scholarly journals High-Intensity Focused Ultrasound Treatment for Advanced Pancreatic Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
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.

The value of dynamic contrast enhanced ultrasound (DCE-US) in monitoring treatment effect of high-intensity focused ultrasound (HIFU) in locally advanced pancreatic cancer (LAPC)

2020 ◽  
pp. 1-11
Author(s):  
Zuo Dan ◽  
Feng Yi ◽  
Zhang Qi ◽  
Qiu Yi-Jie ◽  
Tian Xiao-Fan ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
High Intensity Focused Ultrasound ◽  
Contrast Enhanced Ultrasound ◽  
Hifu Treatment ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced

PURPOSE: To evaluate the feasibility of dynamic contrast enhanced ultrasound (DCE-US) in predicting treatment response of high-intensity focused ultrasound (HIFU) in patients with locally advanced pancreatic cancer (LAPC) lesions. PATIENTS AND METHODS: In this prospective study, 10 patients with pathologically confirmed LAPC lesions (7 men, 3 women; average age, 61.13±5.80 years) were prospectively enrolled. All patients received HIFU treatment with peak intensity at 12000 W/cm2. Contrast enhanced ultrasound (CEUS) was performed with an ACUSON Oxana 2 ultrasound equipment and a 6 C-1 transducer (1–6 Hz). A dose of 2.4 ml SonoVue was injected for each examination. Time intensity curves (TICs) were generated and quantitative analyses were performed by SonoLiver software. B mode ultrasound (BMUS) features, CEUS enhancement patterns, TICs, CEUS quantitative parameters and serum carcinoma antigen 19-9 (CA19-9) levels were compared before and 4 weeks after HIFU treatment. Statistical analyses were performed with SPSS Version 20.0 and GraphPad Prism 5. RESULTS: While comparing before and after HIFU, no significant difference was obtained on mean size of lesion, BMUS or CEUS features. After HIFU treatment, TICs showed decreased and delayed enhancement. Among all CEUS quantitative parameters, significant decrease could be found in maximum intensity (MI) (60.66±23.95% vs 41.31±26.74%) and mean transit time (mTT) (76.66±47.61 s vs 38.42±28.35 s). CA19-9 level decreased significantly after HIFU (2747.92±4237.41 U/ml vs 715.08±1773.90 U/ml) (P = 0.05). CONCLUSION: DCE-US combining with quantitative analysis might be a useful imaging method for early treatment response evaluation of HIFU in LAPC lesions.

Contrast-enhanced ultrasound for evaluating response to pulsed-wave high-intensity focused ultrasound therapy in advanced pancreatic cancer

2022 ◽  
pp. 1-11
Author(s):  
Yu Yang ◽  
Xian-quan Shi ◽  
Guang Chen ◽  
Xiao-na Zhou ◽  
Lin-xue Qian
Keyword(s):  
Pancreatic Cancer ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Advanced Pancreatic Cancer ◽  
High Intensity Focused Ultrasound ◽  
Response To Treatment ◽  
Contrast Enhanced Ultrasound ◽  
Hifu Treatment ◽  
Group 4 ◽  
Contrast Enhanced

OBJECTIVE: To examine whether contrast-enhanced ultrasound (CEUS) parameters in patients with advanced pancreatic cancer could be used to assess response to treatment with pulsed-wave high intensity focused ultrasound (PW-HIFU). METHODS: We prospectively recorded the pretreatment and posttreatment CEUS related parameters, CA19-9, pain scores of 30 patients with advanced pancreatic cancer treated with PW-HIFU treatment. Correlation of clinical parameters, tumor characteristics, and PW-HIFU treatment energy with CEUS parameters were analyzed. RESULTS: Pain score decreased after treatment (from 4.80±2.14 to 3.28±1.93, p = 0.001). CA19-9 dropped in RT decreased group, 4 weeks after one session PW-HIFU, compared with prolonged group (p = 0.013). According to the display of blood vessels in the mass by CEUS, tumors were classified by vessel grade (VG), VG1: no vessel can be seen; VG 2: vessels diameter <  5 mm; VG 3: vessels diameter >  5 mm. VGs were different between increased and decreased relative rise intensity (rRI) groups (p = 0.008). VG1 group shown a decreased rRI after treatment, while VG3 group showed the opposite trend (p = 0.006). CONCLUSIONS: CEUS can evaluating response to PW-HIFU in advanced pancreatic cancer. Quantitative analysis may help to assess the short-term efficacy of patients and help for individualized treatment.

scholarly journals Advanced Pancreatic Cancer: High-Intensity Focused Ultrasound (HIFU) and Other Local Ablative Therapies

2019 ◽  
Vol 191 (03) ◽  
pp. 216-227 ◽  
Author(s):  
Milka Marinova ◽  
Timo Wilhelm-Buchstab ◽  
Holger Strunk
Keyword(s):  
Pancreatic Cancer ◽  
Focused Ultrasound ◽  
Advanced Pancreatic Cancer ◽  
High Intensity Focused Ultrasound ◽  
Treatment Modalities ◽  
Mass Reduction ◽  
Local Tumor ◽  
Tumor Mass ◽  
Ablative Therapies

Background Locally advanced pancreatic cancer is a life-limiting tumor with a wide range of incapacitating symptoms such as cancer-associated pain. Several local ablative therapies with both thermal and non-thermal sources have recently received significant attention as modern treatment options for local tumor control and symptomatic improvement. The following review article provides an overview of currently available techniques and their outcomes including our own experience with high-intensity focused ultrasound (HIFU) being one of the most exciting and innovative modalities. Method Our experiences with HIFU treatment are based on 89 pancreatic cancer patients (UICC III-IV). Outcomes such as treatment-related changes in symptoms particularly in cancer pain and quality of life as well as local tumor response, safety and survival were compared to reported studies concerning HIFU, radiofrequency and microwave ablation, cryoablation, irreversible electroporation and stereotactic body radiation therapy. Results Even though all strategies appeared to be feasible, the unique feature of noninvasiveness represents a substantial advantage of the HIFU procedure. In 85 % of HIFU-treated patients, long-lasting pain relief was achieved. 50 % of patients did not require any analgesic treatment 6 weeks post-ablation. Unfortunately, pain palliation and quality-of-life outcomes are only rarely reported for other local treatment modalities. Tumor mass reduction could be achieved with all ablative therapies, with a mean tumor volume reduction of 60 % after 6 months in HIFU-treated pancreatic tumors. Differences in treatment-associated morbidity were reported. However, they are only partially comparable due to unbalanced study populations. Conclusion Various local ablative treatment modalities are available and feasible for tumor mass reduction of advanced pancreatic cancer but with different symptomatic benefit for patients. An effective and long-lasting reduction of cancer-related pain was observed following HIFU without insertion of needles or electrodes. Randomized controlled studies for head-to-head comparison of these modalities are warranted in the near future. Key points:  Citation Format

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