ultrasound Med Biol. 2014 Mar;40(3):496-503.
Wolfram F, Boltze C, Schubert H, Bischoff S, Lesser TG. Effect of lung flooding and high-intensity focused ultrasound on lung tumours: an experimental study in an ex vivo human cancer model and simulated in vivo tumours in pigs. Eur J Med Res. 2014 Jan 7;19:1
Click here for additional references from PubMed.