High intensity focused ultrasound hifu, already in use for nearly half a. Highintensity focused ultrasound hifu therapy can be used for noninvasive. A comparative evaluation of three hydrophones and a. Pdf highintensity focused ultrasound in small renal masses. A focused beam of sound waves is directed at cancer cells in order to heat them and destroy them. A blood mimicking fluid bmf has been developed for the acoustic and thermal characterizations of high intensity focused ultrasound hifu ablation devices. Ultrasound beams are focused on fibroid, and accumulative energy of the beam at a focal point increases the temperature over 65c and destroys the outgrowth. Highintensity focused ultrasound hifu therapy, also known as focused ultrasound surgery fus, is a noninvasive technology that delivers ultrasound us waves via an extracorporeal or endocavitary approach to specific targets within the human body.
A device which delivers hifu for noninvasively ablating adipose tissue the liposonix system, medicis tech nologies corporation, bothell, wa was installed in. In the focal area tissue temperature increases and a thermal lesion occurred within seconds. Physics and principles of hifu hifu uses the physical effect of ultrasound on tissues. High intensity focused ultrasound hifu is a technique currently used for different medical treatments such as thermal ablation, hyperthermia, and bleeding control 1. High intensity focused ultrasound phi clinic london. Abstract background high intensity focused ultrasound hifu has been widely accepted as a golden standard procedure for skin tightening. Focused ultrasound thyroid nodule treatment in hong kong china after my candidate evaluation for hifu treatment of your benign and or cosmetic thyroid nodule, you can spend 2 days only in hong kong getting the treatment. Kennedy innovation abstract traditionally, surgery has been the only cure for many solid tumours. Highintensity focused ultrasound article about high. Im a radiology resident and i needed something to start me off studying for my physics boards. It destroys target lesions using generated focused ultrasound beams at a speci.
More recently, high intensity focused ultrasound hifu has been developed for therapeutic. An introduction to high intensity focused ultrasound. Highenergy shockwaves and extracorporeal highintensity. Compare the cost of high intensity focused ultrasound treatment hifu abroad.
High intensity focused ultrasound hifu is a noninvasive therapeutic technique that uses nonionizing ultrasonic waves to heat tissue. Basic physical principles from the physical point of view a shock wave is defined by an abrupt, nearly discontinuous change in pressure and by having a velocity that is higher than the speed of sound in the medium it propagates 1. Hifu can be used to increase the flow of blood or lymph, or to destroy tissue, such as tumors, through a number of mechanisms. Ultrasound transducers contain a range of ultrasound frequencies, termed bandwidth.
In diagnostic ultrasound energy is contained within the beam, so the power is the rate of flow of energy through the crosssectional area of the beam. The use of high intensity focused ultrasound has recently expanded from. Highintensity focused ultrasonography hifu is a nonsurgical, noninvasive method for body sculpting in nonobese patients. Nov 12, 2011 for therapeutic ultrasound, beneficial cellular or functional effects are deliberately sought, whether these are at the cell membrane level e. Jan 17, 20 high intensity focused ultrasound hifu is a rapidly maturing technology with diverse clinical applications. This completely noninvasive technology has great potential for. In the short term, high intensity focused ultrasound seems to have fewer side effects than other cancer treatments. An early history of highintensity focused ultrasound william d. High intensity focused ultrasound hifu product analysis of. Highintensity focused ultrasound in small renal masses. It has been studied for 50 years, with recent technological developments allowing its use for tumours of liver, prostate and other sites. A new, noninvasive alternative is to ablate adipose tissue using high intensity focused ultrasound hifu. Hifu treatments are usually carried out in a single session, often as a day case procedure.
As an emerging technique, its possible percutaneous or laparoscopic application, low discomfort to the patient and the absence of complications make this technology attractive. The combination of thermal, mechanical cavitation, and biological effects can result in cell death and tissue necrosis 5. Physical principles of doppler ultrasound radiology key. High intensity focused ultrasound hifu or fus is a medical procedure that applies high intensity focused sonic energy to locally heat and destroy diseased or damaged tissue through ablation. Because of the this, it is not yet widely available in the u. A comprehensive examination of the industry and medical application of ultrasound therapy, this book highlights working principles, research progress, and system structures of therapeutic ultrasound. High intensity focused ultrasound hifu prostate cancer uk. Looking to the future, our radiology department will actively support noninvasive therapies such as high intensity focused ultrasound hifu, a technique that uses focused high intensity ultrasound waves and magnetic resonance imaging to treat masses with pinpoint accuracy. Our team of board certified urologists has the most experience with the hifu procedure in the area, and with the treatment of prostate cancer in general.
Principles of highintensity focused ultrasound springerlink. High intensity focused ultrasound semantic scholar. High intensity focused ultrasound hifu is gaining rapid clinical acceptance as a treatment modality enabling noninvasive tissue heating and ablation for numerous applications. High intensity focused ultrasound in the treatment of solid tumours james e. Mar 11, 2014 what is high intensity focused ultrasound. Physical principles of ultrasound radiology reference. A device under clinical investigation in the united states liposonix. The bmf is based on a degassed and deionized water solution dispersed with low density polyethylene microspheres, nylon particles, gellan gum, and glycerol. The thermal effect of high intensity focused ultrasound hifu has been clinically exploited over a decade, while the mechanical hifu is still largely confined to laboratory investigations. A typical pressure profile of a focused shockwave used for. Similar to sound, the key parameters of ultrasound are wave amplitude and wave frequency measured in cycles per second or hertz hz. High intensity focused ultrasound hifu is a safe and effective nonsurgical, noninvasive treatment for prostate cancer get more information by visiting hifu videos.
Focused ultrasound is an earlystage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with atrial fibrillation af. Mriguided highintensity focused ultrasound mrgfus ablation. A broad range of physical parameters, including attenuation. Several clinical high intensity focused ultrasound projects have been conducted by various research groups, and re sults have shown the technique is safe, effective, and feasible in clinical application 1215. High intensity focused ultrasound originated as a medical procedure that transmits energy locally to destroy types of tissue.
Hifu effects can be observed in a tissuemimicking material phantom. High intensity focused ultrasound as a trackless, noninvasive method of ablating tissue has been a concept with potential for more than 60 years. Highintensity focused ultrasound in the treatment of. It is known that 55 c held for this time will lead to coagulative necrosis and immediate cell death 1, 2. Review article anaesthesia for high intensity focused. Although unique technical challenges remain to be overcome. From the physical point of view a shock wave is defined by an abrupt, nearly discontinuous change in pressure and by having a velocity that is higher than the speed of sound in the medium it propagates 1. Sprawls at rsna, i decide to buy this book and have not been disappointed. It is also necessary to understand the basic concepts of how the ultrasound systems work and the concepts underlying their manipulation of echoes.
Here, we present an ablateandresect prospective study to evaluate the feasibility, safety, and accuracy of intraoperative high intensity focused ultrasound ablation in patients undergoing hepatectomy for liver metastases. For example, the shock formation distance in water for an ultrasound wave of 2 mhz frequency and 15 mpa pressure amplitude 8 kwcm2 is 5 mm. High intensity focused ultrasound has re ceived considerable attention for the manage ment of solid tumors 11. It is only in the past 10 to 15 years that technological advances in both the delivery system and the monitoring systems have allowed us to begin to truly explore this potential clinically.
High intensity focused ultrasound hifu or hifus is a cancer treatment which uses sound waves at high frequency. In the focal area, tissue temperature increases rapidly, within seconds, up to 60 c or higher. As part of the joint development programme, celsions thermodox will be combined with philips sonalleve mrhifu mrguided high intensity focused ultrasound technology for the palliation of painful metastases to the bone caused by lung, prostate or breast cancers. An early history of highintensity focused ultrasound.
Summary principles and applications of therapeutic ultrasound in healthcare introduces concepts, principles, construction, and applications of therapeutic ultrasound. The full text of this article is available in pdf format. Development and characterization of a blood mimicking. High intensity focused ultrasound is a method that focuses ultrasound to heatablate target tissues without injuring surrounding structures. High intensity focused ultrasound medical clinical policy. A high intensity focused ultrasound field is coupled through the intact skin and aimed to the targeted volume. The returned echoes are converted back into electrical impulses by the transducer crystals and are further processed to form the ultrasound image presented on the screen. Prostate cancer prostate cancer, accounting for 33 % of all male cancers, is the 2nd leading cause of cancer death in men, exceeded only by lung cancer. This article focuses on transrectal high intensity focused ultrasound hifu as a therapeutic option for patients who have just been diagnosed with low risk or intermediate risk prostate cancer and who desire aggressive, but noninvasive therapy with the intent to cure the prostate cancer. In the cosmetic industry, we use ultrasound for a range of different indications. As an emerging technique, its possible percutaneous or laparoscopic application, low discomfort to the patient and the absence of complications make this technology attractive for the management of small renal masses. Obrien jr and floyd dunn bill obrien is the director of the bioacoustics research laboratory and the donald biggar willett professor emeritus of engineering at the university of illinois at urbanachampaign. The ones marked may be different from the article in the profile.
A pilot prospective comparative trial of highintensity. Osa in vivo photoacoustics and high frequency ultrasound. An electrical system for exciting hifu transducer mainly consists of. High intensity focused ultrasound for noninvasive body contouring. Evaluation of the feasibility, safety, and accuracy of an. The technique ablates subcutaneous adipose tissue by causing molecular vibrations that increase tissue temperature and induce rapid cell necrosis. Early applications of therapeutic ultrasound were primarily in physical therapy for the treatment of musculoskeletal injuries, albeit in a lowenergy, nonfocused manner. High intensity focused ultrasound, or hifu, is a treatment that has only recently obtained fda approval in the united states. For therapeutic ultrasound, beneficial cellular or functional effects are deliberately sought, whether these are at the cell membrane level e. High intensity focused ultrasound hifu, or sometimes fus for focused ultrasound is a highly precise medical procedure that applies high intensity focused sonic energy to locally heat and destroy diseased or damaged tissue through ablation. High intensity focused ultrasound hifu for fibroid uterus. The high powered focused beams employed are generated from sources placed either outside the body for treatment of tumours of the liver, kidney, breast, uterus, pancreas and bone or in the rectum for treatment of the prostate, and are designed to enable rapid heating of a target tissue volume, while leaving tissue in the ultrasound.
Highintensity focused ultrasound hifu is a minimallyinvasive and nonionizing promising technology and has been assessed for its role in the treatment of not only primary tumors but also. When propagated into human tissue, the pressure waves are either reflected or absorbed. High intensity focused ultrasound hifu is being promoted as a noninvasive method to treat certain primary solid tumors and metastatic disease, to ablate foci of ectopic electrical activity in the heart, and to achieve hemostasis in acute traumatic injuries to the extremities and visceral organs. Evaluation of a novel highintensity focused ultrasound. This kind of technique is based on the use of an acoustic transducer with a concave face used to focus the ultrasound energy in a specific zone figure 1. Hifu or high intensity focused ultrasound is a noninvasive, extremely precise procedure that uses ultrasound to heat and destroy uterine fibroid.
Ce 1 introduction high intensity focused ultrasound hifu is a non invasive technique used for provoking thermal ablation within a target, i. Ultherapy high intensity focused ultrasound hifu for. Focused ultrasound stimulator system for aesthetic use guidance for industry and fda staff. High intensity focused ultrasound thyroid center of santa. In contrast with ultrasound imaging, therapeutic ultrasound uses high energy levels 5 wcm2 and is tightly focused into a small point to rapidly heat and coagulate targeted tissues. High intensity focused ultrasound hifu is a needleless, nonionizing, thermal ablation tool. High intensity focused ultrasound hifu uses high frequency ultrasound energy to heat and destroy cancer cells in the prostate. Clinical use of ultrasound in cancer is not only for the diagnosis but also for the treatment use of focused ultr. This chapter provides the basic introduction to the physical principles and application of doppler ultrasound in practice. Noninvasive devices for fat reduction have become increasingly popular over the past decade. This cited by count includes citations to the following articles in scholar. This is also true for high intensity focused ultrasound, with each company bringing their take on the technology to the table it can be diffcult to separate marketing from real results. In the field of oncology, the use of hifu to noninvasively cause tissue necrosis in a defined target, a technique known as focused ultrasound surgery fus, has considerable potential for tumour ablation. Laparoscopic surgery and minimally invasive techniques continue.
Medical definition diagnostic medical ultrasound is the use of high frequency sound to aid in the diagnosis and treatment of patients. Hifu is a hyperthermia therapy that uses temperature to treat diseases. Though potential clinical applications of hifu were reported as early as 1950s, precise targeting was a major issue. Aesthetic use is a device using focused ultrasound. The application of doppler in ultrasound was first introduced in the 1980s and since then this technique has expanded in all specialist fields of practical ultrasonography. The device is used clinically to treat both benign and malignant solid tumors 5. Intensity is expressed in milliwatts per square centimeter mwattscm2. In principle, where surgery usually aims to remove a tumour with an adequate normaltissue margin, if a minimally invasive technique can destroy the equivalent tissue volume, then outcome in terms of diseasefree survival should be at least equal. Full modelling of highintensity focused ultrasound and thermal. Other ultrasound treatment methods include ultrasound assisted drug delivery. High intensity focused ultrasound hifu competes with radiofrequency and cryotherapy for the treatment of small renal masses as a third option among ablative approaches. Intracranial applications of mr imagingguided focused. Highintensity focused ultrasound for noninvasive body. Hifu treatments are usually carried out in a single session, often as a day case procedure, with the patient either fully conscious, lightly sedated or under light.
Clinical use of ultrasound in cancer is not only for the diagnosis but also for the treatment use of focused. Medicis technologies corporation, bothell, washington uses hifu to reduce localized deposits of abdominal adipose tissue. High intensity focused ultrasound hifu is gaining rapid clinical acceptance as a treatment modality enabling noninvasive tissue heating and ablation. The pressure fields of two different high intensity focused ultrasound hifu transducers operated in burst mode were measured at acoustical power levels of 25 and 50 w continuous wave equivalent with three different hydrophones. High intensity focused ultrasound hifu is an energybased medical technology with many clinical applications. Hifu treatments are usually carried out in a single session, often as a day case procedure, with the patient either fully conscious, lightly sedated or under light general anaesthesia. When focused within subcutaneous adipose tissue, hifu quickly raises the local temperature, resulting in instantaneous cell death via coagulative necrosis within the targeted area but no damage to the surrounding tissue. Highintensity focused ultrasound has re ceived considerable attention for the manage ment of solid tumors 11. To achieve this, high intensity focused ultrasound hifu waves are accurately coupled through the skin and aimed at the target volume, e. The treatment methods associated with high intensity focused ultrasound, or hifu, have received increasing interest in recent years, as technology has advanced to a point where the theoretical possibilities of the treatment modality can often be realized in a clinical setting. High intensity focused ultrasound hifu is a minimallyinvasive and nonionizing promising technology and has been assessed for its role in the treatment of not only primary tumors but also. A beam of ultrasound energy travels into the prostate from a probe put into the back passage rectum.
Technological advances have catalysed a shift from open surgery towards less invasive techniques. Acoustic field comparison of high intensity focused. Several clinical highintensity focused ultrasound projects have been conducted by various research groups, and re sults have shown the technique is safe, effective, and feasible in clinical application 1215. Video embedded018332get rid of wrinkles effectively. High intensity focused ultrasound hifu is gaining rapid clinical acceptance as a treatment modality enabling noninvasive tissue heating and ablation for.
A fiberoptic displacement sensor, a commercial hifu needle hydrophone, and a prototype of a membrane hydrophone with a protective coating against cavitation. Review clinical application of highintensity focused. High intensity focused ultrasound hifu is a technique using focused ultrasound to generate areas of intense heat and thus destroy tissue. Highintensity focused ultrasound effectively reduces.
High intensity focused ultrasound revised april 2014 number. High intensity focused ultrasound in the treatment of solid tumours. Hifu allows for a noninvasive, nonionizing treatment by thermally ablating tissue at a target location while. The use of therapeutic ultrasound predates its role in diagnostic imaging. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without. Highintensity focused ultrasound has now been used for clinical. The safety and feasibility of extracorporeal high intensity focused ultrasound hifu for the treatment of liver and kidney tumours in a western population.
High intensity focused ultrasound hifu applied to hepato. The square root of the product of the material density and its stiffness. During application of focused ultrasound three different physical mechanisms can be observed. Compare the cost of high intensity focused ultrasound. The first hifu application to receive food and drug administration fda approval, which was magnetic resonance mr guided uterine. Highintensity focused ultrasound in the treatment of solid. Highintensity focused ultrasound for therapeutic tissue. Evaluation of a novel high intensity focused ultrasound device for ablating subcutaneous adipose tissue for noninvasive body contouring. High intensity focused ultrasound definition of high. This is in part due to the lack of adequate imaging techniques to better understand the invivo pathological and immunological effects caused by the mechanical treatment.
A typical pressure profile of a focused shockwave used for therapeutic purposes is shown in fig. High intensity focused ultrasound hifu is emerging as a valid minimallyinvasive imageguided treatment of malignancies. Highintensity focused ultrasound hifu for the prostate. This procedure allows the surgeon to manipulate the device placed remotely on the body. Physical definition sound waves greater than 20,000 hertz or cycles per second infrasound ultrasound 20,000 hz 5.
This type of technology is widely used in medicine to treat a range of diseases and has been used in aesthetic medicine. Hifu has the ability to deliver high intensity focused ultrasound from an external source into deep tissues, with a large convergence angle. High intensity focused ultrasound can be characterized by the same physical properties used to describe sound or radio waves, such as frequency, wave length, and amplitude or intensity. Principles and applications of therapeutic ultrasound in. Simultaneous treatment with marketleading devices harkermartinez, simon. Ultrasound waves are acoustic pressure waves that have a frequency range that begins at the limit of human hearing, 20 khz, and extends well into the megahertz range.
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