Hochintensiver fokussierter Ultraschall (HIFU): Grundlagen und Einsatz zur nicht invasiven Tumorablation

Zusammenfassung

Der hochintensive fokussierte Ultraschall (HIFU) ist ein innovatives, nicht invasives Tumorablationsverfahren, das zunehmend Eingang in die klinische Versorgung findet. Dieser Übersichtsartikel erläutert die technischen, klinischen und praktischen Grundlagen des Verfahrens. Zudem wird ein Überblick über die aktuelle Studienlage mit einem Fokus auf den derzeitigen Haupteinsatzgebieten des HIFU gegeben.

Abstract

High intensity focused ultrasound (HIFU) is an emerging non-invasive tumor ablation technique, which enters clinical care. This review illustrates technical, clinical and practical fundamentals of HIFU. Moreover, an overview on current literature is given with an emphasis on the technique’s main indications.

Kernaussagen

• Der hochintensive fokussierte Ultraschall ist ein nicht invasives Ablationsverfahren, das zunehmend Eingang in die klinische Versorgung findet.

• Zur bildgebenden Steuerung und zum Monitoring des Ablationserfolgs sind derzeit MR-gesteuerte und ultraschallgesteuerte Geräte im Einsatz.

• Als Hauptindikationen des MRgHIFU gilt derzeit die Behandlung von Uterusmyomen und skelettaler Veränderungen. Mittels USgHIFU ist darüber hinaus eine Behandlung von Tumoren in parenchymatösen Bauchorganen (z. B. von Pankreaskarzinomen oder hepatozellulären Karzinomen) möglich.

• Bisher publizierte „Machbarkeitsstudien“ berichten über den sicheren und erfolgreichen Einsatz des HIFU bei einer Vielzahl an Erkrankungen.

• Zur weiteren Evaluation des HIFU sind prospektive Studien an größeren Patientenkollektiven und der Vergleich zu anderen lokal-ablativen Verfahren notwendig, um das Verfahren als Alternativtherapie zu etablieren und Indikationen aufzuzeigen.

Keywords

Interventional radiology - high intensity focused ultrasound - non-invasive tumor ablation - pancreatic cancer - liver cancer - uterine fibroids

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