Emerging clinical applications of high-intensity focused ultrasound

Duc, Nguyen Minh; Keserci, Bilgin

doi:10.5152/dir.2019.18556

Cited by 55 publications

(41 citation statements)

References 87 publications

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“…Ultrasound and MRI are two guidance modalities integrated with HIFU, which is an essential prerequisite of HIFU treatment for patient selection, treatment planning, real-time treatment monitoring, safe delivery of the desired therapeutic dose, and treatment efficacy evaluation. Most HIFU treatments are still performed under ultrasound imaging guidance mainly due to its cost-effectiveness and greater accessibility to patients (10).…”

Section: Discussionmentioning

confidence: 99%

“…Many patients show clinical symptoms such as menorrhagia, irregular bleeding, pelvic pain, or infertility (4)(5)(6), which have a significant negative effect on their quality of life. Currently, the management for uterine fibroids includes surgery, medicine, uterine artery embolization (UAE), radiofrequency ablation (RFA), ultrasound-guided high-intensity focused ultrasound (USgHIFU), and magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) (7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

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A Prediction of NPVR ≥ 80% of Ultrasound-Guided High-Intensity Focused Ultrasound Ablation for Uterine Fibroids

et al. 2021

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Objective: To evaluate factors in predicting the treatment outcome of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids with a non-perfused volume ratio (NPVR) of at least 80%.Methods: One thousand patients with uterine fibroids who received USgHIFU were enrolled. Thirty-two independent variables of four dimensions of data set, including general information of patients, clinical symptoms, laboratory tests, and fibroid imaging characteristics, were used to investigate the potential predictors of the NPVR of at least 80% by multivariate logistic regression. NPVR was the gold standard for evaluating the efficiency of HIFU ablation, and a NPVR of at least 80% was considered sufficient ablation, while partial ablation was defined as having an NPVR of <80%.Results: Out of 1,000 fibroids, 758 obtained sufficient ablation and 242 obtained partial ablation, and the median NPVR was 88.3% (interquartile range: 80.3–94.8%). The probability of NPVR reaching 80% fibroids with a signal intensity of T2WI of hypointense, isointense, and hyperintense was 86.4, 76.5, and 62.6%, respectively; fibroids with an enhancement type of T1WI of slight, irregular, and regular was 81.5, 73.6, and 63.7%, respectively; and fibroids with uterine anteroposterior of 30–130 mm was 57.7–78.3%, respectively. In patients with a platelet count of 50 × 109/L−550 × 109/L, the probability of NPVR reaching 80% is from 53.4 to 80.1%, respectively.Conclusions: In predicting NPVR ≥ 80%, the signal intensity on T2WI was the most important factor affecting ablative efficiency, followed by enhancement type on T1WI, uterine anteroposterior, and platelet count.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Prediction of NPVR ≥ 80% of Ultrasound-Guided High-Intensity Focused Ultrasound Ablation for Uterine Fibroids

et al. 2021

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“…authors found that the degree of cell membrane deformation inversely correlated with widening of the bubble-cell membrane gap [28].…”

Section: Mbs Mechanics and Ultrasound Techniquementioning

confidence: 96%

“…Wang et al also studied the impact of bubble-to-cell distance and their interaction using a boundary element method model. The authors found that the degree of cell membrane deformation inversely correlated with widening of the bubble-cell membrane gap [28].…”

Section: Mbs Mechanics and Ultrasound Techniquementioning

confidence: 99%

Applications of Ultrasound-Mediated Drug Delivery and Gene Therapy

Sitta

Howard

2021

IJMS

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Gene therapy has continuously evolved throughout the years since its first proposal to develop more specific and effective transfection, capable of treating a myriad of health conditions. Viral vectors are some of the most common and most efficient vehicles for gene transfer. However, the safe and effective delivery of gene therapy remains a major obstacle. Ultrasound contrast agents in the form of microbubbles have provided a unique solution to fulfill the need to shield the vectors from the host immune system and the need for site specific targeted therapy. Since the discovery of the biophysical and biological effects of microbubble sonification, multiple developments have been made to enhance its applicability in targeted drug delivery. The concurrent development of viral vectors and recent research on dual vector strategies have shown promising results. This review will explore the mechanisms and recent advancements in the knowledge of ultrasound-mediated microbubbles in targeting gene and drug therapy.

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“…Current noninvasive stimulation techniques, such as transcranial magnetic stimulation (TMS) and transcranial current stimulation (TCS), have shown promising pain reduction effects, despite their limited spatial focality and depth penetration. While high-intensity focused ultrasound mainly achieves its effectiveness through thermal induction or non-thermal ablation, and accomplishes a wide range of clinical applications, [1] low intensity transcranial focused ultrasound (tFUS) has recently emerged as a safe, noninvasive neuromodulation technique with high spatial resolution and focality with capability of accessing the deep brain. Recent efforts on ultrasound neuromodulatory and neurosurgical development have been reviewed with respect to pain diagnosis and treatment mainly at the peripheral nervous system.…”

mentioning

confidence: 99%

Neuromodulation Management of Chronic Neuropathic Pain in the Central Nervous System

2020

Adv Funct Materials

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Neuromodulation is a clinical tool used for treating chronic neuropathic pain by transmitting controlled physical energy to the pre‐identified neural targets in the central nervous system. Its drug‐free, nonaddictive, and improved targeting characteristics have attracted increasing attention among neuroscience research and clinical practices. This article provides a brief overview of the neuropathic pain and pharmacological routines for treatment, summarizes both the invasive and noninvasive neuromodulation modalities for pain management, and highlights an emerging brain stimulation technology, transcranial focused ultrasound (tFUS), with a focus on ultrasound transducer devices and the achieved neuromodulation effects and applications on pain management. Practical considerations of spatial guidance for tFUS are discussed for clinical applications. The safety of transcranial ultrasound neuromodulation and its future prospectives on pain management are also discussed.

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Emerging clinical applications of high-intensity focused ultrasound

Cited by 55 publications

References 87 publications

A Prediction of NPVR ≥ 80% of Ultrasound-Guided High-Intensity Focused Ultrasound Ablation for Uterine Fibroids

A Prediction of NPVR ≥ 80% of Ultrasound-Guided High-Intensity Focused Ultrasound Ablation for Uterine Fibroids

Applications of Ultrasound-Mediated Drug Delivery and Gene Therapy

Neuromodulation Management of Chronic Neuropathic Pain in the Central Nervous System

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