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Focused ultrasound surgery (FUS) technology has been used for clinical treatment more than 20 years. Since 2011, relying on the "high intensity focused ultrasound tumor therapy training base", focusing ultrasound surgeons on the treatment of uterine fibroids, based on the basic theories and skills provided by interns who have just access to the qualification of licensed physicians, the training courses are set such as engineering technology principles, biological effects and mechanisms, micro and non-invasive concepts and clinical thinking, image recognition ability, operation training, and postoperative complications management etc.. After strict quality training and performance evaluation, the initial training of focused ultrasound surgeons has been completed. Moreover, the training object can consolidate learning effect through continuing education in order to acquire stable skills and skills.
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Objective: To explore the effect of transcatheter arterial chemoembolization(TACE) combined with high intensity focused ultrasound (HIFU) ablation on patients with middle and advanced liver cancer and to analyze its anti-tumor value. Methods: 126 patients with middle and advanced liver cancer who received palliative treatment were selected in the research. According to the different treatment program, they were divided into TACE groups (66 cases) which patients received TACE and TACE combined with HIFU ablation group (60 cases) which patients received the treatment of TACE combined with HIFU ablation. After 4 weeks of treatment, the therapeutic effect of solid tumor and the change of immune function indicator of the two groups were compared. At the same time, the results of follow-up visit were recorded, and adverse reaction of antineoplaston and survival situation were further compared. Results:After treatment, the immune function both of two groups were enhanced, and the cluster of differentiation (CD)3+, CD4+, and CD4+/ CD8+of TACE combined with HIFU ablation group was significantly higher than that of TACE group (t=6.303, t=6.049, t=2.148, P<0.05). While the clinical benefit rate of TACE combined with HIFU ablation group was significantly higher than that of TACE group (Z=2.975, P<0.05), and the survival rate of 1 year and survival rate of 2 years of TACE combined with HIFU ablation group were significantly higher than that of TACE group (x2=3.99, x2=4.33, P<0.05), respectively. On the other hand, the differences of complications, included skin burn, liver function damage and abdominal discomfort, between the two groups were no significant (x2=2.235, x2=0.847, x2=0.019, P>0.05). Conclusion:The technique of TACE combined with HIFU ablation can enhance immune function and the therapeutic effect of antineoplastic, and its advantages includes obvious effect of antineoplastic and safety of usage. Therefore, its application value should be paid higher attention in oncotherapy of solid tumor as this paper's suggestion.
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Objective: To compare the effects between uterine fibroid ablation of high intensity focused ultrasound (HIFU) and laparoscopic myomectomy for gravidity of postoperative patients. Methods: 120 patients with uterine fibroid were divided into ultrasound ablation group (60 cases) and laparoscopy group (60 cases) as random number table. And the patients of ultrasound ablation group were treated by using HIFU and the patients of laparoscopy group received the treatment of laparoscopic myomectomy. The operative situation, curative effect and post-operative situation of gravidity of the two groups were compared and researched. Results: The effective rate of laparoscopy group was significantly higher than that of ultrasound ablation group (x2=3.56, P<0.05), while operation time, bleeding volume and postoperative recovery time of laparoscopy group were significantly higher than that of ultrasound ablation group, respectively (t=1.560, t=1.975, t=1.896, P<0.05). On the other hand, the postoperative gravidity rate of ultrasound ablation group was significantly higher than that of laparoscopy group (x2=3.65, P<0.05). Conclusion:Although the effective rate of HIFU for ablation of uterine fibroids is lower than that of laparoscopic myomectomy, its recovery time is shorter and its postoperative gravidity rate is higher than that of laparoscopic myomectomy. Therefore, it has popularized worthy in clinical practice.
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A lipodistrofia localizada representa uma das principais condições inestéticas responsáveis pela insatisfação de parte da população que tem como preocupação sua autoimagem. No âmbito da Biomedicina Estética, diversos procedimentos que visam à redução da adiposidade localizada são oferecidos e, entre as abordagens não invasivas mais promissoras, destaca-se o ultrassom focalizado de alta intensidade (HIFU) que utiliza altas intensidades de energia para promover a destruição de adipócitos, com consequente redução da espessura do tecido subcutâneo. Diante disso, esse estudo teve como objetivo avaliar e comparar a eficiência da técnica de lipocavitação focalizada na destruição de células adipocitárias por meio de análises histológicas qualitativas e quantitativas de fragmentos de tecido suíno, além de avaliar os danos teciduais e celulares causados após a exposição desses tecidos ao ultrassom focalizado de alta intensidade às estruturas adjacentes. Foram empregados nesse estudo dois equipamentos de marcas distintas, Lipofocus (Bioset) e Liposoon (Tonederm), mas que apresentam a mesma tecnologia HIFU. As análises qualitativas e quantitativas das lâminas histológicas demonstraram que houve uma redução significativa do número de adipócitos em comparação com as amostras-controle, com preservação da integridade de estruturas circunvizinhas. (AU)
Localized lipodystrophy is one of major unaesthetic conditions responsible for the dissatisfaction of the population whose concern their self-image. Within the Aesthetic Biomedicine, several procedures aimed at reducing localized adiposity are offered and among non-invasive approaches more promising, the High Intensity Focused Ultrasound (HIFU) stands out using high intensities of energy to promote the destruction of adipocytes, with a resulting reduction in the thickness of the subcutaneous tissue. Therefore, this study aimed to evaluate and compare the efficiency of focused high frequency technique in destroying adipocytes through qualitative and quantitative histological analyzes of pig tissue fragments, in addition to evaluate the tissue and cellular damage caused after exposure of these tissues of high intensity focused ultrasound to adjacent structures. Were used in this study two different brands of equipment, Lipofocus (Bioset) and Liposoon (Tonederm), whih use the same technology HIFU. The qualitative and quantitative analysis of histological sections showed that there was a significant reduction in adipocytes number compared to control samples, preserving the integrity of surrounding structures.(AU)
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Animals , Lipodystrophy , Ultrasonics , BeautyABSTRACT
High-intensity focused ultrasound therapy is a novel, emerging, therapeutic modality that uses ultrasound waves, propagated through tissue media, as carriers of energy. This completely non-invasive technology has great potential for tumor ablation as well as hemostasis, thrombolysis and targeted drug/gene delivery. However, the application of this technology still has many drawbacks. It is expected that current obstacles to implementation will be resolved in the near future. In this review, we provide an overview of high-intensity focused ultrasound therapy from the basic physics to recent clinical studies with an interventional radiologist's perspective for the purpose of improving the general understanding of this cutting-edge technology as well as speculating on future developments.
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Humans , Drug Delivery Systems , Gene Targeting , Hemostatic Techniques , Thrombolytic Therapy/methods , Ultrasonic Therapy/methodsABSTRACT
To investigate the safety, feasibility and effectiveness of transrectal high-intensity focused ultrasound (HIFU) in the ablation of canine prostate, 20 dogs were divided randomly into 5 groups.Sixteen canine prostates were treated with the third-generation transrectal HIFU device (Sonablate-500 TM). Transrectal ultrasound images of the prostate and prostatic urethra were observed preoperatively and postoperatively. Serial study was performed 30 min, 30 days, 60 days and 180 days after the therapy. The rectum, periprostatic tissues, and prostate were excised en bloc and the tissues were fixed for gross and histological analysis. Our results showed that the average maximal diameter of prostatic urethra was 0.59±0.11 cm before the operation and 2.57±0.98 cm 60 days after the operation. The volume of prostate was 6.5±3.12 cm3 before the treatment while the volume was 4.13±0.23 cm3 60 days after the treatment and the differences were statistically significant (P＜0.05).Histologically, there was a clear demarcation between the necrotic area of the treated tissues and the unaffected surrounding tissues. All the necrotic tissues in the targeted zone broke off and the prostatic urethra became cavitary 60 days later. The more frequent complications were urinary retention and frequency and hematuria. No rectal injury occurred during the treatment. It is concluded that the third-generation transrectal HIFU is capable of destroying prostatic tissue, substantially increasing the width of the prostatic urethra without causing injury to the adjacent tissues. The risk of postoperative complications associated with HIFU was low. HIFU may become a safe, effective and minimally invasive alternative for the treatment of prostatic diseases..
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To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound (HIFU) in the treatment of benign prostatic hyperplasia (BPH), serial studies were conducted in 150 BPH pa- tients before and 30 min, 1, 2, 6 and 12 month(s) after Sonablate-500TM HIFU treatment. A sili- con-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score (IPSS), quality of life (QOL), uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month(s) (P<0.01). Maximum urine flow rate (6.0 to 17.2 mL/s, P<0.01), PVR (75.0 to 30.3,P<0.01) and prostatic volume (65.0 to 38.1 mL, P<0.05) were significantly improved 12 months after the operation. Recurrent urinary retention (n=2) and urethrorectal fistula (n=1) occurred at the 15th postoperative day. The duration of the HIFU prostate ablation was 25-90 rain. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonab- late-500TM HIFU is safe and effective.
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Objective To observe the effectiveness of high-intensity focused ultrasound(HIFU)in the treatment of lichen sclerosus of vulva.Methods 63 patients with lichen sclerosus of vulva between July 2005 to December 2005 were divided into two groups at random,ultrasound group and control group.Patients in ultrasound group were treated with HIFU.Those in control group were treated with hormone.Results The scores of itch had difference after treatment in both group(P
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Objective To evaluate the recent curative efficacy and security of High Intersity Focused Ultrasound(HIFU)in treating patients with advanced pancretic carcinoma.Methods 17patients with cancer of pancreas were treated by FEP-BY02,received 135(average 8)times.Results The overall response rate was 70%(CR+PR),including11.76%(2/17)complete response(CR)and 58.82%(10/17)partial response(PR).The clinical benefit response(CBR)was 82.36%.The inefficiency was 17.64%(3/17).The cancer pain was relieved in 80% patients(8/10).Nocomplications occurred.such as pancreatic juice leakage,bleeding,perforation of gastrointestinal tracts,scalding of skin in the group.Conclusions The preliminary results show that HIFU has a high efficacy and quite safety for advanced pancreatic carcinoma,it is worthy of futher clinical trail.
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Objective:To explore the safety and efficacy of high intensity focused ultrasound in the treatment of endometrioma. Methods:Sixteen typical patients with endometrioma received HIFU treatment.HIFU treatment was monitored by real-time ul- trasound.The changes of tumor-size and blood-supply of endometrioma before and after HIFU were evaluated by the CDFI or enhanced MRI,and symptoms changes were recorded in follow-up process.Results:After HIFU treatment,in all patients,tumor size shrank 57.16%,blood supply decreased,menstrual cycle and menstrual period decurtated,and menstrual volume decreased 50%.All the patients had a complete remission of menalgia and Hb test became normal level.All the patients had no serious syndrome.Conclusion:HIFU is safe and effective to treat endometioma.
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Objective:To evaluate the safety of high intensity focused ultrasound(HIFU) for the treatment of implanted rabbit breast tumor.Methods:Forty New England rabbits were randomly divided into the following groups:HIFU treatment group(20),surgery group(10) and control group(10).HIFU ablation was performed at focal peak intensity 11500W/cm with a frequency of 1.6MHz in HIFU group.In surgery group all animals underwent lumpectomy.The animals in control group underwent pseudo-irradiation.The sonograms of target tumor were assessed before and immediately after HIFU ablation.The treated tumor was removed immediately after HIFU,and the lesion was measured by gross examination.Routine serum chemistry examination including hepatic,renal function tests,and serum electrolytes in all animals were performed before and at 1st,3rd,5th and 7th days after treatment.Also tumor metastases were observed after treatment.Results:The gray-scale of target tumors on ultrasound image was low before HIFU and increased immediately after HIFU irradiation.The hyperechoic location was the same as the lesion observed by gross observation.The necrotic lesion completely covered the tumor.No significant differences were observed in hepatic,renal function tests,and serum electrolytes before and after therapy in HIFU group.And these indices were not significantly different in HIFU treatment group,surgery group and control group,respectively.The metastatic rates of HIFU treatment group and surgery group were 20% and 30% respectively.They were significantly different from that of control group(100%,P
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HIFU treatment allows the destruction of a precise volume of tissue within an tumour without harming surrounding structures.The FEP-BY02 model is one of commercially available machines based on this technique,which is proved effectively in clinical practice.It's basic architecture,functional principle and some suggestions for safety use are introduced in this paper.
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Objective:To investigate the effects of magnetic nano-particles on the therapeutics efficacy of high intensity focused ultrasound(HIFU).Methods:The magnetic nano-particles with diameter of 80～90 nm and 200～300 nm were distributed into the egg white phantom respectively.At the same HIFU exposure dose,the length and width of the maximum cross section of the lesions were measured.Results:The results showed that the magnetic nano-particles with diameter of 200～300 nm can enhance the therapeutic efficacy of HIFU,and the areas of lesions were about 2 times larger than those of control group(P0.01).Conclusion:The magnetic nano-particles with diameter of 200～300 nm can change the acoustics environment of egg white phantom and enhance the therapeutic efficacy of HIFU.
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Objective: To observe the influence of high intensity focused ultrasound(HIFU) and alcohol blocking celiac ganglion(CG) on the discharge frequency of left greater splanchnic nerve(LGSN) and postganglion fibre.Methods: 10 New Zealand rabbits were randomly divided into two groups: HIFU and alcohol groups with five rabbits in each group.CG was blocked by HIFU and 95% alcohol separately.The discharge of postganglion and preganglion fibre to gastric distension(GD) was recorded.Results: After blocked by HIFU,the discharge frequency of LGSN showed no obvious changes,however the alcohol group kept increasing in discharged frequency to GD(P
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Objective:To explore the effects of ablation of normal rabbit liver tissue by combination of high intensity focused ultrasound(HIFU) and iodized oil emulsion(HIFU liposome 2,HL-2) and the grey scale changes in target region.Methods:Rabbit liver was ablated with HIFU under certain parameters one hour after HL-2 was injected intravenously in the experimental group.The grey scale in target region and the exposure time were recorded.All processes in control group were the same as those in the experimental group only HL-2 was replaced by saline.Results:The changes of grey scale in the target region were similar in two groups.Typical coagulation necrosis happened both in two groups under gross and histological examination.The energy efficiency factor (EEF)in the experimental group was less than that in the control group(P
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Objective:To evaluate the safety of one-lung ventilation and artificial hydrothorax to aid HIFU treatment of liver carcinoma located in distal end of diaphragm and edge of liver and to observe the related indices in the treatment.Methods:Twelve patients with liver carcinoma received general anesthesia using double lumen endobronchial tube bi-chamber trachea cannula.Saline was injected into right thoracic cavity to turn artificial pleural fluid.During HIFU treatment,left lung had a ventilation with 100% FiO_2.Before cannula(value of Base);one lung was ventilated(DLV) for 15 mins,30 mins,60mins,120mins,then double lungs received ventilation again for 30mins(DLV'30).And blood gas was analyzed separately.Vital monitoring machine kept observing ECG,HR,MAP,S_pO_2,and PETCO2.One day and seven days after HIFU,X-ray was made to evaluate the outcome of hydrothorax.Results:All the patients were steady in blood gas and hemodynamic indices at the period of one-lung ventilation with artificial hydrothorax.The indices of PO_2 were higher during one-or two-lung ventilation than Base (P
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Objective To evaluate the safety and clinical efficacy of high intensity focused ultrasound (HIFU) for patients with solid tumors under sedation and analgesia. Methods Sedation and analgesia were induced with i.v. fentanyl(1?g/kg) and midazolam (0.03mg/kg) in 81 patients with benign or malignant solid tumors. High intensity focused ultrasound (HIFU) ablation treatment was then performed. The short-term effect and adverse events of sedatives and analgesics, as well as the effect of HIFU ablation treatment were observed. Results One hundred and twelve HIFU courses were performed on 81 patients, among them 23 patients with benign solid tumors received 26 courses of treatment, and 58 patients with malignant solid tumors, received 86 courses of treatment. A total of 153 foci were targeted. It was estimated that in 81% of all the patients, the tumor size was decreased by 50%, including 72.2%(52/72)of malignant tumors and 97.4%(37/38)of benign tumors. Tumor markers of malignant tumors decreased by more than 50% in 81.3%(13/16) of patients, and remission rate of tumor-related symptoms reached 77.9% (30/39). The adverse events during sedation and analgesia were nausea, reduction in the respiratory rate, visual hallucination, and that of HIFU were pain and swelling. No comblications with severity surpassing grade Ⅲ were found as a result of either sedatives, analgesics or HIFU treatment. Conclusion Sedation and analgesia are relatively safe, effective and feasible during HIFU treatment for solid tumor.