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Fan LX, Zhang Y, Yang LL, Ji XL, Wang Y, Huang YF, Shi L, Wen Y. Analysis of related factors influencing postoperative recurrence of adenomyosis treated with HIFU. Arch Gynecol Obstet 2024; 309:1765-1773. [PMID: 38347252 DOI: 10.1007/s00404-023-07340-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/07/2023] [Indexed: 04/16/2024]
Abstract
OBJECTIVE To analyze the efficacy of high-intensity focused ultrasound (HIFU) for adenomyosis and postoperative recurrence and its influencing factors. METHODS Clinical and follow-up data of 308 patients with adenomyosis who were treated with HIFU in Haifu Center, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from September 2017 to January 2022 were retrospectively analyzed. The recurrence of adenomyosis and the efficacy of HIFU at 6 months after surgery were followed up. To explore factors influencing postoperative prognosis and recurrence, the following variables were analyzed: patients' age, course of disease, gravidity and parity, size of the uterus, duration of HIFU, duration of irradiation, treatment intensity, dysmenorrhea score, time of follow-up, combined treatment of traditional Chinese medicine (TCM), western medicine adjuvant treatment, lesion location and type, and menorrhagia. RESULTS Among the 308 patients, 238 (77%) were followed up from 6 to 36 months, with an average follow-up time of 15.24 ± 9.97 months. The other 70 (23%) were lost to follow-up. At 6-month after surgery, efficacy rates of dysmenorrhea and menorrhagia management were 86.7% and 89.3%, respectively. Postoperative recurrence rates were 4.8% (1-12 months), 9.0% (12-24 months), and 17.0% (24-36 months) for dysmenorrhea; and 6.3% (1-12 months), 2.4% (12-24 months), and 12.2% (24-36 months) for menorrhagia. Multivariate logistic regression analyses showed that parity (P = 0.043, OR = 1.773, 95% CI 1.018-3.087), uterine size (P = 0.019, OR = 1.004, 95% CI 1.001-1.007), combined treatment of TCM (P = 0.047, OR = 1.846, 95% CI 1.008-3.381), diffuse lesion type (P = 0.013, OR = 0.464, 95% CI 0.254-0.848) and ablation rate (P = 0.015, OR = 0.481, 95%CI 0.267-0.868) were prognostic factors (P < 0.05). Age, course of disease, gravidity, duration of HIFU, duration of irradiation, treatment intensity, preoperative dysmenorrhea score, time of follow-up, western medicine adjuvant therapy, lesion location, and preoperative menstrual volume had no effect on prognosis (P > 0.05). CONCLUSION HIFU can effectively relieve dysmenorrhea and reduce menstrual volume in patients with adenomyosis. Parity, uterine size, lesion type (diffuse), and ablation rate are risk factors for symptom recurrence after HIFU, while the combination of TCM therapy is a protective factor for relapse. We, therefore, recommend TCM in the adjuvant setting after HIFU according to patient condition.
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Affiliation(s)
- Ling-Xiu Fan
- Department of Gynecology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Ying Zhang
- Department of Gynecology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Lei-Lei Yang
- Department of Gynecology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Xiao-Li Ji
- Department of Gynecology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yan Wang
- Department of Gynecology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Ye-Fang Huang
- Department of Gynecology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Ling Shi
- Department of Gynecology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yi Wen
- Department of Gynecology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.
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Bucher AM, Penzkofer T, May MS. Editorial for "Magnetic Resonance Imaging-Based Classification Systems for Informing Better Outcomes of Adenomyosis After Ultrasound-Guided High-Intensity Focused Ultrasound Ablating Surgery". J Magn Reson Imaging 2024; 59:1798-1799. [PMID: 37702415 DOI: 10.1002/jmri.28988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Affiliation(s)
- Andreas Michael Bucher
- Institute for Diagnostic and Interventional Radiology, Goethe University Frankfurt, University Hospital, Frankfurt am Main, Hessen, Germany
| | - Tobias Penzkofer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, Berlin, Germany
| | - Matthias Stefan May
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Imaging Science Institute, University Hospital Erlangen, Erlangen, Germany
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Ahmed AK, Zhuo J, Gullapalli RP, Jiang L, Keaser ML, Greenspan JD, Chen C, Miller TR, Melhem ER, Sansur CA, Eisenberg HM, Gandhi D. Focused Ultrasound Central Lateral Thalamotomy for the Treatment of Refractory Neuropathic Pain: Phase I Trial. Neurosurgery 2024; 94:690-699. [PMID: 37947407 DOI: 10.1227/neu.0000000000002752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/19/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Magnetic resonance-guided focused ultrasound (MRgFUS) central lateral thalamotomy (CLT) has not yet been validated for treating refractory neuropathic pain (NP). Our aim was to assess the safety and potential efficacy of MRgFUS CLT for refractory NP. METHODS In this prospective, nonrandomized, single-arm, investigator-initiated phase I trial, patients with NP for more than 6 months related to phantom limb pain, spinal cord injury, or radiculopathy/radicular injury and who had undergone at least one previous failed intervention were eligible. The main outcomes were safety profile and pain as assessed using the brief pain inventory, the pain disability index, and the numeric rating scale. Medication use and the functional connectivity of the default mode network (DMN) were also assessed. RESULTS Ten patients were enrolled, with nine achieving successful ablation. There were no serious adverse events and 12 mild/moderate severity events. The mean age was 50.9 years (SD: 12.7), and the mean symptom duration was 12.3 years (SD: 9.7). Among eight patients with a 1-year follow-up, the brief pain inventory decreased from 7.6 (SD: 1.1) to 3.8 (SD: 2.8), with a mean percent decrease of 46.3 (SD: 40.6) (paired t -test, P = .017). The mean pain disability index decreased from 43.0 (SD: 7.5) to 25.8 (SD: 16.8), with a mean percent decrease of 39.3 (SD: 41.6) ( P = .034). Numeric rating scale scores decreased from a mean of 7.2 (SD: 1.8) to 4.0 (SD: 2.8), with a mean percent decrease of 42.8 (SD: 37.8) ( P = .024). Patients with predominantly intermittent pain or with allodynia responded better than patients with continuous pain or without allodynia, respectively. Some patients decreased medication use. Resting-state functional connectivity changes were noted, from disruption of the DMN at baseline to reactivation of connectivity between DMN nodes at 3 months. CONCLUSION MRgFUS CLT is feasible and safe for refractory NP and has potential utility in reducing symptoms as measured by validated pain scales.
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Affiliation(s)
- Abdul-Kareem Ahmed
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Jiachen Zhuo
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Rao P Gullapalli
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Li Jiang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Michael L Keaser
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore , Maryland , USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore , Maryland , USA
| | - Joel D Greenspan
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore , Maryland , USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore , Maryland , USA
| | - Chixiang Chen
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
- Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Timothy R Miller
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Elias R Melhem
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Charles A Sansur
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Howard M Eisenberg
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore , Maryland , USA
| | - Dheeraj Gandhi
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore , Maryland , USA
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Ye A, Liu X. Clinical value of high-intensity focused ultrasound in fetal reduction. Eur J Obstet Gynecol Reprod Biol 2024; 294:206-209. [PMID: 38295709 DOI: 10.1016/j.ejogrb.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024]
Abstract
Complex twin reduction surgery is a common but challenging procedure that aims to reduce the risks and complications of multiple pregnancies. The search for safer and more effective methods has led to the development of high-intensity focused ultrasound (HIFU) technology in the field of fetal reduction. This technology utilizes high-energy sound waves to focus precisely on specific areas, achieving non-invasive therapeutic effects. This paper discusses the principles and features of HIFU technology, as well as its application in complex twin reduction surgery. The paper aims to elucidate the important role of this technology in improving surgical outcomes and reducing risks, explore the current limitations of the modality, and propose directions for future development. Through these investigations, it is hoped to improve overall understanding of HIFU, and thereby promote the application of this technology in the field of fetal reduction.
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Affiliation(s)
- Aihua Ye
- Department of Obstetrics and Gynaecology, The Maternal and Child Health Hospital of Longhua District, Shenzhen, Guangdong, China
| | - Xinhong Liu
- Department of Obstetrics and Gynaecology, The Maternal and Child Health Hospital of Longhua District, Shenzhen, Guangdong, China.
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Aubignat M. Evaluating the Scope and Safety of Bilateral MRgFUS Thalamotomy for Essential Tremor: A Critical Analysis. Mov Disord Clin Pract 2024; 11:318-319. [PMID: 38168110 PMCID: PMC10928354 DOI: 10.1002/mdc3.13969] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/26/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Mickael Aubignat
- Department of Neurology and Movement DisordersAmiens Picardie University HospitalAmiensFrance
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LeBlang S, Ziemlewicz TJ. The art of histotripsy: a focused ultrasound application that has the potential to treat from head to toe! Int J Hyperthermia 2024; 41:2312608. [PMID: 38323559 DOI: 10.1080/02656736.2024.2312608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Affiliation(s)
- Suzanne LeBlang
- Neuroradiologist, Director of Clinical Relationships-Focused Ultrasound Foundation, Charlottesville, VA, USA
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Ashida R, Kawabata KI, Asami R, Kitano M. Novel treatment system using endoscopic ultrasound-guided high-intensity focused ultrasound: A proof-of-concept study. Pancreatology 2024; 24:88-92. [PMID: 38036413 DOI: 10.1016/j.pan.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/09/2023] [Accepted: 11/16/2023] [Indexed: 12/02/2023]
Abstract
AIM High-intensity focused ultrasound (HIFU) is a novel minimally invasive local treatment of solid tumors. Endoscopic ultrasound-guided HIFU (EUS-HIFU) using mechanical effects would have potential benefits, including precise detection of target lesions and enhance drug delivery. The aim of this study is to develop EUS-HIFU device and to prove our concept in porcine model using a locally injected phase change nano droplet (PCND) as the sensitizer. METHOD A phospholipid PCND contained volatile perfluoro-carbon liquids. The prototype HIFU apparatus comprised a small (20 × 20 mm) transducer with center frequency of 2.1 MHz, attachable to a linear EUS transducer. Under general anesthetic, a single porcine received EUS-guided injection of PCND. The HIFU transducer was placed laparotomically in the stomach, and the liver was ablated through the gastric wall. RESULTS PCND was injected successfully and a distinct lesion was generated at the HIFU transducer focus only in injected areas that received HIFU exposure at 4.7 kW/cm2 at a duty cycle of 5 % (mean temporal intensity, 0.245 kW/cm2) for 30 s. The generated lesions were mechanically fractionated in macroscopic view. CONCLUSION The concept of transluminal HIFU ablation using novel EUS-HIFU system was proved in a porcine animal model. This novel treatment system has great potential for future cancer treatment although further investigation in more animals and different organs are warranted.
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Affiliation(s)
- Reiko Ashida
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
| | | | - Rei Asami
- Imaging Technology Center, FUJIFILM Corporation, Tokyo, Japan
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
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Shoji S. Focal therapy with high-intensity focused ultrasound for localized prostate cancer: approval as advanced medical care and future outlook. J Med Ultrason (2001) 2024; 51:1-3. [PMID: 38252181 DOI: 10.1007/s10396-023-01401-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024]
Affiliation(s)
- Sunao Shoji
- Department of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
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Zhou Y, Zhang J, Li C, Chen J, Lv F, Deng Y, Chen S, Du Y, Li F. Prediction of non-perfusion volume ratio for uterine fibroids treated with ultrasound-guided high-intensity focused ultrasound based on MRI radiomics combined with clinical parameters. Biomed Eng Online 2023; 22:123. [PMID: 38093245 PMCID: PMC10717163 DOI: 10.1186/s12938-023-01182-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 11/23/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Prediction of non-perfusion volume ratio (NPVR) is critical in selecting patients with uterine fibroids who will potentially benefit from ultrasound-guided high-intensity focused ultrasound (HIFU) treatment, as it reduces the risk of treatment failure. The purpose of this study is to construct an optimal model for predicting NPVR based on T2-weighted magnetic resonance imaging (T2MRI) radiomics features combined with clinical parameters by machine learning. MATERIALS AND METHODS This retrospective study was conducted among 223 patients diagnosed with uterine fibroids from two centers. The patients from one center were allocated to a training cohort (n = 122) and an internal test cohort (n = 46), and the data from the other center (n = 55) was used as an external test cohort. The least absolute shrinkage and selection operator (LASSO) algorithm was employed for feature selection in the training cohort. The support vector machine (SVM) was adopted to construct a radiomics model, a clinical model, and a radiomics-clinical model for NPVR prediction, respectively. The area under the curve (AUC) and the decision curve analysis (DCA) were performed to evaluate the predictive validity and the clinical usefulness of the model, respectively. RESULTS A total of 851 radiomic features were extracted from T2MRI, of which seven radiomics features were screened for NPVR prediction-related radiomics features. The radiomics-clinical model combining radiomics features and clinical parameters showed the best predictive performance in both the internal (AUC = 0.824, 95% CI 0.693-0.954) and external (AUC = 0.773, 95% CI 0.647-0.902) test cohorts, and the DCA also suggested the radiomics-clinical model had the highest net benefit. CONCLUSIONS The radiomics-clinical model could be applied to the NPVR prediction of patients with uterine fibroids treated by HIFU to provide an objective and effective method for selecting potential patients who would benefit from the treatment mostly.
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Affiliation(s)
- Ye Zhou
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Jinwei Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Chenghai Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China.
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China.
| | - Jinyun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yongbin Deng
- Chongqing Haifu Hospital, Chongqing, 401121, China
| | - Siyao Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Yuling Du
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Faqi Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China.
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, 400016, China.
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Purrer V, Upadhyay N, Borger V, Schmeel C, Boecker H, Wüllner U. Structural and functional alterations in the gustatory network underlie taste disturbances after lesional tremor therapy with MRgFUS. J Neurol Neurosurg Psychiatry 2023; 94:1072-1074. [PMID: 37321839 DOI: 10.1136/jnnp-2023-331324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Veronika Purrer
- Department of Neurology, University Hospital Bonn, Bonn, Germany
- German Center of Neurodegenerative Diseases, Bonn, Germany
| | - Neeraj Upadhyay
- German Center of Neurodegenerative Diseases, Bonn, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Valeri Borger
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Carsten Schmeel
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Henning Boecker
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
- Department of Diagnostic and Interventional Radiology, German Centre of Neurodegenerative Diseases, Bonn, Germany
| | - Ullrich Wüllner
- Department of Neurology, University Hospital Bonn, Bonn, Germany
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Nouwens S, Paulides M, Lindemeyer J, Sebeke L, van Kampen R, Grüll H, Heemels M. Simultaneous estimation of SAR, thermal diffusivity, and damping using periodic power modulation for MRgFUS quality assurance. Int J Hyperthermia 2023; 40:2283388. [PMID: 37994800 DOI: 10.1080/02656736.2023.2283388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/06/2023] [Indexed: 11/24/2023] Open
Abstract
Purpose: A crucial aspect of quality assurance in thermal therapy is periodic demonstration of the heating performance of the device. Existing methods estimate the specific absorption rate (SAR) from the temperature rise after a short power pulse, which yields a biased estimate as thermal diffusion broadens the apparent SAR pattern. To obtain an unbiased estimate, we propose a robust frequency-domain method that simultaneously identifies the SAR as well as the thermal dynamics.Methods: We propose a method consisting of periodic modulation of the FUS power while recording the response with MR thermometry (MRT). This approach enables unbiased measurements of spatial Fourier coefficients that encode the thermal response. These coefficients are substituted in a generic thermal model to simultaneously estimate the SAR, diffusivity, and damping. The method was tested using a cylindrical phantom and a 3 T clinical MR-HIFU system. Three scenarios with varying modulation strategies are chosen to challenge the method. The results are compared to the well-known power pulse technique.Results: The thermal diffusivity is estimated at 0.151 mm2s-1 with a standard deviation of 0.01 mm2s-1 between six experiments. The SAR estimates are consistent between all experiments and show an excellent signal-to-noise ratio (SNR) compared to the well established power pulse method. The frequency-domain method proved to be insensitive to B0-drift and non steady-state initial temperature distributions.Conclusion: The proposed frequency-domain estimation method shows a high SNR and provided reproducible estimates of the SAR and the corresponding thermal diffusivity. The findings suggest that frequency-domain tools can be highly effective at estimating the SAR from (biased) MRT data acquired during periodic power modulation.
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Affiliation(s)
- Sven Nouwens
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Maarten Paulides
- Department of Radiotherapy, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
- Care & Cure lab of the Electromagnetics group (EM4C&C), Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Johannes Lindemeyer
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Lukas Sebeke
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | | | - Holger Grüll
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Maurice Heemels
- Eindhoven University of Technology, Eindhoven, The Netherlands
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Shi L, Zhang R, Tao S, Yuan X, Zhang J, Wang B, Xiang M, Ren Z, Cai H, Fu C. Efficacy and Safety of Ultrasound-Guided High-Intensity Focused Ultrasound Ablation in Women With Multiple Uterine Fibroids: An Exploratory Study. Ultrasound Med Biol 2023; 49:2378-2387. [PMID: 37596155 DOI: 10.1016/j.ultrasmedbio.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE The aim of the work described here was to explore the clinical efficacy and safety of ultrasound-guided high-intensity focused ultrasound (USg-HIFU) treatment in women with multiple fibroids and identify the characteristic parameters predicting USg-HIFU efficacy in multiple fibroids. METHODS From February 2021 to August 2022, 138 patients with multiple fibroids (group A comprising 125 patients with two to four fibroids and 13 patients with five or more fibroids) and 149 patients with solitary fibroids (group B) were included. HIFU treatment information, efficacy comparisons and adverse events were recorded. A nomogram model of the characteristic parameters used to predict the efficacy of USg-HIFU in multiple fibroids was established. RESULTS After USg-HIFU treatment, the statistical comparison of pre-operative versus post-operative symptom scores and fibroid volume in the two groups indicated obvious symptom relief and substantial shrinkage of fibroid volume (all p values <0.001). Nevertheless, group A required more energy and longer treatment and sonication times to achieve a 70% non-perfused volume (NPV) ratio, and had a lower energy efficiency factor than group B (all p values <0.05). No severe complications were observed in either group. The nomogram model included fibroid volume, fibroid location and signal intensity on T2-weighted imaging (T2WI). The area under the receiver operating characteristic curve and the accuracy of the model were 0.698 and 0.686, respectively. CONCLUSION USg-HIFU appears to be an effective and safe treatment option for multiple fibroids. Knowledge of the fibroid volume, location and signal intensity on T2WI may help determine the efficacy of USg-HIFU in multiple fibroids.
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Affiliation(s)
- Liye Shi
- Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Rongsen Zhang
- Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Siqi Tao
- Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaorui Yuan
- Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Zhang
- Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Beibei Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Mengting Xiang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Zhen Ren
- Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Haiyi Cai
- Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China
| | - Chun Fu
- Department of Obstetrics and Gynecology, Second Xiangya Hospital of Central South University, Changsha, China.
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13
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Benaim EH, Nieri C, Mamidala M, Herr MJ, Sheyn A, Gillespie MB. High-intensity focused ultrasound for benign thyroid nodules: Systemic review and meta-analysis. Am J Otolaryngol 2023; 44:103999. [PMID: 37478539 DOI: 10.1016/j.amjoto.2023.103999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/08/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND High-intensity focused ultrasound (HIFU) is a less invasive option offered for the treatment of large, compressive, benign thyroid nodules. METHODS Observational studies of more than five participants using HIFU in the management of benign thyroid nodules from 2000 to 2021 were identified using predefined inclusion criteria. The primary outcome was an estimate of the effectiveness of HIFU. RESULTS Out of 158 studies reviewed, 8 articles were included with 297 patients and 300 nodules. HIFU significantly reduced nodule volume from 1 to 24 months following therapy (weighted mean difference [WMD], 47.68, 95 % confidence interval [CI], 34.13-59.66, p < 0.0001) and achieved favorable success rates (risk ratio [RR], 1.49, 95 % CI, 1.15-1.84, p < 0.001) for 50 % volume reduction. CONCLUSIONS HIFU appears to be a feasible, safe, and effective treatment modality for patients with benign thyroid nodules. Future research, including randomized controlled trials, is needed to determine therapy optimization, and patient selection to identify the potential role of this new therapy.
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Affiliation(s)
- Ezer H Benaim
- University of Tennessee Health Science Center-Department of Otolaryngology-Head & Neck Surgery, United States of America
| | - Chad Nieri
- University of Tennessee Health Science Center-Department of Otolaryngology-Head & Neck Surgery, United States of America
| | - Madhu Mamidala
- University of Tennessee Health Science Center-Department of Otolaryngology-Head & Neck Surgery, United States of America
| | - Michael J Herr
- University of Tennessee Health Science Center-Department of Otolaryngology-Head & Neck Surgery, United States of America
| | - Anthony Sheyn
- University of Tennessee Health Science Center-Department of Otolaryngology-Head & Neck Surgery, United States of America
| | - M Boyd Gillespie
- University of Tennessee Health Science Center-Department of Otolaryngology-Head & Neck Surgery, United States of America.
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14
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Xiong L, Cheng W, Wang Z, Shi Q. Pregnancy outcomes of adenomyotic patients with primary infertility after high-intensity focused ultrasound treatment. Int J Hyperthermia 2023; 40:2264547. [PMID: 37903541 DOI: 10.1080/02656736.2023.2264547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/22/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVE To evaluate the therapeutic effect of high-intensity focused ultrasound (HIFU) treatment for adenomyotic patients with primary infertility and to explore the factors that affect the pregnancy outcomes. MATERIALS AND METHODS Twenty-seven adenomyotic patients with primary infertility who underwent HIFU at HUNAN Provincial Maternal and Child Health Care Hospital, China, between July 2018 and December 2022 were retrospectively reviewed. We evaluated the pregnancy outcomes and analyzed the factors that may affect pregnancy outcomes including time to conception, pregnancy approach, gestational age, delivery mode, neonatal outcomes, and complications during pregnancy and delivery. RESULTS Among the 27 adenomyotic patients with primary infertility, 10 patients had a total of 11 pregnancies after HIFU treatment. Of these, eight (72%) cases were natural pregnancies and three (23%) were in vitro fertilization (IVF) pregnancies. The median time to conception was 10 (range 4-25) months. There were eight (72%) successful deliveries. The rate of full-term deliveries was 90%. Of the eight live births, four (50%) were born vaginally and four (50%) by cesarean section. No severe complications occurred. The mean birth weight of newborns was 3.1 (range: 2.3-3.9) kg; all newborns developed well without complications during postpartum and breastfeeding. CONCLUSIONS HIFU treatment for adenomyosis could improve fertility of patients with primary infertility. HIFU is a promising therapeutic approach for patients with adenomyosis and infertility who wish to achieve pregnancy and have live birth deliveries.
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Affiliation(s)
- Li Xiong
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- Department of Gynaecology and Obstetrics of Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Wei Cheng
- Department of Gynaecology and Obstetrics of Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| | - Zhibiao Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Qiuling Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
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15
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Salavastru C, Fritz K, Tiplica GS. [High intensity focussed ultrasound for skin tightening]. Dermatologie (Heidelb) 2023; 74:748-752. [PMID: 37582825 DOI: 10.1007/s00105-023-05198-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/17/2023]
Abstract
High intensity microfocussed ultrasound (HIFU) is currently used for skin tightening and recently also for fat reduction. The HIFU uses bundled ultrasound waves that are focussed by a type of concave mirror to bundle thermal energy. The indications for HIFU include, in particular, sagging skin that does not need a plastic surgical operation for tightening. In most cases only one or two treatment sessions are needed. More expensive HIFU treatment can be further optimized by maintenance therapy with radiofrequency (RF). The greatest disadvantage of HIFU is that the treatment is very painful.
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Affiliation(s)
- Carmen Salavastru
- Carol Davila University of Medicine and Pharmacy, Bucharest, Rumänien
- Colentina Clinical Hospital, Bucharest, Rumänien
- Pediatric Dermatology Discipline, Dermato-oncology Research Facility, Bukarest, Rumänien
| | - Klaus Fritz
- Carol Davila University of Medicine and Pharmacy, Bucharest, Rumänien.
- Dermatology and Laser Consultation Center, Reduitstr. 13, 76829, Landau, Deutschland.
| | - George-Sorin Tiplica
- Carol Davila University of Medicine and Pharmacy, Bucharest, Rumänien
- Colentina Clinical Hospital, Bucharest, Rumänien
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16
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Liao M, Chen F, Chen L, Wu Z, Huang J, Pang H, Cheng C, Wu Z, Ma L, Lu Q. Synergistic Enzyme-Mimetic Catalysis-Based Non-Thermal Sonocavitation and Sonodynamic Therapy for Efficient Hypoxia Relief and Cancer Ablation. Small 2023; 19:e2302744. [PMID: 37322373 DOI: 10.1002/smll.202302744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/29/2023] [Indexed: 06/17/2023]
Abstract
Non-invasive cancer treatment strategies that enable local non-thermal ablation, hypoxia relief, and reactive oxygen species (ROS) production to achieve transiently destroying tumor tissue and long-term killing tumor cells would greatly facilitate their clinical applications. However, continuously generating oxygen cavitation nuclei, reducing the transient cavitation sound intensity threshold, relieving hypoxia, and improving its controllability in the ablation area still remains a significant challenge. Here, in this work, an Mn-coordinated polyphthalocyanine sonocavitation agent (Mn-SCA) with large d-π-conjugated network and atomic Mn-N sites is identified for the non-thermal sonocavitation and sonodynamic therapy in the liver cancer ablation. In the tumor microenvironment, the catalytical generation of oxygen assists cavitation formation and generates microjets to ablate liver cancer tissue and relieve hypoxia, this work reports for the first time to utilize the enzymatic properties of Mn-SCA to lower the cavitation threshold in situ. Moreover, under pHIFU irradiation, high reactive oxygen species (ROS) production can be achieved. The two merits in liver cancer ablation are demonstrated by cell destruction and high tumor inhibition efficiency. This work will help deepen the understanding of cavitation ablation and the sonodynamic mechanisms related to the nanostructures and guide the design of sonocavitation agents with high ROS production for solid tumor ablation.
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Affiliation(s)
- Min Liao
- Department of Medical Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Fan Chen
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, China
| | - Lin Chen
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Zihe Wu
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Jianbo Huang
- Department of Medical Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Houqing Pang
- Department of Ultrasound, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Chong Cheng
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, China
| | - Zhe Wu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, China
| | - Lang Ma
- Department of Medical Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Qiang Lu
- Department of Medical Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
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17
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Ebani EJ, Strauss S, Thomas C, RoyChoudhury A, Kaplitt MG, Chazen JL. Cranial MRgFUS intraprocedural diffusion and T2 imaging and comparison with postablation lesion size and location. J Neurosurg 2023; 139:1190-1194. [PMID: 36933258 DOI: 10.3171/2023.2.jns222608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/06/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVE The ability to predict final lesion characteristics during magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy for the treatment of essential tremor remains technically challenging, yet it is essential in order to avoid off-target ablation and to ensure adequate treatment. The authors sought to evaluate the technical feasibility and utility of intraprocedural diffusion-weighted imaging (DWI) in the prediction of final lesion size and location. METHODS Lesion diameter and distance from the midline were measured on both intraprocedural and immediate postprocedural diffusion and T2-weighted sequences. Bland-Altman analysis was utilized to determine differences in measurement between intraprocedural and immediate postprocedural images with both sequences. RESULTS Lesion size increased on both the postprocedural diffusion and T2-weighted sequences, although the difference was smaller on the T2-weighted sequence. There was only a small difference in intraprocedural and postprocedural lesion distance from the midline on both the diffusion and T2-weighted sequences. CONCLUSIONS Intraprocedural DWI is both feasible and useful with regard to predicting final lesion size and providing an early indication of lesion location. Further research should determine the value of intraprocedural DWI in predicting delayed clinical outcomes.
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Affiliation(s)
| | | | - Charlene Thomas
- 2Department of Population Health Sciences, Division of Biostatistics, Weill Cornell Medicine, New York; and
| | - Arindam RoyChoudhury
- 2Department of Population Health Sciences, Division of Biostatistics, Weill Cornell Medicine, New York; and
| | | | - J Levi Chazen
- 4Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
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18
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Filippou A, Georgiou A, Nikolaou A, Evripidou N, Damianou C. Advanced software for MRgFUS treatment planning. Comput Methods Programs Biomed 2023; 240:107726. [PMID: 37480647 DOI: 10.1016/j.cmpb.2023.107726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Herein, a user-friendly software platform for 3-dimensional Focused Ultrasound treatment planning based on Magnetic Resonance Imaging (MRI) images is presented. METHODS The software directly retrieves and loads MRI images. Various design tools can be used on the MRI images to define the treatment area and the sonication parameters. Based on the treatment plan, the software controls the robotic motion and motion pattern of Magnetic Resonance guided Focused Ultrasound (MRgFUS) robotic systems to execute the treatment procedure. Real-time treatment monitoring is achieved through MRI images and thermometry. The software's functionality and performance were evaluated in both laboratory and MRI environments. Different treatment plans were designed on MRI images and sonications were executed on agar-based phantoms and polymer films. RESULTS Magnetic Resonance (MR) thermometry maps were acquired in the agar-based phantoms. An exceptional agreement was observed between the software-planned treatment area and the lesions produced on the polymer films. CONCLUSIONS The developed software was successfully integrated with the MRI and robotic system controls for performing accurate treatment planning and real-time monitoring during sonications. The software provides an extremely user-friendly interface, while in the future it could be enhanced by providing dynamic modulation of the ultrasonic parameters during the treatment process.
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Affiliation(s)
- Antria Filippou
- Cyprus University of Technology, Department of Electrical Engineering, Computer Engineering, and Informatics, 30 Archbishop Kyprianou Str., Limassol 3036, Cyprus.
| | - Andreas Georgiou
- Cyprus University of Technology, Department of Electrical Engineering, Computer Engineering, and Informatics, 30 Archbishop Kyprianou Str., Limassol 3036, Cyprus
| | - Anastasia Nikolaou
- Cyprus University of Technology, Department of Electrical Engineering, Computer Engineering, and Informatics, 30 Archbishop Kyprianou Str., Limassol 3036, Cyprus.
| | - Nikolas Evripidou
- Cyprus University of Technology, Department of Electrical Engineering, Computer Engineering, and Informatics, 30 Archbishop Kyprianou Str., Limassol 3036, Cyprus.
| | - Christakis Damianou
- Cyprus University of Technology, Department of Electrical Engineering, Computer Engineering, and Informatics, 30 Archbishop Kyprianou Str., Limassol 3036, Cyprus.
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19
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Chu Kwan W, den Otter-Moore I, Partanen A, Piorkowska K, Waspe AC, Drake JM. Noninvasive magnetic resonance-guided focused ultrasound for tendon disruption: an in vivo Animal study. Int J Hyperthermia 2023; 40:2260129. [PMID: 37743063 DOI: 10.1080/02656736.2023.2260129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
PURPOSE Surgical resection of the tendon is an effective treatment for severe contracture. Magnetic Resonance-guided Focused Ultrasound (MRgFUS) is a non-invasive ultrasonic therapy which produces a focal increase in temperature, subsequent tissue ablation and disruption. We evaluated MRgFUS as a clinically translatable treatment modality to non-invasively disrupt in vivo porcine tendons. MATERIAL AND METHODS In vivo Achilles tendons (n = 28) from 15-20kg Yorkshire pigs (n = 16) were randomly assigned to 4 treatment groups of 600, 900, 1200 and 1500 J. Pretreatment range of motion (ROM) of the ankle joint was measured with the animal under general anesthesia. Following MRgFUS treatment, success of tendon rupture, ROM increase, temperature, thermal dosage, skin burn, and histology analyses were performed. RESULTS Rupture success was found to be 29%, 86%, 100% and 100% for treatment energies of 600, 900, 1200 and 1500 J respectfully. ROM difference at 90° flexion showed a statistically significant change in ROM between 900 J and 1200 J from 16° to 27°. There was no statistical significance between other groups, but there was an increase in ROM as more energy was delivered in the treatment. For each of the respective treatment groups, the maximal temperatures were 58.4 °C, 63.3 °C, 67.6 °C, and 69.9 °C. The average areas of thermal dose measured were 24.3mm2, 53.2mm2, 77.8mm2 and 91.6mm2. The average areas of skin necrosis were 5.4mm2, 21.8mm2, 37.2mm2, and 91.4mm2. Histologic analysis confirmed tissue ablation and structural collagen fiber disruption. CONCLUSIONS This study demonstrated that MRgFUS is able to disrupt porcine tendons in vivo without skin incisions.
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Affiliation(s)
| | | | | | | | - Adam C Waspe
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - James M Drake
- The Hospital for Sick Children, Toronto, Ontario, Canada
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20
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Jeng CJ. Response letter to: "High-intensity focused ultrasound (HIFU) along may not be a good choice for treatment of adenomyosis". Taiwan J Obstet Gynecol 2023; 62:784-785. [PMID: 37679016 DOI: 10.1016/j.tjog.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- Cherng-Jye Jeng
- Department of Gynecology, Taipei Show Chwan Hospital, 106 Taipei, Taiwan; Department of Obstetrics and Gynecology, Chang-Hua Show Chwan Memorial Hospital, 500009 Changhua County, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, Kaohsiung Medical University, 80756 Kaohiung, Taiwan.
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21
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Trivedi VV, Wallach EL, Bader KB, Shekhar H. Contrast-Enhanced Imaging of Histotripsy Bubble Clouds Using Chirp-Coded Excitation and Volterra Filtering. IEEE Trans Ultrason Ferroelectr Freq Control 2023; 70:989-998. [PMID: 37379172 DOI: 10.1109/tuffc.2023.3289918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Histotripsy is a focused ultrasound therapy that ablates tissue via bubble cloud activity. Real-time ultrasound image guidance is used to ensure safe and effective treatment. Plane-wave imaging enables tracking of histotripsy bubble clouds at a high frame rate but lacks adequate contrast. Furthermore, bubble cloud hyperechogenicity is reduced in abdominal targets, making the development of contrast-specific sequences for deep-seated targets an active area of research. Chirp-coded subharmonic imaging was reported previously to enhance histotripsy bubble cloud detection by a modest 4-6 dB compared to the conventional sequence. Incorporating additional steps into the signal processing pipeline could enhance bubble cloud detection and tracking. In this study, we evaluated the feasibility of combining chirp-coded subharmonic imaging with Volterra filtering for enhancing bubble cloud detection in vitro. Chirped imaging pulses were used to track bubble clouds generated in scattering phantoms at a 1-kHz frame rate. Fundamental and subharmonic matched filters were applied to the received radio frequency signals, followed by a tuned Volterra filter to extract bubble-specific signatures. For subharmonic imaging, the application of the quadratic Volterra filter improved the contrast-to-tissue ratio from 5.18 ± 1.29 to 10.90 ± 3.76 dB, relative to the application of the subharmonic matched filter. These findings demonstrate the utility of the Volterra filter for histotripsy image guidance.
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22
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Hong L, Zhang W, Pan F, Xiaobo G, Huang H, You Y, Deng L, Wang Z, Zhang C. An in vitro and in vivo study on extracorporeal transducer optimization for high-intensity focused ultrasound to improve the safety and efficacy of breast tumor ablation. Int J Hyperthermia 2023; 40:2251734. [PMID: 37654021 DOI: 10.1080/02656736.2023.2251734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/24/2023] [Accepted: 08/19/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVE To observe the characteristics of a new extracorporeal high intensity focused ultrasound transducer, titled Haifu system JCQ-B, and to compare its safety and efficacy for breast ablation with the standard Haifu system JC transducer. MATERIALS AND METHODS Ox liver with pig skin and pork ribs were prepared in a semi-sphere shape, served as in vitro acoustic model. The udders of female goats were used as in vivo acoustic model. Both in vitro and in vivo models were ablated by either JCQ-B or JC transducer. The morphology of biological focal region (BFR), the coagulative necrosis volume, and the temperature increase were observed and compared. RESULTS The BFR morphology of JCQ-B transducer was circular both in vitro and in vivo, with a length-width ratio close to one. Under the same sonication parameters (sonication power, time and depth in tissue), coagulation necrosis volume caused by JCQ-B transducer was larger than that caused by JC transducer both in vitro and in vivo. The increase in temperature in the near and far acoustic pathways with JCQ-B transducer was significantly lower than that of JC transducer in vitro. After receiving high sonication energy during in vivo experimentation, there were no complications observed after the ablation of JCQ-B transducer, while small skin damage was observed after the ablation of JC transducer. CONCLUSIONS The JCQ-B transducer improved the safety and efficacy of treatment by optimizing BFR morphology and ablation efficiency, which could be applied in the treatment of breast tumor.
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Affiliation(s)
- Liu Hong
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
| | - Wendy Zhang
- Department of Radiology, Staten Island University Hospital, Staten Island, NY, USA
| | - Feibao Pan
- Department of Cerebrovascular Disease, Suining Central Hospital, Suining, P.R. China
| | - Gong Xiaobo
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
| | - Haoran Huang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
- Chongqing Haifu Hospital, Chongqing, P.R. China
| | - Yaqing You
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
| | - Lulu Deng
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
| | - Zhibiao Wang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Haifu Hospital, Chongqing, P.R. China
| | - Cai Zhang
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, P.R. China
- National Engineering Research Center of Ultrasound Medicine, Chongqing, P.R. China
- Chongqing Haifu Hospital, Chongqing, P.R. China
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23
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Kinfe T. MR-guided high-intensity focused ultrasound for chronic pain: where do we stand? Expert Rev Neurother 2023; 23:757-761. [PMID: 37556732 DOI: 10.1080/14737175.2023.2246659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Thomas Kinfe
- Division of Functional Neurosurgery and Stereotaxy, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
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Bautista KJB, Kim J, Xu Z, Jiang X, Dayton PA. Current Status of Sub-micron Cavitation-Enhancing Agents for Sonothrombolysis. Ultrasound Med Biol 2023; 49:1049-1057. [PMID: 36868959 DOI: 10.1016/j.ultrasmedbio.2023.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/11/2023] [Accepted: 01/23/2023] [Indexed: 05/11/2023]
Abstract
Thrombosis in cardiovascular disease is an urgent global issue, but treatment progress is limited by the risks of current antithrombotic approaches. The cavitation effect in ultrasound-mediated thrombolysis offers a promising mechanical alternative for clot lysis. Further addition of microbubble contrast agents introduces artificial cavitation nuclei that can enhance the mechanical disruption induced by ultrasound. Recent studies have proposed sub-micron particles as novel sonothrombolysis agents with increased spatial specificity, safety and stability for thrombus disruption. In this article, the applications of different sub-micron particles for sonothrombolysis are discussed. Also reviewed are in vitro and in vivo studies that apply these particles as cavitation agents and as adjuvants to thrombolytic drugs. Finally, perspectives on future developments in sub-micron agents for cavitation-enhanced sonothrombolysis are shared.
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Affiliation(s)
- Kathlyne Jayne B Bautista
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Jinwook Kim
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
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25
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Yuan Y, He X, Liu P, Pu D, Shi Q, Chen J, Teichmann AT, Zhan P. The effectiveness of single ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in managing placenta accreta spectrum (PAS) disorder. Arch Gynecol Obstet 2023; 307:1037-1045. [PMID: 36525091 DOI: 10.1007/s00404-022-06840-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 11/01/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the feasibility and effectiveness of single ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation in managing placenta accreta spectrum (PAS) disorder. MATERIALS AND METHODS We retrospectively analyzed 40 PAS patients between April 2017 and October 2021. All the patients received one session of HIFU treatment. Regular follow-up was done after HIFU treatment until normal menstruation returned and placental tissue disappeared. The patient's reproductive-related outcomes were obtained through telephone interviews. RESULTS The median follow-up time for the 40 patients was 30.50 (15.75-44.00) months and the mean placental tissue elimination time was 45.29 ± 33.32 days. The mean duration of bloody lochia was 13.43 ± 10.01 days, with no incidences of severe bleeding. Notably, Linear regression analysis showed that the residual placenta volume before HIFU was a factor affecting the duration of bloody lochia after HIFU (R2 = 0.284, B = 0.062, P = 0.000). The normal menstrual return time was 58.71 ± 31.14 days. One (2.50%) patient developed an infection. Two (5.00%) patients were subjected to ultrasound-guided suction curettage for persistent vaginal discharge for more than one month without infection. Notably, 7 of the 18 patients who expressed reproductive plans became pregnant during the 4 to 53 months of follow-up without placental abnormalities. The remaining 11 patients were on contraceptives. CONCLUSIONS Single HIFU is an effective treatment option for managing PAS. However, future studies on further treatment strategies to reduce complications and promote patient recovery after HIFU ablation are desirable.
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Affiliation(s)
- Yuan Yuan
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan, China
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Xian He
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan, China
| | - Ping Liu
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan, China
| | - Dali Pu
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan, China
| | - Qiuling Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, 400016, China
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China
| | - Jinyun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, Chongqing Medical University, Chongqing, 400016, China
| | - Alexander T Teichmann
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan, China
| | - Ping Zhan
- Sichuan Provincial Center for Gynaecology and Breast Diseases, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Luzhou, 646000, Sichuan, China.
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McNabb E, Sharma D, Sannachi L, Giles A, Yang W, Czarnota GJ. MR-guided ultrasound-stimulated microbubble therapy enhances radiation-induced tumor response. Sci Rep 2023; 13:4487. [PMID: 36934140 PMCID: PMC10024768 DOI: 10.1038/s41598-023-30286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/20/2023] [Indexed: 03/20/2023] Open
Abstract
High intensity focused ultrasound (HIFU) systems have been approved for therapeutic ultrasound delivery to cause tissue ablation or induced hyperthermia. Microbubble agents have also been used in combination with sonication exposures. These require temperature feedback and monitoring to prevent unstable cavitation and prevent excess tissue heating. Previous work has utilized lower power and pressure to oscillate microbubbles and transfer energy to endothelial cells in the absence of thermally induced damage that can radiosensitize tumors. This work investigated whether reduced acoustic power and pressure on a commercial available MR-integrated HIFU system could result in enhanced radiation-induced tumor response after exposure to ultrasound-stimulated microbubbles (USMB) therapy. A commercially available MR-integrated HIFU system was used with a hyperthermia system calibration provided by the manufacturer. The ultrasound transducer was calibrated to reach a peak negative pressure of - 750 kPa. Thirty male New Zealand white rabbits bearing human derived PC3 tumors were grouped to receive no treatment, 14 min of USMB, 8 Gy of radiation in a separate irradiation cabinet, or combined treatments. In vivo temperature changes were collected using MR thermometry at the tumor center and far-field muscle region. Tissues specimens were collected 24 h post radiation therapy. Tumor cell death was measured and compared to untreated controls through hematoxylin and eosin staining and immunohistochemical analysis. The desired peak negative pressure of - 750 kPa used for previous USMB occurred at approximately an input power of 5 W. Temperature changes were limited to under 4 °C in ten of twelve rabbits monitored. The median temperature in the far-field muscle region of the leg was 2.50 °C for groups receiving USMB alone or in combination with radiation. Finally, statistically significant tumor cell death was demonstrated using immunohistochemical analysis in the combined therapy group compared to untreated controls. A commercial MR-guided therapy HIFU system was able to effectively treat PC3 tumors in a rabbit model using USMB therapy in combination with radiation exposures. Future work could find the use of reduced power and pressure levels in a commercial MR-guided therapy system to mechanically stimulate microbubbles and damage endothelial cells without requiring high thermal doses to elicit an antitumor response.
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Affiliation(s)
- Evan McNabb
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Deepa Sharma
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | | | - Anoja Giles
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Wenyi Yang
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Gregory J Czarnota
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
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27
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Krishna V, Fishman PS, Eisenberg HM, Kaplitt M, Baltuch G, Chang JW, Chang WC, Martinez Fernandez R, Del Alamo M, Halpern CH, Ghanouni P, Eleopra R, Cosgrove R, Guridi J, Gwinn R, Khemani P, Lozano AM, McDannold N, Fasano A, Constantinescu M, Schlesinger I, Dalvi A, Elias WJ. Trial of Globus Pallidus Focused Ultrasound Ablation in Parkinson's Disease. N Engl J Med 2023; 388:683-693. [PMID: 36812432 DOI: 10.1056/nejmoa2202721] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND Unilateral focused ultrasound ablation of the internal segment of globus pallidus has reduced motor symptoms of Parkinson's disease in open-label studies. METHODS We randomly assigned, in a 3:1 ratio, patients with Parkinson's disease and dyskinesias or motor fluctuations and motor impairment in the off-medication state to undergo either focused ultrasound ablation opposite the most symptomatic side of the body or a sham procedure. The primary outcome was a response at 3 months, defined as a decrease of at least 3 points from baseline either in the score on the Movement Disorders Society-Unified Parkinson's Disease Rating Scale, part III (MDS-UPDRS III), for the treated side in the off-medication state or in the score on the Unified Dyskinesia Rating Scale (UDysRS) in the on-medication state. Secondary outcomes included changes from baseline to month 3 in the scores on various parts of the MDS-UPDRS. After the 3-month blinded phase, an open-label phase lasted until 12 months. RESULTS Of 94 patients, 69 were assigned to undergo ultrasound ablation (active treatment) and 25 to undergo the sham procedure (control); 65 patients and 22 patients, respectively, completed the primary-outcome assessment. In the active-treatment group, 45 patients (69%) had a response, as compared with 7 (32%) in the control group (difference, 37 percentage points; 95% confidence interval, 15 to 60; P = 0.003). Of the patients in the active-treatment group who had a response, 19 met the MDS-UPDRS III criterion only, 8 met the UDysRS criterion only, and 18 met both criteria. Results for secondary outcomes were generally in the same direction as those for the primary outcome. Of the 39 patients in the active-treatment group who had had a response at 3 months and who were assessed at 12 months, 30 continued to have a response. Pallidotomy-related adverse events in the active-treatment group included dysarthria, gait disturbance, loss of taste, visual disturbance, and facial weakness. CONCLUSIONS Unilateral pallidal ultrasound ablation resulted in a higher percentage of patients who had improved motor function or reduced dyskinesia than a sham procedure over a period of 3 months but was associated with adverse events. Longer and larger trials are required to determine the effect and safety of this technique in persons with Parkinson's disease. (Funded by Insightec; ClinicalTrials.gov number, NCT03319485.).
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Affiliation(s)
- Vibhor Krishna
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Paul S Fishman
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Howard M Eisenberg
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Michael Kaplitt
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Gordon Baltuch
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Jin Woo Chang
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Wei-Chieh Chang
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Raul Martinez Fernandez
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Marta Del Alamo
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Casey H Halpern
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Pejman Ghanouni
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Roberto Eleopra
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Rees Cosgrove
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Jorge Guridi
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Ryder Gwinn
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Pravin Khemani
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Andres M Lozano
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Nathan McDannold
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Alfonso Fasano
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Marius Constantinescu
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Ilana Schlesinger
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - Arif Dalvi
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
| | - W Jeff Elias
- From the University of North Carolina, Chapel Hill (V.K.); University of Maryland, Baltimore (P.S.F., H.M.E.); Cornell University (M.K.) and Columbia University (G.B.) - both in New York; Yonsei University, Seoul (J.W.C.); Chang Bing Show Chwan Memorial Hospital, Lukang, Taiwan (W.-C.C.); Centro Integral de Neurociencias Abarca Campal-HM Puerta Del Sur, Madrid (R.M.F., M.A.), and Clínica Universidad de Navarra, Pamplona (J.G.) - both in Spain; University of Pennsylvania, Philadelphia (C.H.H.); Stanford University, Stanford, CA (P.G.); Foundation IRCCS Neurological Institute Carlo Besta, Milan, Italy (R.E.); Harvard University, Boston (R.C., N.M.); Swedish Hospital, Seattle (R.G., P.K.); University of Toronto, Toronto (A.M.L., A.F.); Rambam Health Care Campus, Haifa, Israel (M.C., I.S.); Palm Beach Neuroscience Institute, Boynton Beach, FL (A.D.); and University of Virginia, Charlottesville (W.J.E.)
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Dahan M, Cortet M, Lafon C, Padilla F. Combination of Focused Ultrasound, Immunotherapy, and Chemotherapy: New Perspectives in Breast Cancer Therapy. J Ultrasound Med 2023; 42:559-573. [PMID: 35869903 DOI: 10.1002/jum.16053] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/11/2022] [Indexed: 06/15/2023]
Abstract
Focused ultrasound is a treatment modality increasingly used for diverse therapeutic applications, and currently approved for several indications, including prostate cancers and uterine fibroids. But what about breast cancer? Breast cancer is the most common and deadliest cancer in women worldwide. While there are different treatment strategies available, there is a need for development of more effective and personalized modalities, with fewer side effects. Therapeutic ultrasound is such an option, and this review summarizes the state of the art in their use for the treatment of breast cancer and evaluate potentials of novel treatment approaches combining therapeutic ultrasound, immuno- and chemo-therapies.
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Affiliation(s)
- Myléva Dahan
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France
| | - Marion Cortet
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France
- Service de Gynécologie Obstétrique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Cyril Lafon
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France
| | - Frédéric Padilla
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, Lyon, France
- Focused Ultrasound Foundation, Charlottesville, Virginia, USA
- Department of Radiology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
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Kwack MH, Lee WJ. Efficacy of a home-used high-intensity focused ultrasound device on wrinkle reduction. Skin Res Technol 2023; 29:e13266. [PMID: 36704876 PMCID: PMC9838762 DOI: 10.1111/srt.13266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND High-intensity focused ultrasound (HIFU) has been developed for the treatment of skin wrinkles on the face, neck, and body. OBJECTIVES This study aimed to evaluate the effects of a home-used HIFU device on wrinkles in mice based on the expression of fibrosis-related genes and proteins. METHODS The backs of 20-week-old mice were treated with a home-used HIFU using the following probes: 4 MHz, 1.5 mm focal depth. The treated mice were compared with young mice by histological examination, real-time polymerase chain reaction (PCR), and immunohistochemistry. Histological examination was performed by trichrome staining. Real-time PCR and immunohistochemistry were conducted to determine the expression of collagen types I and III, matrix metalloproteinase (MMP)-1, and tissue inhibitor of metalloproteinase (TIMP)-1. RESULTS Dermal thickness was increased after treatment with the home-used HIFU device at 30 and 60 s per day for 1 week or 30 and 60 s per day for 2 weeks on trichrome. Gene and protein expression of collagen types I and III and elastin were increased after treatment with HIFU at all options of 30 and 60 s per day for 1 week or 30 and 60 s per day for 2 weeks. Gene and protein expressions of MMP-1 and TIMP-1 were decreased after treatment with HIFU device at 30 and 60 s per day for 1 week or 30 and 60 s per day for 2 weeks. CONCLUSION The home-used HIFU device can be an effective therapeutic modality for skin tightening.
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Affiliation(s)
- Mi Hee Kwack
- Department of ImmunologySchool of MedicineKyungpook National UniversityDaeguSouth Korea
- BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, School of MedicineKyungpook National UniversityDaeguSouth Korea
| | - Weon Ju Lee
- Department of Dermatology, School of Medicine, Kyungpook National UniversityKyungpook National University HospitalDaeguSouth Korea
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30
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Li Q. The evaluation through contrast-enhanced ultrasonography for high-intensity focused ultrasound ablation treatment of uterine fibroids. J Clin Ultrasound 2023; 51:121-122. [PMID: 36468278 DOI: 10.1002/jcu.23303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Qiuyang Li
- Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, China, 100853, China
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31
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Cambronero S, Dupré A, Mastier C, Melodelima D. Non-invasive High-Intensity Focused Ultrasound Treatment of Liver Tissues in an In Vivo Porcine Model: Fast, Large and Safe Ablations Using a Toroidal Transducer. Ultrasound Med Biol 2023; 49:212-224. [PMID: 36441030 DOI: 10.1016/j.ultrasmedbio.2022.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/30/2022] [Accepted: 08/28/2022] [Indexed: 06/16/2023]
Abstract
A toroidal high-intensity focused ultrasound (HIFU) transducer was used to non-invasively treat liver tissues in vivo in a pig model. The transducer was divided into 32 concentric rings with equal surface areas operating at 2.5 MHz. First, attenuation of skin, fat, muscle and liver tissues was measured in fresh animal samples to adjust the energy delivered to the focal zone. Then, 8 animals were included in the present protocol and placed in a dorsal decubitus proclive position at an angle of 15°. The device was held by hand, and sonications were performed during apnea. Two thermal HIFU lesions were created in 40 s in each animal. The average abdominal wall thickness was 14.8 ± 1.3 mm (12.5-17.6 mm). The longest and shortest axes of the HIFU ablations were 20.9 ± 6.3 mm (14.0-33.7 mm) and 14.2 ± 5.5 mm (7.0-22.0 mm), respectively. All HIFU lesions were visible on sonograms. The correlation between the dimensions of the HIFU lesions observed on sonograms and those obtained during gross examination was r = 0.84. Creating large and fast ablations with reliable ultrasound imaging guidance in the liver using this handheld device may represent a new therapeutic option for patients with liver tumors.
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Affiliation(s)
| | - Aurélien Dupré
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon, Lyon, France; Centre Léon Bérard, Lyon, France
| | | | - David Melodelima
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon, Lyon, France
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Imran KM, Ganguly A, Paul T, Powar M, Vlaisavljevich E, Cho CS, Allen IC. Magic bubbles: utilizing histotripsy to modulate the tumor microenvironment and improve systemic anti-tumor immune responses. Int J Hyperthermia 2023; 40:2244206. [PMID: 37580047 PMCID: PMC10430775 DOI: 10.1080/02656736.2023.2244206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/16/2023] Open
Abstract
Focused Ultrasound (FUS) is emerging as a promising primary and adjunct therapy for the treatment of cancer. This includes histotripsy, which is a noninvasive, non-ionizing, non-thermal ultrasound guided ablation modality. As histotripsy has progressed from bench-to-bedside, it has become evident that this therapy has benefits beyond local tumor ablation. Specifically, histotripsy has the potential to shift the local tumor microenvironment from immunologically 'cold' to 'hot'. This is associated with the production of damage associated molecular patterns, the release of a selection of proinflammatory mediators, and the induction of inflammatory forms of cell death in cells just outside of the treatment zone. In addition to the induction of this innate immune response, histotripsy can also improve engagement of the adaptive immune system and promote systemic anti-tumor immunity targeting distal tumors and metastatic lesions. These tantalizing observations suggest that, in settings of widely metastatic disease burden, selective histotripsy of a limited number of accessible tumors could be a means of maximizing responsiveness to systemic immunotherapy. More work is certainly needed to optimize treatment strategies that best synergize histotripsy parameters with innate and adaptive immune responses. Likewise, rigorous clinical studies are still necessary to verify the presence and repeatability of these phenomena in human patients. As this technology nears regulatory approval for clinical use, it is our expectation that the insights and immunomodulatory mechanisms summarized in this review will serve as directional guides for rational clinical studies to validate and optimize the potential immunotherapeutic role of histotripsy tumor ablation.
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Affiliation(s)
- Khan M. Imran
- Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Roanoke, VA, USA
| | - Anutosh Ganguly
- Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Tamalika Paul
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Manali Powar
- Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Roanoke, VA, USA
| | - Eli Vlaisavljevich
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA, USA
- Institute for Critical and Applied Science Center for Engineered Health, Virginia Tech, Blacksburg, VA, USA
| | - Clifford S. Cho
- Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
- Research Service, Ann Arbor VA Healthcare, Ann Arbor, MI, USA
| | - Irving C. Allen
- Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Roanoke, VA, USA
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
- Institute for Critical and Applied Science Center for Engineered Health, Virginia Tech, Blacksburg, VA, USA
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
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Antoniou A, Evripidou N, Panayiotou S, Spanoudes K, Damianou C. Treatment of canine and feline sarcoma using MR-guided focused ultrasound system. J Ultrasound 2022; 25:895-904. [PMID: 35277843 PMCID: PMC9705640 DOI: 10.1007/s40477-022-00672-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/27/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE In recent years, veterinary medicine has enhanced its applications beyond traditional approaches, progressively incorporating the Focused Ultrasound (FUS) technology. This study investigated the ability of FUS to precisely ablate naturally occurring canine and feline soft tissue sarcomas (STS). METHODS Six dogs and four cats with superficial tumours were enrolled in the study. The tumours were treated with a Magnetic Resonance guided FUS (MRgFUS) robotic system featuring a single element spherically focused transducer of 2.6 MHz. The tumours were then removed by surgery and sent for hematoxylin and eosin (H&E) staining. RESULTS The MRgFUS system was capable of inflicting well-defined overlapping lesions in the tumours. The anatomical sites of the treated tumours were the neck, leg, face, back and belly. Coagulative necrosis was evidenced by histopathology assessment in 80% of cases. CONCLUSION Therefore, this technology can be a therapeutic solution for veterinary cancer and a model for advancing the knowledge on human STS.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus
| | - Nikolas Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus
| | - Stelios Panayiotou
- SGS Diagnostic Centre of Histopathology and Cytology Limited, 21 Thessalonikis, 3025, Limassol, Cyprus
| | - Kyriakos Spanoudes
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, 30 Archbishop Kyprianou Street, 3036, Limassol, Cyprus.
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Lai THT, Seto MTY, Cheung VYT. Intrapartum uterine rupture following ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroid and adenomyosis. Ultrasound Obstet Gynecol 2022; 60:816-817. [PMID: 35748875 DOI: 10.1002/uog.24983] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Affiliation(s)
- T H T Lai
- Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - M T Y Seto
- Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - V Y T Cheung
- Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, Hong Kong
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Peng Y, Dai Y, Yu G, Jin P. High-intensity focused ultrasound ablation combined with systemic methotrexate treatment of intramural ectopic pregnancy: A case report. Medicine (Baltimore) 2022; 101:e31615. [PMID: 36401379 PMCID: PMC9678570 DOI: 10.1097/md.0000000000031615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Intramural ectopic pregnancy (IMP) is a rare ectopic pregnancy with an unclear etiology, and standard treatment guidelines currently remain unclear. The main treatment option is local excision of IMP via laparoscopy or laparotomy. PATIENT CONCERNS A 32-year-old woman with adenomyosis presented with amenorrhea for 7 weeks and a serum β-human chorionic gonadotropin (HCG) level of 6882 IU/L. The patient had a history of laparotomy for adenomyosis 5 years previously. Three-dimensional ultrasonography showed a live gestational sac (GS) of 9 × 15 × 18 mm located in the left posterior wall of the uterus and a sinus tract connecting the sac and the endometrial cavity. MRI revealed the GS located in the adenomyosis and a 1.0-cm sinus tract connecting the GS and the endometrial cavity. DIAGNOSES IMP with adenomyosis. INTERVENTIONS High-intensity focused ultrasound (HIFU) treatment combined with systemic methotrexate (MTX) was performed to treat IMP, which would avoid operation and massive bleeding. OUTCOMES Serum β-HCG levels decreased to normal 4 weeks after HIFU treatment and the GS was not found on MRI after 4 months. The sinus tract was significantly shortened after the HIFU treatment. LESSONS HIFU ablation combined with systemic MTX is effective for the treatment of IMP and is favorable for maintaining fertility.
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Affiliation(s)
- Yan Peng
- Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
- *Correspondence: Yan Peng, Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, Guangdong, China (e-mail: )
| | - Yu Dai
- Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Guiyuan Yu
- Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Ping Jin
- Department of Gynecology, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China
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Akpinar E, Bayrak OC, Nadarajan C, Müslümanoğlu MH, Nguyen MD, Keserci B. Role of machine learning algorithms in predicting the treatment outcome of uterine fibroids using high-intensity focused ultrasound ablation with an immediate nonperfused volume ratio of at least 90. Eur Rev Med Pharmacol Sci 2022; 26:8376-8394. [PMID: 36459021 DOI: 10.26355/eurrev_202211_30373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This study aimed to investigate the role of machine learning (ML) classifiers to determine the most informative multiparametric (mp) magnetic resonance imaging (MRI) features in predicting the treatment outcome of high-intensity focused ultrasound (HIFU) ablation with an immediate nonperfused volume (NPV) ratio of at least 90%. PATIENTS AND METHODS Seventy-three women who underwent HIFU treatment were divided into groups A (n=47) and B (n=26), comprising patients with an NPV ratio of at least 90% and <90%, respectively. An ensemble feature ranking model was introduced based on the score values assigned to the features by five different ML classifiers to determine the most informative mpMRI features. The relationship between the mpMRI features and the immediate NPV ratio of 90% was evaluated using Pearson's correlation coefficients. The diagnostic ability of the ML classifiers was evaluated using standard performance metrics, including the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity in eight folds cross-validation. RESULTS For all the 12 most informative features, the area under receiver operating characteristic curve (AUROC), accuracy, specificity, and sensitivity ranged from 0.5 to 0.97, 0.34 to 0.97, 0.56 to 1.0, and 0.87 to 1.0, respectively. The gradient boosting (GBM) classifier demonstrated the best predictive performance with an AUROC of 0.95 and accuracy of 0.92, followed by the random forest, AdaBoost, logistic regression, and support vector classifiers, which yielded an AUROC of 0.92, 0.92, 0.83, and 0.78 and accuracy of 0.96, 0.88, 0.84, and 0.84, respectively. GBM had the best classifier performance with the best performing features from each mpMRI group, Ktrans ratio of the fibroid to the myometrium, the ratio of area under the curve of the fibroid to the myometrium, subcutaneous fat thickness, the ratio of apparent diffusion coefficient value of fibroid to the myometrium, and T2-signal intensity of the fibroid. CONCLUSIONS The preliminary findings of this study suggest that the most informative and best performing features from each mpMRI group should be considered for predicting the treatment outcome of HIFU ablation to achieve an immediate NPV ratio of 90%.
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Affiliation(s)
- E Akpinar
- Department of Physics, Intelligent Healthcare Innovation Research Center, Yildiz Technical University, Istanbul, Turkey.
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Yuan B, Qin X, Xi J. The Comparison of Life Quality between Ultrasound-Guided High-Intensity Focused Ultrasound and Laparoscopic Myomectomy for the Treatment of Uterine Fibroids. Comput Math Methods Med 2022; 2022:9604915. [PMID: 36035293 PMCID: PMC9410940 DOI: 10.1155/2022/9604915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/18/2022] [Accepted: 07/22/2022] [Indexed: 01/18/2023]
Abstract
Objective This study is aimed at comparing the uterine fibroids patients' postoperative living quality between ultrasound-guided high-intensity focused ultrasound (HIFU) and laparoscopic myomectomy. Materials and Methods A total of 164 patients were included with uterine fibroids who underwent laparoscopic myomectomy and HIFU in Cangzhou Central Hospital from September 2020 to November 2021. This study divided these objects into HIFU group and laparoscopic group, and both groups were followed up 6 months after surgery. After obtaining the results, Uterine Fibroid Symptom and health-related Quality Of Life questionnaire (UFS-QOL) and 36-Item Short Form Health Survey (SF-36) were performed before and after treatment to assess patient outcome. Results After treatments, the living quality in both groups was significantly improved compared with that before surgery, which had statistical significant (P < 0.05). After treatment, the scores of the two scales in HIFU group were significantly better than those in the laparoscopic group (P < 0.05). Conclusion In comparison with laparoscopic myomectomy, ultrasound-guided high-intensity focused ultrasound could improve the life quality of patients more effectively than traditional laparoscopic myomectomy and was helpful to the recovery and prognosis of uterine fibroids after treatment. The outcomes will provide a reference for clinicians to select a more appropriate treatment for uterine fibroids.
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Affiliation(s)
- Bilin Yuan
- Hebei Medical University, Shijiazhuang 050051, China
| | - Xinyi Qin
- Hebei Medical University, Shijiazhuang 050051, China
| | - Jie Xi
- Department of Gynecology, Cangzhou Central Hospital, Cangzhou 061000, China
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Zhong X, Cao Y, Zhou P. Thermochromic Tissue-Mimicking Phantoms for Thermal Ablation Based on Polyacrylamide Gel. Ultrasound Med Biol 2022; 48:1361-1372. [PMID: 35623921 DOI: 10.1016/j.ultrasmedbio.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 06/15/2023]
Abstract
In recent years, thermal ablation has played an increasingly important role in treating various tumors in the clinic. A practical thermochromic phantom model can provide a favorable platform for clinical thermotherapy training of young physicians or calibration and optimization of thermal devices without risk to animals or human participants. To date, many tissue-mimicking thermal phantoms have been developed and are well liked, especially the polyacrylamide gel (PAG)-based phantoms. This review summarizes the PAG-based phantoms in the field of thermotherapy, details their advantages and disadvantages and provides a direction for further optimization. The relevant physical parameters (such as electrical, acoustic, and thermal properties) of these phantoms are also presented in this review, which can assist operators in a deeper understanding of these phantoms and selection of the proper recipes for phantom fabrication.
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Affiliation(s)
- Xinyu Zhong
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuting Cao
- Institute of Ultrasound Imaging & Department of Ultrasound, Second Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China
| | - Ping Zhou
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
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40
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Vorländer C, Fischer A, Korkusuz H. High intensity focused ultrasound in the therapy of benign thyroid nodules-first German bicentric study with long-term follow-up. Endocrine 2022; 77:112-120. [PMID: 35476180 DOI: 10.1007/s12020-022-03058-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/10/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE The study evaluated high-intensity-focused ultrasound (HIFU) for benign thyroid nodules in terms of efficiency, complication rate, influence of preablative nodule size, parameters influencing the therapeutic success and hormonal-thyroid-function. METHODS Seventy-two patients with 75 nodules were treated with HIFU at 2 centers from 2014-2019. Median nodule volume was 4.4 ml (range 0.33-53). The therapeutic ultrasound probe (EchoPulse THC900888-H) generated 80-90 °C in the target tissue with 87.6-320.3 J per sonication. Nodal volume was measured at baseline and over 12 months after therapy in a retrospective bicentric-study with long-term follow-up. Hormonal-thyroid function (TSH, T3, T4) was measured before and after ablation. Complications were assessed. RESULTS Significant volume reduction (p < 0.05 Wilcoxon-signed-rank test) of thyroid nodules was 38.98% at 3 months, 37.32% at 6 months, 61.54% at 9 months and 60.66% at 12 months. Volume reduction of nodules <3 ml did not differ significantly from nodules >3 ml (p > 0.05 Mann-Whitney test). At 3 months solid nodules had a significant volume reduction of 52.08%, complex nodules of 32.57%, nodules treated under regional anesthesia of 33.07% and under general anesthesia of 49.47%. Hormonal-thyroid function was not influenced significantly by HIFU therapy (p > 0.05 Wilcoxon-signed-rank test). Complication rate was 3.8%. No long-term complications occurred. CONCLUSION Significant volume reduction of thyroid nodules up to 12 months after HIFU was shown. All complications were reversible. Therapy was more efficient in solid than complex nodules and in nodules treated under general anesthesia than with regional anesthesia. Hormonal-thyroid-function was not affected. TRIAL REGISTRAFTION NUMBER 2020-1728-evBO. Date of registration: 16.06.2020. Agency: Ethik-Kommission bei der Landesäztekammer Hessen.
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Affiliation(s)
- Christian Vorländer
- Bürgerhospital Frankfurt, Nibelungenallee 37, 60318, Frankfurt am Main, Hessen, Germany
| | - Anne Fischer
- DZTA - Deutsches Zentrum für Thermoablation e.V., Nibelungenallee 37-41, 60318, Frankfurt am Main, Hessen, Germany.
| | - Hüdayi Korkusuz
- Afyonkarahisar Sağlık Bilimleri Üniversitesi, Zafer Sağlık Külliyesi, Dörtyol Mahallesi 2078 Sokak No: 3, Afyonkarahisar, Turkey
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41
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Wu H, Zhou H, Zhang W, Jin P, Shi Q, Miao Z, Wang H, Zha Z. Three birds with one stone: co-encapsulation of diclofenac and DL-menthol for realizing enhanced energy deposition, glycolysis inhibition and anti-inflammation in HIFU surgery. J Nanobiotechnology 2022; 20:215. [PMID: 35524259 PMCID: PMC9074192 DOI: 10.1186/s12951-022-01437-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 04/25/2022] [Indexed: 01/12/2023] Open
Abstract
Despite attracting increasing attention in clinic, non-invasive high-intensity focused ultrasound (HIFU) surgery still commonly suffers from tumor recurrence and even matastasis due to the generation of thermo-resistance in non-apoptotic tumor cells and adverse therapy-induced inflammation with enhanced secretion of growth factors in irradiated region. In this work, inspired by the intrinsic property that the expression of thermo-resistant heat shock proteins (HSPs) is highly dependent with adenosine triphosphate (ATP), dual-functionalized diclofenac (DC) with anti-inflammation and glycolysis-inhibition abilities was successfully co-encapsulated with phase-change dl-menthol (DLM) in poly(lactic-co-glycolic acid) nanoparticles (DC/DLM@PLGA NPs) to realize improved HIFU surgery without causing adverse inflammation. Both in vitro and in vivo studies demonstrated the great potential of DC/DLM@PLGA NPs for serving as an efficient synergistic agent for HIFU surgery, which can not only amplify HIFU ablation efficacy through DLM vaporization-induced energy deposition but also simultaneously sensitize tumor cells to hyperthermia by glycolysis inhibition as well as diminished inflammation. Thus, our study provides an efficient strategy for simultaneously improving the curative efficiency and diminishing the harmful inflammatory responses of clinical HIFU surgery.
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Affiliation(s)
- Haitao Wu
- School of Food and Biological Engineering, School of Instrument Science and Opto-Electronics Engineering, Hefei University of Technology, Anhui, 230009, Hefei, China
| | - Hu Zhou
- Shenzhen Maternity and Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, 518028, Guangdong, China
| | - Wenjie Zhang
- School of Food and Biological Engineering, School of Instrument Science and Opto-Electronics Engineering, Hefei University of Technology, Anhui, 230009, Hefei, China
| | - Ping Jin
- Shenzhen Maternity and Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, 518028, Guangdong, China.
| | - Qianqian Shi
- School of Food and Biological Engineering, School of Instrument Science and Opto-Electronics Engineering, Hefei University of Technology, Anhui, 230009, Hefei, China
| | - Zhaohua Miao
- School of Food and Biological Engineering, School of Instrument Science and Opto-Electronics Engineering, Hefei University of Technology, Anhui, 230009, Hefei, China
| | - Hua Wang
- Department of Oncology, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
| | - Zhengbao Zha
- School of Food and Biological Engineering, School of Instrument Science and Opto-Electronics Engineering, Hefei University of Technology, Anhui, 230009, Hefei, China.
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42
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Byra M, Klimonda Z, Kruglenko E, Gambin B. Unsupervised deep learning based approach to temperature monitoring in focused ultrasound treatment. Ultrasonics 2022; 122:106689. [PMID: 35134653 DOI: 10.1016/j.ultras.2022.106689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/25/2021] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
Temperature monitoring in ultrasound (US) imaging is important for various medical treatments, such as high-intensity focused US (HIFU) therapy or hyperthermia. In this work, we present a deep learning based approach to temperature monitoring based on radio-frequency (RF) US data. We used Siamese neural networks in an unsupervised way to spatially compare RF data collected at different time points of the heating process. The Siamese model consisted of two identical networks initially trained on a large set of simulated RF data to assess tissue backscattering properties. To illustrate our approach, we experimented with a tissue-mimicking phantom and an ex-vivo tissue sample, which were both heated with a HIFU transducer. During the experiments, we collected RF data with a regular US scanner. To determine spatiotemporal variations in temperature distribution within the samples, we extracted small 2D patches of RF data and compared them with the Siamese network. Our method achieved good performance in determining the spatiotemporal distribution of temperature during heating. Compared with the temperature monitoring based on the change in radio-frequency signal backscattered energy parameter, our method provided more smooth spatial parametric maps and did not generate ripple artifacts. The proposed approach, when fully developed, might be used for US based temperature monitoring of tissues.
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Affiliation(s)
- Michal Byra
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland.
| | - Ziemowit Klimonda
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Eleonora Kruglenko
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Barbara Gambin
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
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Ji J, Liu J, Chen Y, Liu X, Hao L. Analysis of high intensity focused ultrasound in treatment of uterine fibroids on ovarian function and pregnancy outcome. J Clin Ultrasound 2022; 50:202-208. [PMID: 34965313 DOI: 10.1002/jcu.23116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
AIM To investigate the ovarian function and pregnancy outcome of patients with uterine fibroids and the influencing factors after high intensity focused ultrasound (HIFU) ablation treatment. METHODS A total of 80 patients were recruited. All patients were divided into the pregnancy group (64 cases) and the non-pregnancy group (16 cases). The pregnancy group was categorized into the good pregnancy outcome (GOP) group (46 cases) and adverse pregnancy outcome (APO) group (18 cases). The general data of all study subjects were collected. The changes of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), inhibin B (INHB), and antral follicle count (AFC) before HIFU and 3, 6, and 12 months after HIFU were compared. The related factors affecting pregnancy and pregnancy outcomes were analyzed. RESULTS There were no significant differences in AMH, FSH, INHB levels, and AFC at 6 and 12 months after HIFU compared with those before HIFU in pregnancy and non-pregnancy groups (p > 0.05). This study demonstrated that patients with prior history of pregnancy, younger age, lower body mass index (BMI), and smaller fibroids volume had a higher pregnancy rate (p < 0.05). Besides, younger age and smaller fibroids volume were associated with better pregnancy outcomes (p < 0.05). CONCLUSIONS HIFU in the treatment of uterine fibroids has little effect on ovarian function and does not increase the risk of infertility and adverse pregnancy. The prior history of pregnancy, age, BMI, and fibroids volume are essential factors affecting the postoperative pregnancy.
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Affiliation(s)
- Jingjing Ji
- Department of ultrasound, Wuxi No.2 People's Hospital, Affiliated Hospital of Nanjing Medical University, Wuxi City, China
| | - Jun Liu
- Department of ultrasound, Wuxi No.2 People's Hospital, Affiliated Hospital of Nanjing Medical University, Wuxi City, China
| | - Yingzhen Chen
- Department of ultrasound, Wuxi No.2 People's Hospital, Affiliated Hospital of Nanjing Medical University, Wuxi City, China
| | - Xi Liu
- Department of ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lihong Hao
- Department of ultrasound, Wuxi No.2 People's Hospital, Affiliated Hospital of Nanjing Medical University, Wuxi City, China
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Hendricks-Wenger A, Saunier S, Simon A, Grider D, Luyimbazi D, Allen IC, Vlaisavljevich E. Histotripsy for the Treatment of Cholangiocarcinoma in a Patient-Derived Xenograft Mouse Model. Ultrasound Med Biol 2022; 48:293-303. [PMID: 34750030 DOI: 10.1016/j.ultrasmedbio.2021.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/29/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
Histotripsy is a focused ultrasound ablation therapy being developed for the treatment of liver tumors. A recent study investigating the feasibility of using histotripsy for the ablation of cholangiocarcinoma (CC), bile duct cancer that is difficult to treat with current therapies because of its location near critical structures and fibrous tissue, reported the feasibility of treating CC in an acute mouse model. Here, we investigate histotripsy for the in vivo ablation of CC in a chronic study using a 1-MHz transducer at an applied dose of 500 pulses/point. A pilot study determined that treating the CC tumors plus a 1- to 2-mm margin induced significant injuries to intestinal tissues, thus precluding the use of this strategy. Next, histotripsy was applied to CCs (n = 6) with the treatment contained to the tumor. Post-treatment, the ablation was visualized using ultrasound, and subjects were monitored over time. Histotripsy achieved an average of 73% reduction of tumor diameter 26 d after treatment, with no significant adverse events. Notably, three of six treated tumors were undetectable after 2.5 wk. The treated animals were found to have significantly increased tumor progression-free and overall survival. Overall, results indicate that histotripsy can be used as a safe and effective method for treating CC.
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Affiliation(s)
- Alissa Hendricks-Wenger
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA; Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA; Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Roanoke, Virginia, USA
| | - Sofie Saunier
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA; Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Alexander Simon
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA
| | - Douglas Grider
- Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Dominion Pathology Associates, Roanoke, Virginia, USA
| | - David Luyimbazi
- Department of Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Department of Surgery, Carilion Clinic, Roanoke, Virginia, USA
| | - Irving C Allen
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, USA; Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Roanoke, Virginia, USA; Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA; Dominion Pathology Associates, Roanoke, Virginia, USA
| | - Eli Vlaisavljevich
- Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, Virginia, USA; Graduate Program in Translational Biology, Medicine and Health, Virginia Tech, Roanoke, Virginia, USA; Institute for Critical Technology and Applied Sciences Center for Engineered Health, Virginia Tech, Kelly Hall, Blacksburg, Virginia, USA.
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Vorländer C, Fischer A, Korkusuz H. Effects of Regional and General Anesthesia on the Therapeutic Outcome of Benign Thyroid Nodules Treated with High Intensity Focused Ultrasound (HIFU). World J Surg 2022; 46:1076-1081. [PMID: 35072745 DOI: 10.1007/s00268-022-06447-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The study investigated whether anesthesia performed during high-intensity-focused-ultrasound treatment (HIFU) of benign thyroid nodules influenced the therapy outcome, based on volume reduction and the amount of energy delivered. METHODS Thirty patients with benign thyroid nodules were treated with HIFU under general or regional anesthesia at two centers from 2014 to 2019. During HIFU, a therapeutic ultrasound probe, EchoPulse (Teraclion, Malakoff, France), heats the focus to 80-90 degrees Celsius. Nodal volumes were measured by ultrasound before and 3 months after therapy. For statistical analysis, the total population was divided into two groups according to the anesthesia performed. In a retrospective long-term multicenter study, volume reduction and the energy delivered were analyzed using the Wilcoxon signed-rank test and the Mann-Whitney test. RESULTS At three months follow-up, the total study population had an average volume reduction of 39.26% (range 4.03-91.16%, p < 0.001, n = 30), the general anesthesia group of 47.46% (range 13.64-91.16%, p = 0.001, n = 15) and the regional anesthesia group of 31.06% (range 4.03-68.63%, p = 0.001, n = 15). Under regional anesthesia a median energy of 3.16 kJ/cm3 (range: 0.96 - 8.2 kJ/cm3) and under general anesthesia a median energy of 0.88 kJ/cm3 (range: 0.18 - 1.63 kJ/cm3) were delivered. All results were significant with p < 0.05. The complication rate was 6.67%. CONCLUSION HIFU is an effective method to treat benign thyroid nodules. Comparing anesthesia methods, volume reduction is higher in patients treated under general anesthesia and less energy has to be delivered under general anesthesia. TRIAL REGISTRATION NUMBER 2020-1728-evBO. AGENCY Ethik-Kommission bei der Landesäztekammer Hessen.
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Affiliation(s)
- Christian Vorländer
- Bürgerhospital Frankfurt, Nibelungenallee 37, 60318, Frankfurt am Main, Hessen, Germany
| | - Anne Fischer
- DZTA-Deutsches Zentrum Für Thermoablation E.V, Nibelungenallee 37-41, 60318, Frankfurt am Main, Hessen, Germany.
| | - Hüdayi Korkusuz
- Afyonkarahisar Sağlık Bilimleri Üniversitesi, Dörtyol, 2078 Sokak No: 3, Merkez/Afyonkarahisar, 03030, Turkey
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46
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Yang Y, Shi XQ, Chen G, Zhou XN, Qian LX. Contrast-enhanced ultrasound for evaluating response to pulsed-wave high-intensity focused ultrasound therapy in advanced pancreatic cancer. Clin Hemorheol Microcirc 2022; 81:57-67. [PMID: 35001881 DOI: 10.3233/ch-211342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine whether contrast-enhanced ultrasound (CEUS) parameters in patients with advanced pancreatic cancer could be used to assess response to treatment with pulsed-wave high intensity focused ultrasound (PW-HIFU). METHODS We prospectively recorded the pretreatment and posttreatment CEUS related parameters, CA19-9, pain scores of 30 patients with advanced pancreatic cancer treated with PW-HIFU treatment. Correlation of clinical parameters, tumor characteristics, and PW-HIFU treatment energy with CEUS parameters were analyzed. RESULTS Pain score decreased after treatment (from 4.80±2.14 to 3.28±1.93, p = 0.001). CA19-9 dropped in RT decreased group, 4 weeks after one session PW-HIFU, compared with prolonged group (p = 0.013). According to the display of blood vessels in the mass by CEUS, tumors were classified by vessel grade (VG), VG1: no vessel can be seen; VG 2: vessels diameter < 5 mm; VG 3: vessels diameter > 5 mm. VGs were different between increased and decreased relative rise intensity (rRI) groups (p = 0.008). VG1 group shown a decreased rRI after treatment, while VG3 group showed the opposite trend (p = 0.006). CONCLUSIONS CEUS can evaluating response to PW-HIFU in advanced pancreatic cancer. Quantitative analysis may help to assess the short-term efficacy of patients and help for individualized treatment.
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Affiliation(s)
- Yu Yang
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xian-Quan Shi
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guang Chen
- Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Na Zhou
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lin-Xue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Zhao LY, Chao X, Yang BS, Wang GG, Zou JZ, Wu F. Phase-shift Perfluoropentane Nanoemulsions Enhance Pulsed High-intensity Focused Ultrasound Ablation in an Isolated Perfused Liver System and Their Potential Value for Cancer Therapy. J Ultrasound Med 2022; 41:107-121. [PMID: 33724514 DOI: 10.1002/jum.15686] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/26/2021] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To investigate whether phase-shift perfluoropetane (PFP) nanoemulsions can enhance pulsed high-intensity focused ultrasound (HIFU) ablation. METHODS PFP was encapsulated by poly(lactic-co-glycolic acid) (PLGA) to form a nanometer-sized droplet (PLGA-PFP), which was added to an isolated perfused liver system. Meanwhile, phosphate-buffered saline (PBS) was used as a control. The perfused liver was exposed to HIFU (150 W, t = 3/5/10 s) at various duty cycles (DCs). The ultrasound images, cavitation emissions, and temperature were recorded. Rabbits with subcutaneous VX2 tumors were exposed to HIFU (150 W) at various DCs with or without PLGA-PFP. After ablation, necrosis volume and energy efficiency factor were calculated. Pathologic characteristics were observed. RESULTS Compared to the PBS control, PLGA-PFP nanoemulsions markedly enhanced HIFU-induced necrosis volume in both perfused livers and subcutaneous VX2 tumor-bearing rabbits (P <.05). Inertial cavitation was much stronger in the pulsed-HIFU exposure at 10% than that in the continuous-wave HIFU exposure (P <.01). Peak temperature at 100% DC was significantly higher than that at 10% (P <.05). Compared to 100% DC HIFU exposure, the mean necrosis volume induced by 10 s exposure at 50% DC was significantly larger (P <.005) but lower at 10% DC in the isolated perfused livers (P <.05). In addition, the mean necrosis volume in subcutaneous VX2 tumor-bearing rabbits was significantly increased after HIFU exposure at 10% DC when compared to those at 100% DC (P <.05). Histopathologic analysis showed liquefaction necrosis in pulsed HIFU. CONCLUSION PLGA-PFP nanoemulsions can enhance HIFU ablation in the isolated perfused livers and promote tumor ablation in the subcutaneous xenograft rabbit model. Appropriate pulsed HIFU exposure may increase the necrosis volume and reduce total ultrasound energy required for HIFU ablation.
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Affiliation(s)
- Lu-Yan Zhao
- Transformational Medical Center, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Xu Chao
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Bing-She Yang
- Transformational Medical Center, The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Guo-Guan Wang
- The College of Basic Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Jian-Zhong Zou
- College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Feng Wu
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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Ciccarone F, Biscione A, Lorusso D, Zannoni GF, Cina A, Ferrandina G, Scambia G, Testa AC. Diagnosis of uterine leiomyosarcoma 5 years after magnetic-resonance-guided high-intensity focused ultrasound treatment of fibroid. Ultrasound Obstet Gynecol 2022; 59:125-126. [PMID: 34532904 DOI: 10.1002/uog.24775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/05/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Affiliation(s)
- F Ciccarone
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Biscione
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - D Lorusso
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G F Zannoni
- Unità Operativa di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - A Cina
- Dipartimento di Scienze Radiologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - G Ferrandina
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A C Testa
- Dipartimento Scienze della Salute della Donna, del Bambino, e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dipartimento Scienze della Vita e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
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Gao H, Wang Z, Tan M, Liu W, Zhang L, Huang J, Cao Y, Li P, Wang Z, Wen J, Shang T, Ran H. pH-Responsive Nanoparticles for Enhanced Antitumor Activity by High-Intensity Focused Ultrasound Therapy Combined with Sonodynamic Therapy. Int J Nanomedicine 2022; 17:333-350. [PMID: 35115772 PMCID: PMC8800590 DOI: 10.2147/ijn.s336632] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/24/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Hui Gao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhaoxia Wang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Mixiao Tan
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Weiwei Liu
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Liang Zhang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Ju Huang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yang Cao
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Pan Li
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zhigang Wang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jiexin Wen
- Department of Ultrasound, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Tingting Shang
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Haitao Ran
- Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Haitao Ran Chongqing Key Laboratory of Ultrasound Molecular Imaging & Institute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing, 400010, People’s Republic of ChinaTel +86-13-512373563 Email
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Maxwell AD, Haworth KJ, Holland CK, Hendley SA, Kreider W, Bader KB. Design and Characterization of an Ultrasound Transducer for Combined Histotripsy-Thrombolytic Therapy. IEEE Trans Ultrason Ferroelectr Freq Control 2022; 69:156-165. [PMID: 34534078 PMCID: PMC8802531 DOI: 10.1109/tuffc.2021.3113635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Chronic thrombi of the deep veins of the leg are resistant to dissolution or removal by current interventions and can act as thrombogenic sources. Histotripsy, a focused ultrasound therapy, uses the mechanical activity of bubble clouds to liquefy target tissues. In vitro experiments have shown that histotripsy enhances thrombolytic agent recombinant tissue plasminogen activator in a highly retracted clot model resistant to lytic therapy alone. Although these results are promising, further refinement of the acoustic source is necessary for in vivo studies and clinical translation. The source parameters for use in vivo were defined, and a transducer was fabricated for transcutaneous exposure of porcine and human iliofemoral deep-vein thrombosis (DVT) as the target. Based on the design criteria, a 1.5-MHz elliptical source with a 6-cm focal length and a focal gain of 60 was selected. The source was characterized by fiber-optic hydrophone and holography. High-speed photography showed that the cavitation cloud could be confined to dimensions smaller than the specified vessel lumen. The source was also demonstrated in vitro to create confined lesions within clots. The results support that this design offers an appropriate clinical prototype for combined histotripsy-thrombolytic therapy.
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