Abstract
Traditionally, surgery has been the only cure for many solid tumours. Technological advances have catalysed a shift from open surgery towards less invasive techniques. Laparoscopic surgery and minimally invasive techniques continue to evolve, but for decades high-intensity focused ultrasound has promised to deliver the ultimate objective — truly non-invasive tumour ablation. Only now, however, with recent improvements in imaging, has this objective finally emerged as a real clinical possibility.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Vogl, T. J., Straub, R., Eichler, K., Sollner, O. & Mack, M. G. Colorectal carcinoma metastases in liver: laser–induced interstitial thermotherapy: local tumor control rate and survival data. Radiology 230, 450–458 (2003).
Nagaoka, Y., Nakayama, R. & Iwata, M. Cutaneous seeding following percutaneous ethanol injection therapy for hepatocellular carcinoma. Intern. Med. 43, 268–269 (2004).
Liu, C., Frilling, A., Dereskewitz, C. & Broelsch, C. E. Tumor seeding after fine needle aspiration biopsy and percutaneous radiofrequency thermal ablation of hepatocellular carcinoma. Dig. Surg. 20, 460–463 (2003).
Thuroff, S. et al. High-intensity focused ultrasound and localized prostate cancer: efficacy results from the European multicentric study. J. Endourol. 17, 673–677 (2003).
Kennedy, J. E. et al. High-intensity focused ultrasound for the treatment of liver tumours. Ultrasonics 42, 931–935 (2004).
Wu, F. et al. Extracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience. Ultrasound Med. Biol. 30, 245–260 (2004).
Gianfelice, D., Khiat, A., Boulanger, Y., Amara, M. & Belblidia, A. Feasibility of magnetic resonance imaging-guided focused ultrasound surgery as an adjunct to tamoxifen therapy in high-risk surgical patients with breast carcinoma. J. Vasc. Interv. Radiol. 14, 1275–1282 (2003).
Wu, F. et al. Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy. J. Urol. 170, 2237–2240 (2003).
Chen, L. et al. Histological changes in rat liver tumours treated with high-intensity focused ultrasound. Ultrasound Med. Biol. 19, 67–74 (1993).
ter Haar, G., Clarke, R. L., Vaughan, M. G. & Hill, C. R. Trackless surgery using focused ultrasound: technique and case report. Minimally Invasive Therapy 1, 13–19 (1991).
Hill, C. R. & ter Haar, G. R. High intensity focused ultrasound: potential for cancer treatment. Br. J. Radiol. 68, 1296–1303 (1995).
Wu, F. et al. Pathological changes in human malignant carcinoma treated with high-intensity focused ultrasound. Ultrasound Med. Biol. 27, 1099–1106 (2001).
Chen, L., ter Haar, G. & Hill, C. R. Influence of ablated tissue on the formation of high-intensity focused ultrasound lesions. Ultrasound Med. Biol. 23, 921–931 (1997).
Billard, B. E., Hynynen, K. & Roemer, R. B. Effects of physical parameters on high temperature ultrasound hyperthermia. Ultrasound Med. Biol. 16, 409–420 (1990).
Chen, L. et al. Effect of blood perfusion on the ablation of liver parenchyma with high-intensity focused ultrasound. Phys. Med. Biol. 38, 1661–1673 (1993).
Rouviere, O. et al. Can color doppler predict the uniformity of HIFU-induced prostate tissue destruction? Prostate 60, 289–297 (2004).
Oosterhof, G. O. N., Cornel, E. B., Smits, G. A. H. J., Debruyne, F. M. J. & Schalken, J. A. Influence of high-intensity focused ultrasound on the development of metastases. Eur. Urol. 32, 91–95 (1997).
Wu, F. et al. Circulating tumor cells in patients with solid malignancy treated by high-intensity focused ultrasound. Ultrasound Med. Biol. 30, 511–517 (2004).
Vallejo, R., Hord, E. D., Barna, S. A., Santiago-Palma, J. & Ahmed, S. Perioperative immunosuppression in cancer patients. J. Environ. Pathol. Toxicol. Oncol. 22, 139–146 (2003).
Mafune, K. & Tanaka, Y. Influence of multimodality therapy on the cellular immunity of patients with esophageal cancer. Ann. Surg. Oncol. 7, 609–616 (2000).
Wu, F. et al. Activated anti-tumor immunity in cancer patients after high intensity focused ultrasound ablation. Ultrasound Med. Biol. 30, 1217–1222 (2004).
den Brok, M. H. et al. In situ tumor ablation creates an antigen source for the generation of antitumor immunity. Cancer Res. 64, 4024–4029 (2004).
Schueller, G. et al. Expression of heat shock proteins in human hepatocellular carcinoma after radiofrequency ablation in an animal model. Oncol. Rep. 12, 495–499 (2004).
Kramer, G. et al. Response to sublethal heat treatment of prostatic tumor cells and of prostatic tumor infiltrating T-cells. Prostate 58, 109–120 (2004).
Visioli, A. G. et al. Preliminary results of a phase I dose escalation clinical trial using focused ultrasound in the treatment of localised tumours. Eur. J. Ultrasound 9, 11–18 (1999).
Vallancien, G., Harouni, M., Guillonneau, B., Veillon, B. & Bougaran, J. Ablation of superficial bladder tumors with focused extracorporeal pyrotherapy. Urology 47, 204–207 (1996).
Stewart, E. A. et al. Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive thermoablative technique. Am. J. Obstet. Gynecol. 189, 48–54 (2003).
Thuroff, S. & Chaussy, C. High-intensity focused ultrasound: complications and adverse events. Mol. Urol. 4, 183–187 (2000).
Fry, W. J., Mosberg, W. H., Barnard, J. W. & Fry, F. J. Production of focal destructive lesions in the central nervous system with ultrasound. J. Neurosurg. 11, 471–478 (1954).
Blana, A., Walter, B., Rogenhofer, S. & Wieland, W. F. High-intensity focused ultrasound for the treatment of localized prostate cancer: 5-year experience. Urology 63, 297–300 (2004).
Uchida, T. et al. Transrectal high-intensity focused ultrasound for treatment of patients with stage T1b-2n0m0 localized prostate cancer: a preliminary report. Urology 59, 394–398 (2002).
Gelet, A. et al. Local recurrence of prostate cancer after external beam radiotherapy: early experience of salvage therapy using high-intensity focused ultrasonography. Urology 63, 625–629 (2004).
Kohrmann, K. U., Michel, M. S., Gaa, J., Marlinghaus, E. & Alken, P. High intensity focused ultrasound as noninvasive therapy for multilocal renal cell carcinoma: case study and review of the literature. J. Urol. 167, 2397–2403 (2002).
Gianfelice, D., Khiat, A., Amara, M., Belblidia, A. & Boulanger, Y. MR imaging-guided focused US ablation of breast cancer: histopathologic assessment of effectiveness — initial experience. Radiology 227, 849–855 (2003).
McDannold, N. et al. MRI-guided focused ultrasound surgery in the brain: tests in a primate model. Magn. Reson. Med. 49, 1188–1191 (2003).
Pernot, M., Aubry, J. F., Tanter, M., Thomas, J. L. & Fink, M. High power transcranial beam steering for ultrasonic brain therapy. Phys. Med. Biol. 48, 2577–2589 (2003).
Wu, F. et al. A randomised clinical trial of high-intensity focused ultrasound ablation for the treatment of patients with localised breast cancer. Br. J. Cancer 89, 2227–2233 (2003).
Marberger, M., Schatzl, G., Cranston, D. & Kennedy, J. E. Extracorporeal ablation of renal tumors with high intensity focused ultrasound. BJU Int 95 (Suppl. 2), 52–55 (2005).
Wu, F. et al. High intensity focused ultrasound ablation combined with transcatheter arterial embolisation in the treatment of advanced hepatocellular carcinoma. Radiology (in the press).
Moore, W. E. et al. Evaluation of high-intensity therapeutic ultrasound irradiation in the treatment of experimental hepatoma. J. Pediatr. Surg. 24, 30–33 (1989).
Bohris, C. et al. MR monitoring of focused ultrasound surgery in a breast tissue model in vivo. Magn. Reson. Imaging 19, 167–175 (2001).
Sedelaar, J. P. et al. The application of three-dimensional contrast-enhanced ultrasound to measure volume of affected tissue after HIFU treatment for localized prostate cancer. Eur. Urol. 37, 559–568 (2000).
Kennedy, J. E. et al. Contrast-enhanced ultrasound assessment of tissue response to high-intensity focused ultrasound. Ultrasound Med. Biol. 30, 851–854 (2004).
Goldberg, S. N. et al. Image-guided tumor ablation: proposal for standardization of terms and reporting criteria. Radiology 228, 335–345 (2003).
Anderson, G. S., Brinkmann, F., Soulen, M. C., Alavi, A. & Zhuang, H. FDG positron emission tomography in the surveillance of hepatic tumors treated with radiofrequency ablation. Clin. Nucl. Med. 28, 192–197 (2003).
Cannon, J. W. et al. Real-time three-dimensional ultrasound for guiding surgical tasks. Comput. Aided Surg. 8, 82–90 (2003).
Righetti, R. et al. Elastographic characterization of HIFU-induced lesions in canine livers. Ultrasound Med. Biol. 25, 1099–1113 (1999).
Wu, T., Felmlee, J. P., Greenleaf, J. F., Riederer, S. J. & Ehman, R. L. Assessment of thermal tissue ablation with MR elastography. Magn. Reson. Med. 45, 80–87 (2001).
Penney, G. P. et al. Registration of freehand 3D ultrasound and magnetic resonance liver images. Med. Image Anal. 8, 81–91 (2004).
Miller, D. L. & Song, J. Tumor growth reduction and DNA transfer by cavitation-enhanced high-intensity focused ultrasound in vivo. Ultrasound Med. Biol. 29, 887–893 (2003).
Goldberg, S. N. et al. Large-volume tissue ablation with radio frequency by using a clustered, internally cooled electrode technique: laboratory and clinical experience in liver metastases. Radiology 209, 371–379 (1998).
Sotsky, T. K. & Ravikumar, T. S. Cryotherapy in the treatment of liver metastases from colorectal cancer. Semin. Oncol. 29, 183–191 (2002).
Shingleton, W. B. & Sewell, P. E. Jr. Cryoablation of renal tumours in patients with solitary kidneys. BJU Int. 92, 237–239 (2003).
Johnson, D. B. & Nakada, S. Y. Cryoablation of renal and prostate tumors. J. Endourol. 17, 627–632 (2003).
Nikfarjam, M. & Christophi, C. Interstitial laser thermotherapy for liver tumours. Br. J. Surg. 90, 1033–1047 (2003).
Kohrmann, K. U. et al. Technical characterization of an ultrasound source for noninvasive thermoablation by high-intensity focused ultrasound. BJU Int. 90, 248–252 (2002).
Mougenot, C., Salomir, R., Palussiere, J., Grenier, N. & Moonen, C. T. Automatic spatial and temporal temperature control for MR-guided focused ultrasound using fast 3D MR thermometry and multispiral trajectory of the focal point. Magn. Reson. Med. 52, 1005–1015 (2004).
Jolesz, F. A. & Hynynen, K. Magnetic resonance image-guided focused ultrasound surgery. Cancer J. 8 (Suppl. 1), 100–112 (2002).
Acknowledgements
I would like to thank the following individuals for their helpful comments during the preparation of this review: D. Cranston, G. ter Haar, R. Illing and F. Wu. The research into HIFU at the Churchill Hospital has been supported by grants from Ultrasound Therapeutics Limited, Stockport, UK. I would also like to acknowledge the Nuffield Department of Surgery, University of Oxford and the Cancer Research UK Medical Oncology Unit, Oxford, for their ongoing support.
Author information
Authors and Affiliations
Ethics declarations
Competing interests
Between 2001 and 2004, salary for the author was funded through a research grant provided by Ultrasound Therapeutics Limited, Stockport, UK. The company continue to support the research programme in the HIFU unit, Churchill Hospital, Oxford.
Related links
Related links
DATABASES
National Cancer Institute
FURTHER INFORMATION
Rights and permissions
About this article
Cite this article
Kennedy, J. High-intensity focused ultrasound in the treatment of solid tumours. Nat Rev Cancer 5, 321–327 (2005). https://doi.org/10.1038/nrc1591
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrc1591
This article is cited by
-
Thermal immuno-nanomedicine in cancer
Nature Reviews Clinical Oncology (2023)
-
Sonogenetic control of multiplexed genome regulation and base editing
Nature Communications (2023)
-
Engineered exosomes from different sources for cancer-targeted therapy
Signal Transduction and Targeted Therapy (2023)
-
Ultrasound responsive microcapsules for antibacterial nanodrug delivery
Nano Research (2023)
-
Investigation of single beam ultrasound sensitivity as a monitoring tool for local hyperthermia treatment in breast cancer
Multimedia Tools and Applications (2023)