HIFU Tissue Ablation: Concept and Devices
High intensity focused ultrasound (HIFU) is rapidly gaining clinical acceptance as a technique capable of providing non-invasive heating and ablation for a wide range of applications. Usually requiring only a single session, treatments are often conducted as day case procedures, with the patient either fully conscious, lightly sedated or under light general anesthesia. HIFU scores over other thermal ablation techniques because of the lack of necessity for the transcutaneous insertion of probes into the target tissue. Sources placed either outside the body (for treatment of tumors or abnormalities of the liver, kidney, breast, uterus, pancreas brain and bone), or in the rectum (for treatment of the prostate), provide rapid heating of a target tissue volume, the highly focused nature of the field leaving tissue in the ultrasound propagation path relatively unaffected. Numerous extra-corporeal, transrectal and interstitial devices have been designed to optimize application-specific treatment delivery for the wide-ranging areas of application that are now being explored with HIFU. Their principle of operation is described here, and an overview of their design principles is given.
KeywordsUltrasound therapy Thermal ablation Cancer Heating High Intensity Focused Ultrasound (HIFU) Ultrasound transducers
I should like to thank my team at the ICR for providing me with photographs and figures, most especially Drs Ian Rivens, John Civale, David Sinden and Pierre Gelat.
- Crouzet S, Rouvière O, Lafon C, Chapelon JY, Gelet A (2015) Focal High-Intensity Focused Ultrasound (HIFU). In: Technical aspects of focal therapy in localized prostate cancer. Springer, Paris, pp 137–151Google Scholar
- Duck FA (2013) Physical properties of tissues: a comprehensive reference book. Academic press, LondonGoogle Scholar
- Froeling VK, Meckelburg NF, Schreiter C, Scheurig-Muenkler J, Kamp MH, Maurer A, Beck A, Hamm B, Kroencke TJ (2013) Outcome of uterine artery embolization versus MR-guided high-intensity focused ultrasound treatment for uterine fibroids: long-term results. Eur J Radiol 82:2265–2269PubMedCrossRefGoogle Scholar
- Gelet A et al (2004) Local recurrence of prostate cancer after external beam radiotherapy: early experience of salvage therapy using high-intensity focused ultrasonography. Urology 63:625–629Google Scholar
- Hurwitz MD, Ghanouni P, Kanaev SV, Iozeffi D, Gianfelice D, Fennessy FM, Kuten A, Meyer JE, LeBlang SD, Roberts A, Choi J, Larner JM, Napoli A, Turkevich VG, Inbar Y, Tempany CM, Pfeller RM (2014) Magnetic resonance-guided focused ultrasound for patients with painful bone metastases: phase III trial results. J Natl Cancer Inst 106:1–9CrossRefGoogle Scholar
- Illing RO, Kennedy JE, Wu F, ter Haar GR, Protheroe AS, Friend PJ, Gleeson FV, Cranston DW, Philips RR, Middleton MR (2005) The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population. Br J Cancer 93:890–895PubMedCentralPubMedCrossRefGoogle Scholar
- Lee BC, Nikoozadeh A, Park KK, Khuri-Yakub BPT (2013) Fabrication of CMUTs with substrate-embedded springs. In: Proceeding IEEE Ultrasonics Symposium, Czech Republic, Prague, pp 1733–1736Google Scholar
- Liberman B, Gianfelice D, Inbar Y, Beck A, Rabin T, Shabshin N, Chander G, Hengst S, Pfeller R, Chechick A, Hanannel A, Dogadkin O, Catane R (2009) Pain palliation in patients with bone metastases using MR-guided focused ultrasound surgery: a multicenter study. Ann Surg Oncol 16:140–146PubMedCrossRefGoogle Scholar
- Lizzi FL, Coleman DJ, Driller J, Franzen LA, Jackobiec FA (1978) Experimental ultrasonically induced lesions in the retina, choroid, and sclera. Invest Ophthalmol 17:350–360Google Scholar
- Quinn SD, Gedroye WM (2015) Thermal ablation treatment of uterine fibroids. Int J Hyperthermia 31:272–279Google Scholar
- Thüroff S, Chaussy CG (2015) Transrectal prostate cancer ablation by robotic High-Intensity Focused Ultrasound (HIFU) at 3 MHz: 18 years clinical experiences. In: Focal therapy of prostate cancer, Springer International Publishing, Switzerland, pp 105–133Google Scholar