Saturday, March 16, 2013

International HIFU, A Short Explanation

By Brown Jack


There is a highly precise medical technique referred to as High Intensity Focused Ultrasound or in short HIFU that uses a high-intensity focused sonic energy to heat and destroy tissues that are damaged or diseased through ablation. It is a form of hyperthermia therapy because it uses high temperatures to treat diseases. It is applied in conjunction with an imaging procedure that helps in targeting and planning the treatment before applying any ablative or therapeutic ultrasound energy.

Sometimes this technique is referred to as magnetic resonance-guided focused ultrasound or in short MRgHIFU. Part of the acoustic wave propagating through the tissue is absorbed and converted to heat. A very tiny focus can be achieved with focused beams that go deep into the tissue. Tissue damage occurs both due to the time and the temperature to which this tissue is exposed to.

Non-invasive ablation investigations regarding this medical procedure were first reported by Lynn et al in the early 40s. Further research was conducted in the 50s and 60s by other scientists that culminated in clinical treatment of some neurological disorders. There were few clinical trials in the past maybe because of the treatments complexity or difficulty of noninvasive beam targeting. Recent advances in medical imaging as well as ultrasound technology have brought about a lot of interest regarding the ablation of tumors using this technique.

In 1994 the Sonablate 200 was approved by CE and was launched in Europe making it the first commercial machine ever developed courtesy of a certain American company. Comprehensive studies by practitioners regarding this device showed clinical efficacy in the destruction of prostatic tissue minus blood loss or long term side effects. This procedure has been approved by a couple of developed countries as a prostate cancer treatment.

High intensity focused ultrasound is a technology often considered promising within the non-invasive or medical technology segments of minimally invasive therapy. This therapy is unique because it has the capacity to generate precise and in-depth tissue necrosis through an external applicator without affecting the surrounding structures. This procedure is different from many other forms of focused energy like radio surgery or radiation therapy. The ultrasound energy that passes through intervening tissue does not have any cumulative effect on the tissue.

In case of partial treatment or the first procedure fails the procedure can be repeated because it has no cumulative tissue effects. When radiation therapy fails, the recurrence of prostate cancer can be treated using this therapy because it is a non-ionizing clean treatment. This treatment has been successfully known to treat cancer through the destruction of solid tumors that grow in different organs and parts of the body.

The palliative treatment of metastasis using this technique has been approved by CE because it has been found to offer palliative care. There are temperature sensitive cancer drug carriers known as liposomes that deliver the drug on targeted tumor sites and these can be activated using the high temperatures of this medical procedure. Additionally it is also used to temporarily open the blood brain barrier thus allowing a drug to be absorbed into the brain.

AF or atrial fibrillation is a common heart arrhythmia that can be treated using this procedure. There are also MRI guided treatment tests that have been done regarding liver tumor, breast fibroadenomas, breast cancer, uterine fibroids and bone metastases. Many uterine fibroids patients have been treated using HIFU.




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