Abstract
Purpose: To evaluate the complications of high-intensity focused ultrasound (HIFU) in patients with hepatic and pancreatic cancer. Materials and Methods: From January 2006 to December 2008, 133 sessions of HIFU treatment were performed in 114 consecutive patients with primary hepatic tumor (n = 57), hepatic metastasis (n = 22), and pancreatic cancer (n = 35) under general anesthesia. The extracorporeal, ultrasound-guided Model-JC system (HAIFU, Chongqing, China) was used. Artificial pleural effusion was created to obtain an adequate sonographic window for ablating hepatic dome masses in 53 patients. We reviewed medical records and imaging findings before, during, and after HIFU. Results: All patients had skin redness, edema, and pain in the treatment regions. All hepatic tumor patients had necrosis of the ribs along the main ultrasound beam path that did not require further treatment. Major complications included biliary obstruction, symptomatic pleural effusion, pneumothorax and fistula formation between an abdominal wall abscess and the ablated hepatic tumor. In 35 pancreatic cancer patients, major complications included third-degree burns and fistula formation between the tumor and duodenum. Delayed complications in hepatic tumor patients included a diaphragmatic rupture and rib fractures along the ultrasound pathway. Conclusion: The complications of HIFU develop mainly around the targeted lesions or along the ultrasound beam pathway. It is essential to have awareness of the possible complications related to HIFU and its imaging features for to avoiding serious complications.
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References
Kennedy JE, Ter Haar GR, Cranston D (2003) High intensity focused ultrasound: surgery of the future? Br J Radiol 76:590–599
Li CX, Xu GL, Jiang ZY, et al. (2004) Analysis of clinical effect of high-intensity focused ultrasound on liver cancer. World J Gastroenterol 10:2201–2204
Wu F, Wang ZB, Chen WZ, et al. (2004) Extracorporeal high intensity focused ultrasound ablation in the treatment of 1038 patients with solid carcinomas in China: an overview. Ultrason Sonochem 11:149–154
Illing RO, Kennedy JE, Wu F, et al. (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 93:890–895
Wu F, Wang ZB, Chen WZ, et al. (2005) Advanced hepatocellular carcinoma: treatment with high-intensity focused ultrasound ablation combined with transcatheter arterial embolization. Radiology 235:659–667
Li YY, Sha WH, Zhou YJ, Nie YQ (2007) Short and long term efficacy of high intensity focused ultrasound therapy for advanced hepatocellular carcinoma. J Gastroenterol Hepatol 22:2148–2154
Park MY, Jung SE, Cho SH, et al. (2009) Preliminary experience using high intensity focused ultrasound for treating liver metastasis from colon and stomach cancer. Int J Hyperthermia 25:180–188
Wu F, Wang ZB, Zhu H, et al. (2005) Feasibility of US-guided high-intensity focused ultrasound treatment in patients with advanced pancreatic cancer: initial experience. Radiology 236:1034–1040
Hwang JH, Wang YN, Warren C, et al. (2009) Preclinical in vivo evaluation of an extracorporeal HIFU device for ablation of pancreatic tumors. Ultrasound Med Biol 35:967–975
Haar GT, Coussios C (2007) High intensity focused ultrasound: physical principles and devices. Int J Hyperthermia 23:89–104
Li JJ, Xu GL, Gu MF, et al. (2007) Complications of high intensity focused ultrasound in patients with recurrent and metastatic abdominal tumors. World J Gastroenterol 13:2747–2751
Goldberg SN, Grassi CJ, Cardella JF, et al. (2005) Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739
Haar TG (2001) High intensity ultrasound. Semin Laparosc Surg 8:77–89
Wu F, Chen WZ, Bai J, et al. (2001) Pathological changes in human malignant carcinoma treated with high-intensity focused ultrasound. Ultrasound Med Biol 27:1099–1106
Dubinsky TJ, Cuevas C, Dighe MK, Kolokythas O, Hwang JH (2008) High-intensity focused ultrasound: current potential and oncologic applications. Am J Roentgenol 190:191–199
Coussios CC, Farny CH, Haar GT, Roy RA (2007) Role of acoustic cavitation in the delivery and monitoring of cancer treatment by high-intensity focused ultrasound (HIFU). Int J Hyperthermia 23:105–120
Daum DR, Smith NB, King R, Hynynen K (1999) In vivo demonstration of noninvasive thermal surgery of the liver and kidney using an ultrasonic phased array. Ultrasound Med Biol 25:1087–1098
Wu F, Wang ZB, Chen WZ, et al. (2004) Extracorporeal high intensity focused ultrasound ablation in the treatment of patients with large hepatocellular carcinoma. Ann Surg Oncol 11:1061–1069
Cochard E, Prada C, Aubry JF, Fink M (2009) Ultrasonic focusing through the ribs using the DORT method. Med Phys 36:3495–3503
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Jung, S.E., Cho, S.H., Jang, J.H. et al. High-intensity focused ultrasound ablation in hepatic and pancreatic cancer: complications. Abdom Imaging 36, 185–195 (2011). https://doi.org/10.1007/s00261-010-9628-2
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DOI: https://doi.org/10.1007/s00261-010-9628-2