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The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population.

Illing RO, Kennedy JE, Wu F, ter Haar GR, Protheroe AS, Friend PJ, Gleeson FV, Cranston DW, Phillips RR, Middleton MR - Br. J. Cancer (2005)

Bottom Line: Ablation of liver tumours was achieved more consistently than for kidney tumours (100 vs 67%, assessed radiologically).The adverse event profile was favourable when compared to more invasive techniques.These findings have significant implications for future noninvasive image-guided tumour ablation.

View Article: PubMed Central - PubMed

Affiliation: HIFU Unit, Churchill Hospital, Oxford OX3 7LJ, UK, and Clinical Center for Tumor Therapy, Chongqing University of Medical Sciences, People's Republic of China. rowland@doctors.org.uk

ABSTRACT
High-intensity focused ultrasound (HIFU) provides a potential noninvasive alternative to conventional therapies. We report our preliminary experience from clinical trials designed to evaluate the safety and feasibility of a novel, extracorporeal HIFU device for the treatment of liver and kidney tumours in a Western population. The extracorporeal, ultrasound-guided Model-JC Tumor Therapy System (HAIFU Technology Company, China) has been used to treat 30 patients according to four trial protocols. Patients with hepatic or renal tumours underwent a single therapeutic HIFU session under general anaesthesia. Magnetic resonance imaging 12 days after treatment provided assessment of response. The patients were subdivided into those followed up with further imaging alone or those undergoing surgical resection of their tumours, which enabled both radiological and histological assessment. HIFU exposure resulted in discrete zones of ablation in 25 of 27 evaluable patients (93%). Ablation of liver tumours was achieved more consistently than for kidney tumours (100 vs 67%, assessed radiologically). The adverse event profile was favourable when compared to more invasive techniques. HIFU treatment of liver and kidney tumours in a Western population is both safe and feasible. These findings have significant implications for future noninvasive image-guided tumour ablation.

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Related in: MedlinePlus

Axial FAME series MRI images, 1 min post IV gadolinium contrast. (A) Before HIFU with a right hepatic metastasis within segment VIII showing central necrosis, and (B) 12 days after HIFU, a larger zone consistent with coagulation necrosis within the metastasis.
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fig3: Axial FAME series MRI images, 1 min post IV gadolinium contrast. (A) Before HIFU with a right hepatic metastasis within segment VIII showing central necrosis, and (B) 12 days after HIFU, a larger zone consistent with coagulation necrosis within the metastasis.

Mentions: Of the 30 patients treated, 27 were evaluable in terms of response to treatment. Evidence of ablation was seen (radiologically or histologically) in 25 patients (93%). Of the 26 patients who had radiological evaluation, 24 had clear zones of ablation on post-HIFU MRI. Accuracy was assessed as ‘good' in 21. Two patients had zones of ablation lying 2 mm in front of the target tumour, and one patient had a zone of ablation lying 2 mm beyond the target. The data for overall radiological and histological evaluation are given in Table 3. Examples of radiological evidence of ablation are shown in Figures 3 and 4, for liver and kidney tumours, respectively.


The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population.

Illing RO, Kennedy JE, Wu F, ter Haar GR, Protheroe AS, Friend PJ, Gleeson FV, Cranston DW, Phillips RR, Middleton MR - Br. J. Cancer (2005)

Axial FAME series MRI images, 1 min post IV gadolinium contrast. (A) Before HIFU with a right hepatic metastasis within segment VIII showing central necrosis, and (B) 12 days after HIFU, a larger zone consistent with coagulation necrosis within the metastasis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2361666&req=5

fig3: Axial FAME series MRI images, 1 min post IV gadolinium contrast. (A) Before HIFU with a right hepatic metastasis within segment VIII showing central necrosis, and (B) 12 days after HIFU, a larger zone consistent with coagulation necrosis within the metastasis.
Mentions: Of the 30 patients treated, 27 were evaluable in terms of response to treatment. Evidence of ablation was seen (radiologically or histologically) in 25 patients (93%). Of the 26 patients who had radiological evaluation, 24 had clear zones of ablation on post-HIFU MRI. Accuracy was assessed as ‘good' in 21. Two patients had zones of ablation lying 2 mm in front of the target tumour, and one patient had a zone of ablation lying 2 mm beyond the target. The data for overall radiological and histological evaluation are given in Table 3. Examples of radiological evidence of ablation are shown in Figures 3 and 4, for liver and kidney tumours, respectively.

Bottom Line: Ablation of liver tumours was achieved more consistently than for kidney tumours (100 vs 67%, assessed radiologically).The adverse event profile was favourable when compared to more invasive techniques.These findings have significant implications for future noninvasive image-guided tumour ablation.

View Article: PubMed Central - PubMed

Affiliation: HIFU Unit, Churchill Hospital, Oxford OX3 7LJ, UK, and Clinical Center for Tumor Therapy, Chongqing University of Medical Sciences, People's Republic of China. rowland@doctors.org.uk

ABSTRACT
High-intensity focused ultrasound (HIFU) provides a potential noninvasive alternative to conventional therapies. We report our preliminary experience from clinical trials designed to evaluate the safety and feasibility of a novel, extracorporeal HIFU device for the treatment of liver and kidney tumours in a Western population. The extracorporeal, ultrasound-guided Model-JC Tumor Therapy System (HAIFU Technology Company, China) has been used to treat 30 patients according to four trial protocols. Patients with hepatic or renal tumours underwent a single therapeutic HIFU session under general anaesthesia. Magnetic resonance imaging 12 days after treatment provided assessment of response. The patients were subdivided into those followed up with further imaging alone or those undergoing surgical resection of their tumours, which enabled both radiological and histological assessment. HIFU exposure resulted in discrete zones of ablation in 25 of 27 evaluable patients (93%). Ablation of liver tumours was achieved more consistently than for kidney tumours (100 vs 67%, assessed radiologically). The adverse event profile was favourable when compared to more invasive techniques. HIFU treatment of liver and kidney tumours in a Western population is both safe and feasible. These findings have significant implications for future noninvasive image-guided tumour ablation.

Show MeSH
Related in: MedlinePlus