Introduction: Pancreatic cancer is with the poorest prognosis of all common cancers worldwide. Despite the advances in treatment the results are poor throughout the different methods. Pancreatic resection still yields the best outcome. However only a quarter of the patients present at operable stage. HIFU is a noninvasive technique that can be used to treat pancreatic cancer. Aim: The aim of this review is to perform a systematic review on the data about the resection rate after HIFU ablation in patients with borderline resectable pancreatic cancer (BRPC) and the impact of this technique over the oncological results. Materials and methods: The PubMed and Wanfang databases were searched using keywords: pancreatic cancer, HIFU ablation and high-intensity focused ultrasound. All found articles were reviewed. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard guidelines. This study was financially supported by 2019 'Kuan-Ren Elite' Program of 2nd Affiliated Hospital of Chongqing Medical University, China (Grant no. KY2019G019). Results: The English database search showed 109 papers, of which 3 met the inclusion criteria. The Wanfang database resulted in 110 papers; however, none met the inclusion criteria of the review. From the included studies 97 patients underwent neoadjuvant HIFU ablation ± chemotherapy. Thirtyfour patients reached resection (35.1%). In two patients, residual tumor (R) classification was not reported. R0 resection rate in all reported patients is 30.5% (29/95). R1 resection rate is 3.2% (3/95). Conclusion: HIFU is found to be safe and feasible in locally advanced and metastatic pancreatic cancer with proven downstaging and downsizing effects. Further research on role of HIFU ablation as a neoadjuvant treatment for borderline resectable pancreatic cancer is needed.

We present a case of recurrent pancreatic cancer diagnosed by computer tomography (CT) and positron emission tomography(PET), 7 months after Whipple radical surgery in a 61-year-old female patient. The patient was successfully treated byfocused ultrasound surgery (FUS) by innovative high intensity focused ultrasound device. The patient had no complications.Multiple cycles of chemotherapy were done. Twelve months after FUS the new PET-CT showed no evidence of metabolite activezone in the area of ablation and no progression of disease. The presented case is unique according to the literature as a localrecurrence after radical surgery for pancreatic cancer, successfully managed by local FUS ablation and adjuvant chemotherapy.

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Introduction: This study aims to determine whether the Chinese clinical protocol, ultrasound guided high-intensity focused ultrasound (USgHIFU) combined with real-time monitoring using a contrast enhanced ultrasound (CEUS), also applies well in European patients with uterine fibroids. Methods: Seventy-five patients with 87 nodules of uterine fibroids from China and Bulgaria were treated with USgHIFU from April 2015 to July 2016, in the study. In Group A (Bulgarian) 26 (33 nodules) patients and in group B (Chinese) 49 (54 nodules) patients were included in the study. The same clinical procedure of USgHIFU treatment as well as a follow-up was performed on patients from China and Bulgaria. The general characteristics of the patients, the USgHIFU treatment and evaluation parameters, including; complications, fibroid size, tumor volume, subcutaneous fat size, non-perfused volume (NPV) and shrinkage process, were comparatively studied in Chinese and Bulgarian patients. Results: There were no significant differences in clinical parameters of Chinese and Bulgarian patients with uterine fibroids, such as vertical, left-right and аnterior-posterior size, treatment time, USgHIFU time.After USgHIFU treatment, no complications were recorded in both groups. On the 6 th and 12 th month after USgHIFU, fibroid nodules shrunk and the NPV was statistically significant compared to NPV before USgHIFU, but there were no statistically significant differences. Conclusions: The initial results of our study showed that CEUS clinical protocol for real time monitoring of efficacy and quality of the USgHIFU for uterine fibroid treatment that had been used in Chinese centers may also be applicable for European patients.

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