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 kidney tumors. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) enabling kidney tumors to be treated without surgery. The primary options for treatment of kidney tumors depend on the type of the tumor, but typically is partial or complete surgical removal. Radiation, arterial embolization or chemotherapy may also be considered.
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 ongoing at Indiana University for patients with a small renal mass to receive ablation with focused ultrasound followed by a partial nephrectomy.
There are two pediatric clinical trials being conducted by the Children’s National Health System in Washington, DC. The first study looks at recurrent or refractory tumors that occur in close proximity to bone. The second study is using thermally sensitive doxorubicin to treat recurrent or refractory tumors.
For a full list of kidney tumor clinical trials, please see here.
Regulatory Approval and Reimbursement
A focused ultrasound system has been approved in China and in Europe for treatment of kidney cancer.
To the best of our knowledge, the use of focused ultrasound to treat kidney cancer is not yet reimbursed by medical insurance.
Schade GR, Wang YN, D'Andrea S, Hwang JH, Liles WC, Khokhlova TD. Boiling Histotripsy Ablation of Renal Cell Carcinoma in the Eker Rat Promotes a Systemic Inflammatory Response. Ultrasound Med Biol. 2018 Oct 16. pii: S0301-5629(18)30403-4. doi: 10.1016/j.ultrasmedbio.2018.09.006.
Magda Abbas A, Constatin-Coussios C, Robin Cleveland O. Patient Specific Simulation of HIFU Kidney Tumour Ablation. Conf Proc IEEE Eng Med Biol Soc. 2018 Jul;2018:5709-5712. doi: 10.1109/EMBC.2018.8513647.
Suomi V, Jaros J, Treeby B, Cleveland RO. Full Modeling of High-Intensity Focused Ultrasound and Thermal Heating in the Kidney Using Realistic Patient Models. IEEE Trans Biomed Eng. 2018 Nov;65(11):2660-2670. doi: 10.1109/TBME.2018.2870064. Epub 2018 Sep 13.
Weissenbacher A, Lo Faro L, Boubriak O, Soares MF, Roberts IS, Hunter JP, Voyce D, Mikov N, Cook A, Ploeg RJ, Coussios CC, Friend PJ. Twenty-four-hour normothermic perfusion of discarded human kidneys with urine recirculation. Am J Transplant. 2018 May 14. doi: 10.1111/ajt.14932.
Suomi V, Jaros J, Treeby B, Cleveland R. Full Modelling of High-Intensity Focused Ultrasound and Thermal Heating in the Kidney using Realistic Patient Models. IEEE Trans Biomed Eng. 2017 Jul 28. doi: 10.1109/TBME.2017.2732684.
Suomi V, Jaros J, Treeby B, Cleveland R. Nonlinear 3-D simulation of high-intensity focused ultrasound therapy in the Kidney. Conf Proc IEEE Eng Med Biol Soc. 2016 Aug;2016:5648-5651. doi: 10.1109/EMBC.2016.7592008.
Abhilash RH, Chauhan S, Che MV, Ooi CC, Bakar RA, Lo RH. Quantitative Study on the Effect of Abnormalities on Respiration-Induced Kidney Movement. Ultrasound Med Biol. 2016 Jul;42(7):1681-8. doi: 10.1016/j.ultrasmedbio.2016.01.015. Epub 2016 Apr 25.
de Senneville BD, Moonen C, Ries M. MRI-Guided HIFU Methods for the Ablation of Liver and Renal Cancers. Adv Exp Med Biol. 2016;880:43-63. doi: 10.1007/978-3-319-22536-4_3.
Click here for additional references from PubMed.