Simultaneous Evaluation of Thermal and Non-Thermal Effects of High-Intensity Focused Ultrasound on a Tissue-Mimicking Phantom

Kim, Yong Tae,Ma, Donghee,Sim, Jai Kyoung,Kim, Se-Hwa Elsevier 2018 Ultrasound in medicine & biology Vol.44 No.8

<P><B>Abstract</B></P> <P>Physiologically relevant phantoms with high reliability are essential for extending the therapeutic applications of high-intensity therapeutic ultrasound. Here we describe a tissue-mimicking phantom capable of quantifying temperature changes and observing non-thermal phenomena by high-intensity therapeutic ultrasound. Using polydiacetylene liposomes, we fabricated agar-based polydiacetylene hydrogel phantoms (PHPs) that not only respond to temperature, but also have acoustic properties similar to those of human liver tissue. The color of PHPs changed from blue to red depending on the temperature in the range 40°C–70°C, where the red/blue ratio of PHP had a good linearity of 99.06% for the temperature changes. Furthermore, repeated high-intensity focused ultrasound led to histotripsy on the PHP with liquefied and damaged areas measuring 0.7 and 4.0 cm<SUP>2</SUP>, respectively, at the signal generator amplitude setting voltage of 80 mV. Our results indicate not only the usability of the thermochromic phantom, but also its potential for evaluating non-thermal phenomena in various high-intensity focused ultrasound therapies.</P>

High-Intensity Focused Ultrasound Therapy: an Overview for Radiologists

김영선,임현철,최민주,임효근,최동일 대한영상의학회 2008 Korean Journal of Radiology Vol.9 No.4

High-intensity focused ultrasound therapy is a novel, emerging, therapeutic modality that uses ultrasound waves, propagated through tissue media, as carriers of energy. This completely non-invasive technology has great potential for tumor ablation as well as hemostasis, thrombolysis and targeted drug/gene delivery. However, the application of this technology still has many drawbacks. It is expected that current obstacles to implementation will be resolved in the near future. In this review, we provide an overview of high-intensity focused ultrasound therapy from the basic physics to recent clinical studies with an interventional radiologist's perspective for the purpose of improving the general understanding of this cutting-edge technology as well as speculating on future developments.

High-intensity focused ultrasound beam path visualization using ultrasound imaging

송재희,장진호,유양모 한국음향학회 2020 韓國音響學會誌 Vol.39 No.1

In High-Intensity Focused Ultrasound (HIFU) treatment, effective localization of HIFU focus is important for developing a safe treatment plan. While Magnetic Resonance Imaging guided HIFU (MRIgHIFU) can visualize the ultrasound path during the treatment for localizing HIFU focus, it is challenging in ultrasound imaging guided HIFU (USIgHIFU). In the present study, a real-time ultrasound beam visualization technique capable of localizing HIFU focus is presented for USIgHIFU. In the proposed method, a short pulse, with the same center frequency of an imaging ultrasound transducer below the regulated acoustic intensity (i.e., Ispta < 720 mW/cm2), was transmitted through a HIFU transducer whereupon backscattered signals were received by the imaging transducer. To visualize the HIFU beam path, the backscattered signals underwent dynamic receive focusing and subsequent echo processing. From in vitro experiments with bovine serum albumin gel phantoms, the HIFU beam path was clearly depicted with low acoustic intensity (i.e., Ispta of 94.8 mW/cm2) and the HIFU focus was successfully localized before any damages were produced. This result indicates that the proposed ultrasound beam path visualization method can be used for localizing the HIFU focus in real time while minimizing unwanted tissue damage in USIgHIFU treatment.

Uterine Perforation after High-Intensity focused Ultrasound Treatment for Adenomyosis

Sat Byul Kim,Mi Jung Um,Suk Jin Kim,Mi Ja Lee,Hyuk Jung 조선대학교 의학연구원 2016 The Medical Journal of Chosun University Vol.41 No.4

High intensity focused ultrasound (HIFU) treatment of uterine myoma is a non-invasive procedure that uses high intensity, focused ultrasound to heat and destroy the tissue of uterine myoma. The history of using therapeutic ultrasound dates back to the early 20th century, and since, the technique has been continuously improved to an extent that the breadth of its clinical applications, both diagnostic and therapeutic, justify the integral role it plays in medicine today. HIFU treatment requires that ultrasound beams be focused on targeted uterine myoma. Due to significant energy dissipation at the focus, temperatures within tissues increase to more than 65℃, and destroy diseased tissue. This technology can achieve precise "ablation" of myoma tissue, and because it destroys diseased tissue non-invasively, it is also known as "Non-invasive HIFU surgery". Development of this technology significantly broadened the range of treatment options for patients suffering from uterine myoma. Furthermore, in contrast to surgery, HIFU requires only a short period of hospitalization and has a low complication rate. Today, HIFU is being used more frequently to treat adenomyosis, but its increased use has led to the reporting of more complications. Here, the authors report a case of uterine perforation after HIFU ablation for adenomyosis.

High-intensity focused ultrasound combined with hysteroscopic resection to treat retained placenta accreta

( Jae Seong Lee ),( Gi Youn Hong ),( Byung Joon Park ),( Hyejin Hwang ),( Rayon Kim ),( Tae Eung Kim ) 대한산부인과학회 2016 Obstetrics & Gynecology Science Vol.59 No.5

We present a case of retained placenta accreta treated by high-intensity focused ultrasound (HIFU) ablation followed by hysteroscopic resection. The patient was diagnosed as submucosal myoma based on ultrasonography in local clinic. Pathologic examination of several pieces of tumor mass from the hysteroscopic procedure revealed necrotic chorionic villi with calcification. HIFU was performed using an ultrasound-guided HIFU tumor therapeutic system. The ultrasound machine had been used for real-time monitoring of the HIFU procedure. After HIFU treatment, no additional vaginal bleeding or complications were observed. A hysteroscopic resection was performed to remove ablated placental tissue 7 days later. No abnormal vaginal bleeding or discharge was seen after the procedure. The patient was stable postoperatively. We proposed HIFU and applied additional hysteroscopic resection for a safe and effective method for treating retained placenta accreta to prevent complications from the remaining placental tissue and to improve fertility options.

Review : Current and Future Clinical Applications of High-Intensity Focused Ultrasound (HIFU) for Pancreatic Cancer

( Hyun Joo Jang ),( Jae Young Lee ),( Don Haeng Lee ),( Won Hong Kim ),( Joo Ha Hwang ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.s1

High-intensity focused ultrasound (HIFU) is a novel therapeutic modality that permits noninvasive treatment of various benign and malignant solid tumors, including prostatic cancer, uterine fibroids, hepatic tumors, renal tumors, breast cancers, and pancreatic cancers. Several preclinical and clinical studies have investigated the safety and efficacy of HIFU for treating solid tumors, including pancreatic cancer. The results of nonrandomized studies of HIFU therapy in patients with pancreatic cancer have suggested that HIFU treatment can effectively alleviate cancer-related pain without any significant complications. This noninvasive method of delivering ultrasound energy into the body has recently been evolving from a method for purely thermal ablation to harnessing the mechanical effects of HIFU to induce a systemic immune response and to enhance targeted drug delivery. This review provides a brief overview of HIFU, describes current clinical applications of HIFU for pancreatic cancer, and discusses future applications and challenges. (Gut Liver 2010;4(Suppl. 1):S57-61)

종양조직에 항암제 전달을 강화하기 위한 고강도 초음파 집적술의 역할

정진태 ( Jin Tae Jung ),이돈행 ( Don Haeng Lee ),황주하 ( Joo Ha Hwang ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.4

Cancer is the first leading cause of death in Korea. Systemic chemotherapy is currently the standard treatment for a wide variety of cancers; however, in the majority of cases, cure is not achieved, and the attendant side effects of the treatment are considerable. The effectiveness of chemotherapy in cancers depends on the adequate delivery of the chemotherapeutic agent to cancer cells. The achievement of uniform drug delivery of chemotherapeutic agents throughout tumors is limited by the anomalous vascularization and blood vessel permeability. Ultrasound has an ever-increasing role in the delivery of therapeutic agents including chemotherapeutic agents, proteins, and genetic materials. Ultrasound technology allows for the use of focused ultrasound energy for therapeutic purposes by delivering high-intensity focused ultrasound for applications such as tissue ablation, and enhanced drug delivery. We reviewed recent work in the emerging field of ultrasound-based therapeutics, with particular emphasis on the delivery of drugs to tumor tissue. (Korean J Gastroenterol 2009;53:216-220)

Case Report : Three cases of complications after high-intensity focused ultrasound treatment in unmarried women

( Hyun Kyung Kim ),( Doa Kim ),( Min Kyoung Lee ),( Chae Rim Lee ),( So Yeon Kang ),( Youn Jee Chung ),( Hyun Hee Cho ),( Jang Heub Kim ),( Mee Ran Kim ) 대한산부인과학회 2015 Obstetrics & Gynecology Science Vol.58 No.6

High-intensity focused ultrasound (HIFU) has been regarded as a non-surgical, minimally invasive therapeutic option for patients who prioritize uterus-conservation. Although many studies have shown that HIFU therapy is a safe and effective treatment of uterine fibroid, not all fibroids are suitable for HIFU due to risks of serious complications. We experienced three cases of complications after the HIFU ablation for huge uterine fibroids, including two cases of rapid myoma enlargement and one case of heavy vaginal bleeding.

P139 : Comparative histometric analysis of the effects of high intensity focused ultrasound (HIFU) and radiofrequency (RF) on Asian skin

( Dong Hye Suh ),( Jeong Hwee Choi ),( Sang Jun Lee ),( Ki Heon Jeong ),( Kye Yong Song ),( Min Kyung Shin ) 대한피부과학회 2014 대한피부과학회 학술발표대회집 Vol.66 No.2

Background: High-intensity focused ultrasound (HIFU) and radiofrequency (RF) are used for non-invasive skin tightening. Neocollagenesis and neoelastogenesis have been reported to have a mechanism of controlled thermal injury. Objectives: To compare neocollagenesis and neoelastogenesis in each layer of the dermis after each session of HIFU and monopolar RF. Methods: We analyzed the area fraction of collagen and elastic fibers using the Masson’s trichrome and Victoria blue special stains, respectively, before and after 2 months of treatments. Histometric analyses were performed in each layer of the dermis, including the papillary dermis, and upper, mid,and deep reticular dermis. Results: Monopolar RF led to neocollagenesis in the papillary dermis, and upper, mid, and deep reticular dermis, and neoelastogenesis in the papillary dermis, and upper and midreticular dermis. HIFU led to neocollagenesis in the mid and deep reticular dermis and neoelastogenesis in the deep reticular dermis. Among these treatment methods, HIFU showed the highest level of neocollagenesis and neoelastogenesis in the deep reticular dermis. Conclusion: HIFU affects deep tissues and impacts focal regions. Monopolar RF also affects deep tissues, but impacts diffuse regions. We believe this data provide further insight into effective skin tightening.

High-Intensity Focused Ultrasound for the Treatment of Wrinkles and Skin Laxity in Seven Different Facial Areas

( Hyunchul Park ),( Eunjin Kim ),( Jeongeun Kim ),( Youngsuck Ro ),( Jooyeon Ko ) 대한피부과학회 2015 Annals of Dermatology Vol.27 No.6

Background: High-intensity focused ultrasound (HIFU) treatment has recently emerged in response to the increasing demand for noninvasive procedures for skin lifting and tightening. Objective: This study was aimed at evaluating the clinical efficacy of and patient satisfaction with HIFU treatment for wrinkles and laxity in seven different areas of the face in Asian skin. Methods: Twenty Korean patients with facial wrinkle and laxity were analyzed after a single session of HIFU treatment. Two independent, blinded clinicians evaluated the clinical improvement in seven areas of the face by comparison of standardized photographs obtained before, and at 3 and 6 months after treatment. Assessment of subjective satisfaction and adverse effects of treatment were done by using questionnaires. Results: The physicians` evaluation and patients` satisfaction with the clinical effects of HIFU in each area were similar regardless of the number of treatment shots. The jawline, cheek, and perioral areas were the sites where HIFU was most effective, in decreasing order. The adverse effects included erythema and swelling in six cases, and purpura and bruising in two cases. However, the adverse effects were mild and transient. Conclusion: HIFU could be a safe, effective, and noninvasive procedure that can be used to improve facial wrinkles and skin laxity in Asian skin. It is particularly effective for clinical improvement in the jawline, cheek, and perioral areas. (Ann Dermatol 27(6) 688∼693, 2015)