MP46-09 FOCAL HIFU TREATMENT OF APICAL LESION: SAFETY AND ONCOLOGICAL RESULTS

Patients with unilateral vocal fold cancer (T1a) have a favorable prognosis. In addition to the oncological results of CO2 transoral laser microsurgery (TOLMS), voice function is among the outcome measures. Previous early glottic cancer studies have reported voice function in patients grouped into combined T stages (Tis, T1, T2) and merged cordectomy types (lesser- vs. larger-extent cordectomies). Some authors have questioned the value of objective vocal parameters. Therefore, the purpose of this exploratory prospective study was to investigate TOLMS-associated oncological and vocal outcomes in 60 T1a patients, applying the ELS protocols for cordectomy classification and voice assessment. Pre- and postoperative voice function analysis included: Vocal Extent Measure (VEM), Dysphonia Severity Index (DSI), auditory-perceptual assessment (GRB), and 9-item Voice Handicap Index (VHI-9i). Altogether, 51 subjects (43 male, eight female, mean age 65 years) completed the study. The 5-year recurrence-free, overall, and disease-specific survival rates (Kaplan–Meier method) were 71.4%, 94.4%, and 100.0%. Voice function was preserved; the objective parameter VEM (64 ± 33 vs. 83 ± 31; mean ± SD) and subjective vocal measures (G: 1.9 ± 0.7 vs. 1.3 ± 0.7; VHI-9i: 18 ± 8 vs. 9 ± 9) even improved significantly (p < 0.001). The VEM best reflected self-perceived voice impairment. It represents a sensitive measure of voice function for quantification of vocal performance.

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The feasibility of a noise elimination method using continuous wave response of therapeutic ultrasound signals for ultrasonic monitoring of high-intensity focused ultrasound treatment

Journal of Medical Ultrasonics ◽

10.1007/s10396-021-01083-5 ◽

2021 ◽

Author(s):

Ryo Takagi ◽

Toshikatsu Washio ◽

Yoshihiko Koseki

Keyword(s):

Noise Reduction ◽

High Intensity ◽

Focused Ultrasound ◽

Continuous Wave ◽

High Intensity Focused Ultrasound ◽

Hifu Treatment ◽

Noise Elimination ◽

Tissue Samples ◽

Wave Response ◽

Failure Conditions

Abstract Purpose In this study, the robustness and feasibility of a noise elimination method using continuous wave response of therapeutic ultrasound signals were investigated when tissue samples were moved to simulate the respiration-induced movements of the different organs during actual high-intensity focused ultrasound (HIFU) treatment. In addition to that, the failure conditions of the proposed algorithm were also investigated. Methods The proposed method was applied to cases where tissue samples were moved along both the lateral and axial directions of the HIFU transducer to simulate respiration-induced motions during HIFU treatment, and the noise reduction level was investigated. In this experiment, the speed of movement was increased from 10 to 40 mm/s to simulate the actual movement of the tissue during HIFU exposure, with the intensity and driving frequency of HIFU set to 1.0–5.0 kW/cm2 and 1.67 MHz, respectively. To investigate the failure conditions of the proposed algorithm, the proposed method was applied with the HIFU focus located at the boundary between the phantom and water to easily cause cavitation bubbles. The intensity of HIFU was set to 10 kW/cm2. Results Almost all HIFU noise was constantly able to be eliminated using the proposed method when the phantom was moved along the lateral and axial directions during HIFU exposure. The noise reduction level (PRL in this study) at an intensity of 1.0, 3.0, and 5.0 kW/cm2 was in the range of 28–32, 38–40, and 42–45 dB, respectively. On the other hand, HIFU noise was not basically eliminated during HIFU exposure after applying the proposed method in the case of cavitation generation at the HIFU focus. Conclusions The proposed method can be applicable even if homogeneous tissues or organs move axially or laterally to the direction of HIFU exposure because of breathing. A condition under which the proposed algorithm failed was when instantaneous tissue changes such as cavitation bubble generation occurred in the tissue, at which time the reflected continuous wave response became less steady.

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Parenchymal-sparing hepatectomies (PSH) for bilobar colorectal liver metastases are associated with a lower morbidity and similar oncological results: A propensity score matching analysis

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2018.01.067 ◽

2018 ◽

Vol 44 (4) ◽

pp. 553

Author(s):

R. Memeo ◽

French Surgical Association (F.D.C)

Keyword(s):

Propensity Score ◽

Liver Metastases ◽

Propensity Score Matching ◽

Colorectal Liver Metastases ◽

Propensity Score Matching Analysis ◽

Oncological Results ◽

Lower Morbidity

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High-Intensity Focused Ultrasound Treatment for Advanced Pancreatic Cancer

Gastroenterology Research and Practice ◽

10.1155/2014/205325 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 20

Author(s):

Yufeng Zhou

Keyword(s):

Pancreatic Cancer ◽

High Intensity ◽

Focused Ultrasound ◽

Advanced Pancreatic Cancer ◽

High Intensity Focused Ultrasound ◽

Treatment Modalities ◽

Karnofsky Performance Scale ◽

Great Success ◽

Hifu Treatment ◽

Performance Scale

Pancreatic cancer is under high mortality but has few effective treatment modalities. High-intensity focused ultrasound (HIFU) is becoming an emerging approach of noninvasively ablating solid tumor in clinics. A variety of solid tumors have been tried on thousands of patients in the last fifteen years with great success. The principle, mechanism, and clinical outcome of HIFU were introduced first. All 3022 clinical cases of HIFU treatment for the advanced pancreatic cancer alone or in combination with chemotherapy or radiotherapy in 241 published papers were reviewed and summarized for its efficacy, pain relief, clinical benefit rate, survival, Karnofsky performance scale (KPS) score, changes in tumor size, occurrence of echogenicity, serum level, diagnostic assessment of outcome, and associated complications. Immune response induced by HIFU ablation may become an effective way of cancer treatment. Comments for a better outcome and current challenges of HIFU technology are also covered.

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