TU‐A‐144‐01: Clinical Delivery and Advanced Novel Technologies/Strategies
Authors: Sanghvi N , Hananel A , Hurwitz M , Moonen C 
Published: July 2013

High Intensity Focused ultrasound, (HIFU), is a novel medical procedure using acoustic energy, delivered in a focused manner and under guidance of ultrasound or MRI, to a targeted volume of living tissue. The energy can induces mechanical, thermal and biological outcomes determined by the acoustic parameters used and their interaction with the tissue. The most common and already clinically used effect is heating in an accurate, localized and non‐invasive manner the tissue to a high enough temperature thereby inducing thermal necrosis. During this session we will cover current and future trends of MR guided HIFU in Radiation Oncology and would take an in‐depth look at HIFU usage for treatment of prostate cancer, bone metastasis and MRI guided hyperthermia. Current and future trends in HIFU for radiation oncology: HIFU already has a proven track record for the treatment of liver tumors, pancreatic and breast cancer as well as a significant potential to improve the care of brain cancer patients. We will cover the clinical and regulatory status of this method for the listed clinical indications as well as existing devices. Prostate cancer: Ultrasound guided High Intensity Focused Ultrasound for prostate treatment has been used clinically since 1992. To date over 42,000 men have received HIFU treatment for localized prostate cancer: Primarily two commercial devices provide US guided HIFU treatment for prostate cancer. The Sonablate 500 (manufactured by SonaCare Medical, Indianapolis, IN) and Ablatherm (manufactured by EDAP, Lyon, France). The prostate cancer presentation will cover imaging and localization of prostate, treatment planning using 2D and 3D ultrasound images, HIFU treatment and real time treatment monitoring with Tissue Change Monitoring derived from backscattered RF pulse/echo signals. Clinical analysis will include efficacy and safety data for whole gland and focal treatment. Bone Metastasis: The current status of palliation for painful bone metastases including the role of MRgFUS in this sphere will be reviewed. Results of clinical trials including a recently completed phase III trial demonstrating high rates of pain relief and improvement in quality of life with use of MR guided Focused Ultrasound, (MRgFUS), for patients who had recurrent or persistent pain following radiation of for whom radiation therapy was otherwise contraindicated will be presented. Future directions including novel new applicators and use as primary treatment with or without radiation will be discussed. MRI guided hyperthermia and Ultrasound Triggered Local Drug Delivery: we will review the delivery, monitoring and control techniques as well as promising usages of HIFU for localized drug delivery using hyperthermia.

Learning Objectives:

1. Know the current status and understand the potential of HIFU in the field of oncology

2. Understand in details the usage of HIFU for the treatment of prostate cancer

3. Understand in details the usage of HIFU for the palliation of painful bone metastasis

4. Understand the principle and potential of HIFU for MR guided localized drug delivery.

My trip will be supported by my current employer, the focused ultrasound foundation. I own InSightec stocks.