OBJECTIVE: To demonstrate in a porcine model that high-intensity focused ultrasound (HIFU) with toroid-shaped emitters may have a role in treating unresectable colorectal liver metastases. SUMMARY BACKGROUND DATA: Surgical resection is the only curative option for colorectal hepatic metastases. Only 20% of patients are suitable for surgery. Many ablative techniques have been assessed but several limitations have been documented: traumatic puncture of the parenchyma, limited size of lesions, and inability to monitor the treatment in real time. METHODS: A HIFU device with 256 toroid-shaped emitters and integrated ultrasound imaging probe was used. Single lesions, induced in 40 seconds, and juxtaposition of 6 single lesions were created under ultrasound guidance on 13 pigs. The lesions were studied on sonograms, macroscopically and microscopically up to 30 days after the treatment. RESULTS: Ninety percent of the HIFU lesions were immediately hypoechoic on ultrasound imaging. The average coagulated volume obtained from a 40 seconds total exposure in the liver was 7.0 +/- 2.5 cm (1.5-20.0), average diameter: 19.5 +/- 3.8 mm (10.0-29.0). Using the real-time visualization of the treated region, single lesions were easily juxtaposed to produce larger lesions up to 6 cm in diameter without any major complication. CONCLUSIONS: This toroid HIFU device allows short treatment times, noninvasiveness regarding the liver and real time ultrasound guidance. It seems to be simpler and more reliable to use than current ablative methods. Additionally, lesions through large vessels (up to 5 mm) being feasible, treatment of some juxta-vascular metastases should be possible.
OBJECTIVE: To demonstrate in a porcine model that high-intensity focused ultrasound (HIFU) with toroid-shaped emitters may have a role in treating unresectable colorectal liver metastases. SUMMARY BACKGROUND DATA: Surgical resection is the only curative option for colorectal hepatic metastases. Only 20% of patients are suitable for surgery. Many ablative techniques have been assessed but several limitations have been documented: traumatic puncture of the parenchyma, limited size of lesions, and inability to monitor the treatment in real time. METHODS: A HIFU device with 256 toroid-shaped emitters and integrated ultrasound imaging probe was used. Single lesions, induced in 40 seconds, and juxtaposition of 6 single lesions were created under ultrasound guidance on 13 pigs. The lesions were studied on sonograms, macroscopically and microscopically up to 30 days after the treatment. RESULTS: Ninety percent of the HIFU lesions were immediately hypoechoic on ultrasound imaging. The average coagulated volume obtained from a 40 seconds total exposure in the liver was 7.0 +/- 2.5 cm (1.5-20.0), average diameter: 19.5 +/- 3.8 mm (10.0-29.0). Using the real-time visualization of the treated region, single lesions were easily juxtaposed to produce larger lesions up to 6 cm in diameter without any major complication. CONCLUSIONS: This toroid HIFU device allows short treatment times, noninvasiveness regarding the liver and real time ultrasound guidance. It seems to be simpler and more reliable to use than current ablative methods. Additionally, lesions through large vessels (up to 5 mm) being feasible, treatment of some juxta-vascular metastases should be possible.
Authors: Clare M C Tempany; Elizabeth A Stewart; Nathan McDannold; Bradley J Quade; Ferenc A Jolesz; Kullervo Hynynen Journal: Radiology Date: 2003-03 Impact factor: 11.105
Authors: C H Scudamore; S I Lee; E J Patterson; A K Buczkowski; L V July; S W Chung; A R Buckley; S G Ho; D A Owen Journal: Am J Surg Date: 1999-05 Impact factor: 2.565
Authors: Steven A Curley; Paolo Marra; Karen Beaty; Lee M Ellis; J Nicolas Vauthey; Eddie K Abdalla; Courtney Scaife; Chan Raut; Robert Wolff; Haesun Choi; Evelyne Loyer; Paolo Vallone; Francesco Fiore; Fabrizio Scordino; Vincenzo De Rosa; Raffaele Orlando; Sandro Pignata; Bruno Daniele; Francesco Izzo Journal: Ann Surg Date: 2004-04 Impact factor: 12.969
Authors: Aurélien Dupré; David Melodelima; David Pérol; Yao Chen; Jérémy Vincenot; Jean-Yves Chapelon; Michel Rivoire Journal: PLoS One Date: 2015-02-26 Impact factor: 3.240
Authors: Aurélien Dupré; David Pérol; Ellen Blanc; Patrice Peyrat; Valéria Basso; Yao Chen; Jérémy Vincenot; Anthony Kocot; David Melodelima; Michel Rivoire Journal: Trials Date: 2017-02-06 Impact factor: 2.279