HIFU for Bone Metastases and other Musculoskeletal Applications

AbstractHigh-intensity focused ultrasound (HIFU) is a totally noninvasive procedure that has shown promising results in the management of numerous malignant and nonmalignant conditions. Under magnetic resonance or ultrasound guidance, high-intensity ultrasound waves are focused on a small, well-defined target region, inducing biologic tissue heating and coagulative necrosis, thus resulting in a precise and localized ablation. This treatment has shown both great safety and efficacy profiles, and may offer a multimodal approach to different diseases, providing pain palliation, potential local tumor control, and, in some cases, remineralization of trabecular bone. In musculoskeletal field, HIFU received FDA approval for treating bone metastasis, but its application has also been extended to other conditions, such as osteoid osteoma, desmoid tumor, low-flow vascular malformation, and facet joint osteoarthritis. This article illustrates the basic principles of HIFU and its main effects on biologic tissues with particular attention on bone, provides a step-by-step description of the HIFU procedure, and discusses the commonly treated conditions, in particular bone metastases.

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The role of acoustic nonlinearity in tissue heating behind a rib cage using a high-intensity focused ultrasound phased array

Physics in Medicine and Biology ◽

10.1088/0031-9155/58/8/2537 ◽

2013 ◽

Vol 58 (8) ◽

pp. 2537-2559 ◽

Cited By ~ 23

Author(s):

Petr V Yuldashev ◽

Svetlana M Shmeleva ◽

Sergey A Ilyin ◽

Oleg A Sapozhnikov ◽

Leonid R Gavrilov ◽

...

Keyword(s):

High Intensity ◽

Focused Ultrasound ◽

Phased Array ◽

High Intensity Focused Ultrasound ◽

Rib Cage ◽

Acoustic Nonlinearity ◽

Tissue Heating

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High intensity focused ultrasound and tissue heating: the effect of nonlinear sound propagation and vessel presence

1998 IEEE Ultrasonics Symposium. Proceedings (Cat. No. 98CH36102) ◽

10.1109/ultsym.1998.765209 ◽

2002 ◽

Cited By ~ 1

Author(s):

F.P. Curra ◽

P.D. Mourad ◽

V.A. Khokhlova ◽

L.A. Crum

Keyword(s):

High Intensity ◽

Focused Ultrasound ◽

Sound Propagation ◽

High Intensity Focused Ultrasound ◽

Tissue Heating

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Transcatheter and Ablative Therapeutic Approaches for Solid Malignancies

Journal of Clinical Oncology ◽

10.1200/jco.2006.09.8657 ◽

2007 ◽

Vol 25 (8) ◽

pp. 978-986 ◽

Cited By ~ 125

Author(s):

Eleni Liapi ◽

Jean-Francois H. Geschwind

Keyword(s):

Focused Ultrasound ◽

Local Tumor Control ◽

High Intensity Focused Ultrasound ◽

Tumor Control ◽

Curative Intent ◽

Medline Search ◽

Ablative Therapies ◽

Technological Advances ◽

Solid Malignancies ◽

Bland Embolization

The purpose of this article is to present in a concise manner an overview of the most widely used locoregional transcatheter and ablative therapies for solid malignancies. An extensive MEDLINE search was performed for this review. Therapies used for liver cancer were emphasized because these therapies are used most commonly in the liver. Applications in pulmonary, renal, and bone tumors were also discussed. These approaches were divided into catheter-based therapies (such as transcatheter arterial chemoembolization, bland embolization, and the most recent transcatheter arterial approach with drug-eluting microspheres), ablative therapies (such as chemical [ethanol or acetic acid injection]), and thermal ablative therapies (such as radiofrequency ablation, laser induced thermotherapy, microwave ablation, cryoablation, and extracorporeal high-intensity focused ultrasound ablation). A brief description of each technique and analysis of available data was reported for all therapies. Locoregional transcatheter and ablative therapies continue to be used mostly for palliation, but have also been used with curative intent. A growing body of evidence suggests clear survival benefit, excellent results regarding local tumor control, and improved quality of life. Clinical trials are underway to validate these results. Image-guided transcatheter and ablative approaches currently play an important role in the management of patients with various types of cancer—a role that is likely to grow even more given the technological advances in imaging, image-guidance systems, catheters, ablative tools, and drug delivery systems. As a result, the outcomes of patients with cancer undoubtedly will improve.

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Feasibility of volumetric MRI-guided high intensity focused ultrasound (MR-HIFU) for painful bone metastases

Journal of Therapeutic Ultrasound ◽

10.1186/2050-5736-2-16 ◽

2014 ◽

Vol 2 (1) ◽

pp. 16 ◽

Cited By ~ 36

Author(s):

Merel Huisman ◽

Mie K Lam ◽

Lambertus W Bartels ◽

Robbert J Nijenhuis ◽

Chrit T Moonen ◽

...

Keyword(s):

Bone Metastases ◽

High Intensity ◽

Focused Ultrasound ◽

High Intensity Focused Ultrasound ◽

Volumetric Mri ◽

Mri Guided ◽

Painful Bone Metastases

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Numerical simulations of tissue heating created by high‐intensity focused ultrasound

The Journal of the Acoustical Society of America ◽

10.1121/1.421629 ◽

1998 ◽

Vol 103 (5) ◽

pp. 2867-2867 ◽

Cited By ~ 1

Author(s):

Francesco P. Curra ◽

Peter Kaczkowski ◽

Pierre D. Mourad ◽

Lawrence A. Crum ◽

Vera A. Khokhlova

Keyword(s):

Numerical Simulations ◽

High Intensity ◽

Focused Ultrasound ◽

High Intensity Focused Ultrasound ◽

Tissue Heating

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Bubble cloud dynamics in an ultrasound field

Journal of Fluid Mechanics ◽

10.1017/jfm.2018.968 ◽

2019 ◽

Vol 862 ◽

pp. 1105-1134 ◽

Cited By ~ 11

Author(s):

Kazuki Maeda ◽

Tim Colonius

Keyword(s):

Interaction Parameter ◽

High Intensity ◽

High Speed ◽

Focused Ultrasound ◽

High Intensity Focused Ultrasound ◽

Energy Localization ◽

Cloud Cavitation ◽

Ultrasound Waves ◽

Void Fractions ◽

Bubble Clouds

The dynamics of bubble clouds induced by high-intensity focused ultrasound is investigated in a regime where the cloud size is similar to the ultrasound wavelength. High-speed images show that the cloud is asymmetric; the bubbles nearest the source grow to a larger radius than the distal ones. Similar structures of bubble clouds are observed in numerical simulations that mimic the laboratory experiment. To elucidate the structure, a parametric study is conducted for plane ultrasound waves with various amplitudes and diffuse clouds with different initial void fractions. Based on an analysis of the kinetic energy of liquid induced by bubble oscillations, a new scaling parameter is introduced to characterize the dynamics. The new parameter generalizes the cloud interaction parameter originally introduced by d’Agostino & Brennen (J. Fluid Mech., vol. 199, 1989, pp. 155–176). The dynamic interaction parameter controls the energy localization and consequent anisotropy of the cloud. Moreover, the amplitude of the far-field, bubble-scattered acoustics is likewise correlated with the proposed parameter. Findings of the present study not only shed light on the physics of cloud cavitation, but may also be of use for the quantification of the effects of cavitation on outcomes of ultrasound therapies including high-intensity focused ultrasound-based lithotripsy.

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