High-Intensity Focused Ultrasound Therapy

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What is High-Intensity Focused Ultrasound?

High-Intensity Focused Ultrasound (HIFU) therapy is a new, emerging type of therapy that uses ultrasound waves, sent through tissue. It is a non-invasive procedure that has great potential for tumour ablation and other treatments like thrombolysis (a treatment to dissolve blood clots (“Thrombolysis”, 2019)) and targeted gene therapy (Kim et al., 2008).

What is therapeutic ultrasound?

Therapeutic ultrasound uses sound waves above the frequency detectable by human hearing but does not produce images like diagnostic ultrasound. It could be used to move or push tissue, heat tissue, dissolve blood clots, or send drugs to specific locations in the body. In high-intensity beams, therapeutic ultrasound can also be used to destroy disease or abnormal tissues, like tumours and fibroids (“Ultrasound”, 2016).

How does HIFU therapy work?

The ultrasound wave is focused on a specific point to raise the temperature to 70-80℃. HIFU uses sonication to create the heat. As a single sound wave only heats a small focal point, the radiologist doing your procedure will use multiple sonications to remove the whole affected area (Sanghvi and Xiaoping, 2013).

What are the risks of HIFU Therapy?

There are risks related to non-target specific sonication (the application of energy to the tissue surrounding the tissue around the area being treated). This inadequate heating could injure the targeted area more. HIFU should also not be used in certain areas of the body as ultrasound waves have a harmful effect on some materials. (Sanghvi and Xiaoping, 2013).

What are some advantages to HIFU therapy?

Clinical trials of HIFU therapy for different illnesses have shown promising results. Doctors have recommended this form of therapy for uterine fibroids and the alleviation of pain from bone cancer. There has also been success in its usage in treatment for liver, breast, and brain tumours. HIFU is proven to show positive results for essential tremors, neuropathic pain, and Parkinson’s disease. (Sanghvi and Xiaoping, 2013).

What are some disadvantages to HIFU therapy?

While it is a wonderful way to treat some illnesses, HIFU is not covered by health insurance. The treatment could range anywhere from $15,000 to $25,000 (Applyby, 2016). There is no long-term outcome data available as it is a relatively new study, making the results of this treatment unclear. HIFU therapy for prostate cancer has been found to potentially give patients urinary incontinence (involuntary loss of bladder control) , urinary tract infection, and retention. There is a possibility of brief and temporary pain and lowered quality of life after the procedure (“High Intensity Focused Ultrasound (HIFU) therapy for prostate cancer”, n.d.).

Treatments - Usage in Medicine

Treatment for Muscle Atrophy - There have been positive results using HIFU therapy for muscle atrophy. Focused Ultrasound (FUS) Therapy uses the convergence of beams of focused ultrasound to stimulate angiogenesis. This treatment has been proven to diminish muscle atrophy but still requires a lot more work for it to be used in a clinical setting (Focused Ultrasound Foundation, 2020). As the main treatment for muscle atrophy is usually invasive surgery, this treatment option, once fully developed, can be a cheaper, less risky alternative (Focused Ultrasound Foundation, 2020). Refer to figure 8.16.

Treatment for Colon Cancer - Colorectal Tumours - Using Focused Ultrasound therapy, we could ablate part or all of the tumor (through thermal destruction of the harmful tissue), allowing a full or partial treatment of colorectal cancer. FUS therapy can also aid cancer patients with better absorption of chemotherapy through local hyperthermia (Focused Ultrasound Foundation, “Colorectal Tumors”, 2020). As the main treatment for colorectal cancer is usually surgery or medication, this treatment option is a less risky alternative that has less impact on the rest of the patient, unlike intense chemo (Focused Ultrasound Foundation, “Colorectal Tumors”, 2021).

Treatment for Parkinson’s Disease - The therapeutic effects of HIFU allow Parkinson’s disease to be treated without surgery. As there is no current cure for Parkinson’s disease and the main course of treatment for the motor symptoms of this disease are drugs or surgery, Focused Ultrasound therapy could be a newly developing alternative. It has already been proven to help relieve some symptoms of this disease (Focused Ultrasound Foundation, “Parkinson’s Disease”, 2021).

Sources:

• Appleby, J. (2016, October 05). Prostate cancer patients are paying hefty price for controversial new treatment. Retrieved February 02, 2021, from https://www.pbs.org/newshour/health/prostate-cancer-patients-paying-hefty-price-controversial-new-treatment

• Colorectal cancer. (2021, January 14). Retrieved February 02, 2021, from https://en.wikipedia.org/wiki/Colorectal_cancer

• Colorectal Tumors. (n.d.). Retrieved February 02, 2021, from https://www.fusfoundation.org/diseases-and-conditions/oncological/colorectal-tumors

• Gene Therapy for Parkinson's Disease via Focused Ultrasound-Targeted Nanoparticle Delivery. (n.d.). Retrieved February 02, 2021, from https://www.price-lab.org/portfolio-item/gene-therapy-for-parkinsons-disease-via-focused-ultrasound-targeted-nanoparticle-delivery/

• HIFU - High Intensity Focused Ultrasound. (2018, July 17). Retrieved February 02, 2021, from https://urologyaustin.com/male-urology/hifu-high-intensity-focused-ultrasound/

• Image-Guided Transcranial Focused Ultrasound Stimulates Human Primary Somatosensory Cortex. (n.d.). Retrieved February 2, 2021, from https://www.researchgate.net/figure/Schematics-of-the-image-guided-FUS-sonication-setup-and-parameters-a-The-acoustic_fig1_273152552/actions#reference

• Jamie, E. (2019, May 30). Muscle atrophy: Causes, symptoms, and treatments (1175153629 880687345 W. Morrison M.D., Ed.). Retrieved February 02, 2021, from https://www.medicalnewstoday.com/articles/325316

• Kim, Y., Rhim, H., Choi, M., Lim, H., & Choi, D. (2008). High-intensity focused ultrasound therapy: An overview for radiologists. Retrieved February 02, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2627265/

• Matsumoto, Y., Nakano, J., Oga, S., Kataoka, H., Honda, Y., Sakamoto, J., & Okita, M. (2014, March 6). Muscle Atrophy. Retrieved February 02, 2021, from https://www.fusfoundation.org/diseases-and-conditions/pain-relief/muscle-atrophy#:~:text=Focused%20ultrasound%20is%20an%20early,targets%20deep%20in%20the%20body.

• Mohammed, M., & Alhajhoj, M. (2019, September 06). Importance and Applications of Ultrasonic Technology to Improve Food Quality. Retrieved February 02, 2021, from https://www.intechopen.com/books/food-processing/importance-and-applications-of-ultrasonic-technology-to-improve-food-quality

• Parkinson's Disease Brain Malfunction Evident in Scans Potentially Years Before Symptoms. (2019, June 20). Retrieved February 02, 2021, from https://www.genengnews.com/news/parkinsons-disease-brain-malfunction-evident-in-scans-potentially-years-before-symptoms/

• Parkinson's Disease. (n.d.). Retrieved February 02, 2021, from https://www.fusfoundation.org/diseases-and-conditions/neurological/parkinsons-disease

• Sanghvi, N., & Xiaoping, L. (2018, October 03). High-intensity focused ultrasound (HIFU). Retrieved February 02, 2021, from https://www.cirse.org/patients/ir-procedures/high-intensity-focused-ultrasound-hifu/

• Ultrasound. (n.d.). Retrieved February 02, 2021, from https://www.nibib.nih.gov/science-education/science-topics/ultrasound

Adapted from a school project, proper sourcing is done.

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Published May 14, 2021 to May 18, 2021

Adapted from Fiona Xu's school project