Evaluation of high-intensity therapeutic ultrasound irradiation in the treatment of experimental hepatoma

doi:10.1016/S0022-3468(89)80295-7

Journal of Pediatric Surgery

Volume 24, Issue 1, January 1989, Pages 30-33

https://doi.org/10.1016/S0022-3468(89)80295-7 Get rights and content

A study evaluating the efficacy of high-intensity therapeutic ultrasound (HITU) as a treatment modality in experimental hepatoma is reported. Morris hepatoma (3924) 1 × 10⁶ cells were transferred subcutaneously into 40 male ACI rats (weight, 150 to 200 g). Animals were divided into four experimental groups: group 1 (n=10) consisted of untreated controls; group 2 (n=10) received intraperitoneal cyclophosphamide 50 mg/kg as a single dose; group 3 (n=10) underwent HITU only; and group 4 (n=10) received both chemotherapy (as in group 2) and HITU (as in group 3). HITU was administered with a 5.5-cm diameter 4-MHz quartz transducer creating a continuous wave with 400 W/cm² focal intensity. The entire tumor was irradiated in 1-mm increments (horizontal and vertical) using treatment cycles of 4 seconds on and 11 seconds off. Total body weight and tumor volume were measured on the day of treatment, and 4 weeks later. At 4 weeks, the animals were killed, the tumor was excised and weighed, and tumor volume was determined. Tumor volume in all treated animals (groups 2, 3 and 4) was significantly smaller than in controls (P<.001) at 4 weeks, and tumor volume for animals in group 4 was significantly smaller than for those in groups 2 and 3 (P<.01). These data indicate that HITU significantly reduces tumor size when compared with control rats with Morris hepatoma. A synergistic effect of chemotherapy and HITU was observed and resulted in an enhanced tumor response and reduction of tumor size. These data suggest that HITU may be a useful form of adjuctive cancer therapy.

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A review of high intensity focused ultrasound in relation to the treatment of renal tumours and other malignancies
2015, Ultrasonics Sonochemistry
Citation Excerpt :
Normal tissue studies continued in the 1990’s, investigating the histological impact of HIFU [36], the relationship between tissue depth and the required intensity levels [37], and the effects of blood perfusion on tissue ablation [38]. A number of tumour models have also been used to predict the effects of HIFU on hepatocellular carcinoma or discrete liver metastases in humans [39–44]. Clinical studies began when Vallancien et al. treated two patients with solitary liver metastases prior to surgical resection.
For 60 years, high-intensity focused ultrasound (HIFU) has been the subject of interest for medical research. HIFU causes tissue necrosis in a very well defined area, at a variable distance from the transducer, through heating or cavitation. Over the past two decades, the use of high-intensity focused ultrasound has been investigated in many clinical settings. This review summarises recent advances made in the field of renal cancer in particular, and gives an overview on the use of the extracorporeal machines in the treatment of other malignant tumours.
Conservative treatment of renal cancer using HIFU. Procedure, indications, and results
2009, Actas Urologicas Espanolas
En este artículo se revisan los mecanismos de acción de los ultrasonidos de alta intensidad HIFU, así como los trabajos tanto experimentales como clínicos en relación con el tratamiento de los tumores renales.
Aunque hasta la actualidad la mayor parte de la experiencia oncológica en Urología con HIFU tiene relación con el cáncer de próstata, son cada vez más los trabajos que avalan su eficacia y seguridad en la destrucción de tumores renales, completando, junto con la crioterapia y la radiofrecuencia, el espectro de la cirugía mínimamente invasiva en el cáncer renal, tratamientos que pretenden disminuir la morbilidad operatoria alcanzando similares tasas de control oncológico.
Es aún pronto para recomendar esta técnica en la práctica clínica diaria, ya que conocemos su seguridad y pocos efectos secundarios, pero es preciso que se completen muchos de los trabajos, en marcha en la actualidad, que confirmen su eficacia oncológica a medio y largo plazo.
This article reviews the mechanisms of action of high-intensity focused ultrasound (HIFU), as well as both experimental and clinical work related to renal tumor treatment.
While most currently available experience in urological tumors with HIFU has been obtained with prostate cancer, an increasing number of studies support the efficacy and safety of this procedure for renal tumor destruction. HIFU completes, with cryotherapy and radiofrequency, the spectrum of minimally invasive surgery in renal cancer, intended to decrease surgical morbidity while achieving similar oncological control rates.
It is still early to recommend this procedure for daily clinical practice because, while its safety and few side effects are known, many ongoing studies intended to confirm its mid- and long-term oncological efficacy should be completed.
Current state of high intensity focused ultrasound (HIFU) as treatment of prostatic carcinoma
2007, Actas Urologicas Espanolas
Evaluar el estado actual de la utilización del Ultrasonido de Alta Intensidad (HIFU) en el tratamiento del adenocarcinoma prostático (Cap).
Hemos llevado a cabo una revisión del papel actual del HIFU en el tratamiento del Cap.
La tecnología HIFU está actualmente siendo aplicada ya de forma habitual en Europa en el tratamiento del Cap. Las indicaciones principales en la actualidad son dos: la aplicación del HIFU como primer escalón terapéutico y como terapia de rescate en recidivas post-radioterapia. Los trabajos actuales están basados en equipos clínicos en desarrollo. Aunque las últimas publicaciones sugieren que HIFU es una forma de tratamiento útil para el Cap bien y moderadamente diferenciado, existe todavía falta de comparaciones de esta terapia menos invasiva con los tratamientos estándar. Seguimos detectando en los trabajos disparidad en la definición de supervivencia libre de enfermedad (SLE), lo que dificulta la interpretación de resultados y la extracción de conclusiones definitivas.
La experiencia de los grupos de trabajo especializados en HIFU es altamente prometedora. Entre los aspectos a destacar está su gran capacidad de destrucción tumoral local tanto en los casos primarios como en las recidivas post-radioterapia. Para extraer conclusiones a medio y largo plazo debemos generar ensayos clínicos randomizados y controlados con seguimiento suficiente para medir beneficios en términos de supervivencia global y calidad de vida (balance efectos adversos / beneficios), realizar comparaciones con las terapias estándar y homogeneizar los criterios de definición de la SLE.
To evaluate the current state of high intensity focused ultrasound as therapeutical option of prostatic carcinoma (PCa)
We completed an extense review of urologic literature on the role of HIFU on the treatment of PCa.
This technique is nowadays usually being indicated in Europe as treatment of many cases of either primary or relapsed PCa after radiotherapy. Although some reports suggest that HIFU is very effective as treatment for low and medium risk localized PCa patients, no randomized series comparing this technique with conventional therapies have been presented yet. Great disparity in criteria to define free-disease survival is detected, which make difficult the interpretation of results.
Experience of some groups in HIFU is highly promising. Local tumour destruction is evident both in primary and relapsed PCa cases. To make conclusions in the long-term, controlled-randomized trials must be designed, with follow-up to measure benefits in global survival and quality of live. Comparisons must be completed with conventional techniques, and a uniform definition of disease free-survival is necessary.
Sonodynamic therapya review of the synergistic effects of drugs and ultrasound
2004, Ultrasonics Sonochemistry
Sonodynamic therapy, the ultrasound dependent enhancement of cytotoxic activities of certain compounds (sonosensitizers) in studies with cells in vitro and in tumor bearing animals, is reviewed. The attractive features of this modality for cancer treatment emerges from the ability to focus the ultrasound energy on malignancy sites buried deep in tissues and to locally activate a preloaded sonosensitizer. Possible mechanisms of sonodynamic therapy include generation of sonosensitizer derived radicals which initiate chain peroxidation of membrane lipids via peroxyl and/or alkoxyl radicals, the physical destabilization of the cell membrane by the sonosensitizer thereby rendering the cell more susceptible to shear forces or ultrasound enhanced drug transport across the cell membrane (sonoporation). Evidence against the role of singlet oxygen in sonodynamic therapy is discussed. The mechanism of sonodynamic therapy is probably not governed by a universal mechanism, but may be influenced by multiple factors including the nature of the biological model, the sonosensitizer and the ultrasound parameters. The current review emphasizes the effect of ultrasound induced free radicals in sonodynamic therapy.
What is the Newest Technology in Treating Prostate Cancer? Transrectal High-intensity Focused Ultrasound
2003, Prostate Cancer: Science and Clinical Practice
Thermal ablation therapy for hepatocellular carcinoma
2002, Journal of Vascular and Interventional Radiology
Thermal ablation strategies, including the use of radiofrequency, microwaves, lasers, and high-intensity focused ultrasound, are gaining increasing attention as an alternative to standard surgical therapies in the treatment of primary hepatocellular carcinoma. Benefits over surgical resection include the anticipated reduction in morbidity and mortality, low cost, suitability for real-time imaging guidance, ability to perform ablative procedures on an outpatient basis, and the potential application in a wider spectrum of patients—including those who are not surgical candidates. In this review, the authors examine the reported clinical success of each of these four therapies, potential complications, current limitations, and future directions of development.

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^*: Presented at the 19th Annual Meeting of the American Pediatric Surgical Association, Tucson, Arizona, May 11–14, 1988.

¹: From the Section of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine and The James Whitcomb Riley Hospital for Children; and The Indianapolis Center For Advanced Research, Indianapolis.

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Evaluation of high-intensity therapeutic ultrasound irradiation in the treatment of experimental hepatoma*

Ultrasound Med Biol

J Pediatr Surg

Ultrasound Med Biol

Physiological effects of hyperthermia

Recent Results Cancer Res

The effect of high intensity ultrasonic irradiation on tumor growth

IEEE Trans Sonics Ultrasonics

Hepatocellular carcinoma in young people

Cancer

A primary method for determination of ultrasonic intensity with the elastic sphere radiometer

Acustica