Approximately 250 attendees gathered at the historic Dom church in Utrecht, The Netherlands for the International Society for Therapeutic Ultrasound’s (ISTU) recent symposium. Presentations included updates from several ongoing clinical and technical studies. Jean-Francois Aubry, PhD, who spent more than a year as a Fellow at the Foundation, was chosen as the next President of ISTU.
Scientific highlights included:
- Eye opening plenary lectures on neuromodulation by Shy Shoham, PhD (Technion) and on immunotherapy by Gosse Adema, PhD (Radboud University Medical Center), who called for multidisciplinary teams to explore this area.
- Presentations on topics such as boiling histotripsy and the use of a toroidal transducer were given to address the need for larger and faster volume ablations.
- Exciting advances in blood brain barrier (BBB) disruption were presented with applications such as drug and gene delivery. Disruption of the BBB has the potential to treat a wide range of neurological disorders including Alzheimer’s disease and brain tumors.
- Other meeting highlights included the application of focused ultrasound for uses beyond thermal ablation: sonoporation, thrombolysis, and drug delivery.
In addition, several important clinical studies were presented at the symposium, including the following highlights:
Prostate Cancer
Whole gland surgery or radiotherapy is associated with urinary incontinence, erectile dysfunction, and bowel toxicity. Up to 33% of patients with localized prostate cancer have unilateral disease that may suitable for treatment of one lobe. Albert Gelet, MD, presented a study to evaluate the ability of focused ultrasound to achieve local control of the tumor in these patients. Recurrence was found in 34 patients (37%). Although long-term outcomes should still be studied, the hemi-ablation strategy with focused ultrasound allowed encouraging local control of the cancer and decreased the side effects associated with standard treatment.
Breast Cancer
Ten women with histopathologically proven invasive breast cancer were treated in a clinical study designed to assess the safety and accuracy of a dedicated focused ultrasound breast system designed by Philips Healthcare. Floor Knuttel, MD, PhD, and her team at Utrecht Medical Center in the Netherlands performed the ablation study. Clear thermal damage, with a size comparable to the number and extent of applied sonications, was found. Focused ultrasound ablation with the dedicated breast system was safe and accurate. Five minor adverse events were observed.
Vascular Malformations
Focused ultrasound is a promising means of achieving thermal ablation of slow flow vascular malformations. Potential advantages over existing approaches include the ability to visualize and target the entire tumor while minimizing the risk to skin, nerves, muscles, and normal vessels. Dr. Pejman Ghanouni from Stanford University presented a study using the InSightec ExAblate 2100 system to treat four patients (median age 44 years, range 18 to 66) with thigh or calf vascular malformations. One lesion was treated per patient in one session per patient. The only complication of the procedures was anterior thigh fat necrosis in one patient. No serious adverse events occurred.
All abstracts will be made available on the ISTU website, www.istu.org.