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The road to clinical use of high-intensity focused ultrasound for liver cancer: technical and clinical consensus

Jean-Francois Aubry12, Kim Butts Pauly3, Chrit Moonen4, Gail ter Haar5, Mario Ries4, Rares Salomir6, Sham Sokka7, Kevin Michael Sekins8, Yerucham Shapira9, Fangwei Ye10, Heather Huff-Simonin11, Matt Eames11, Arik Hananel11*, Neal Kassell11, Alessandro Napoli12, Joo Ha Hwang13, Feng Wu14, Lian Zhang15, Andreas Melzer16, Young-sun Kim17 and Wladyslaw M Gedroyc1819

Author Affiliations

1 Institut Langevin, ESPCI ParisTech, CNRS UMR 7587, INSERM U979, Université Denis Diderot, Paris VII, Paris, France

2 Department of Radiation Oncology, University of Virginia, Charlottesville, VA, USA

3 Radiological Sciences Laboratory, Stanford University School of Medicine, Palo Alto, CA, USA

4 Imaging Division, University Medical Center Utrecht, Amsterdam, The Netherlands

5 Division of Radiotherapy and Imaging, The Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey, UK

6 Faculty of Medicine, University of Geneva, Geneva, Switzerland

7 Philips Healthcare, Boston, MA, USA

8 Ultrasound Innovations Applications, Siemens Healthcare, Issaquah, WA, USA

9 InSightec Ltd, 5 Nahum Heth Street, Haifa, Israel

10 Chongqing Haifu Medical Technology Co., Ltd, Chongqing, China

11 Focused Ultrasound Foundation, Charlottesville, VA, USA

12 University of Rome, La Sapienza, Rome, Italy

13 Digestive Disease Center, University of Washington, Seattle, WA, USA

14 Institute of Ultrasonic Engineering in Medicine, Chongqing Medical University, Chongqing, China

15 Clinical Center for Tumor Therapy, Second Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing, China

16 Institute for Medical Science and Technology, University of Dundee, Dundee, Scotland, UK

17 Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

18 Department of Medicine, Imperial College, South Kensington Campus, Exhibition Rd, London SW7 2AZ, UK

19 Saint Mary’s Hospital, Praed St, W2 1NY, London, UK

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Journal of Therapeutic Ultrasound 2013, 1:13  doi:10.1186/2050-5736-1-13

Published: 1 August 2013

Abstract

Clinical use of high-intensity focused ultrasound (HIFU) under ultrasound or MR guidance as a non-invasive method for treating tumors is rapidly increasing. Tens of thousands of patients have been treated for uterine fibroid, benign prostate hyperplasia, bone metastases, or prostate cancer. Despite the methods' clinical potential, the liver is a particularly challenging organ for HIFU treatment due to the combined effect of respiratory-induced liver motion, partial blocking by the rib cage, and high perfusion/flow. Several technical and clinical solutions have been developed by various groups during the past 15 years to compensate for these problems. A review of current unmet clinical needs is given here, as well as a consensus from a panel of experts about technical and clinical requirements for upcoming pilot and pivotal studies in order to accelerate the development and adoption of focused ultrasound for the treatment of primary and secondary liver cancer.

Keywords:
Ultrasound; Non-invasive surgery; High-intensity ultrasound; Focused ultrasound; Liver cancer