Subscribe to RSS
DOI: 10.1055/s-0034-1391326
Hochintensiver fokussierter Ultraschall (HIFU): Grundlagen und Einsatz zur nicht invasiven Tumorablation
High intensity focused ultrasound: Fundamentals and application to tumor ablationPublication History
Publication Date:
10 March 2015 (online)
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.
-
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.
-
Literatur
- 1 Wu F, Wang ZB, Chen WZ et al. Extracorporal high intensity focused ultrasound ablation in the treatment of 1038 patients with solid carcinomas in China: an overview. Ultrason Sonochem 2004; 11: 149-154
- 2 Lynn JG, Zwemer RL, Chick AJ et al. A New Method for the Generation and Use of Focused Ultrasound in Experimental Biology. J Gen Physiol 1942; 26: 179-193
- 3 Hynynen K, Lulu BA. Hyperthermia in cancer treatment. Invest Radiol 1990; 25: 824-834
- 4 Dong X, Yang Z. High-intensity focused ultrasound ablation of uterine localized adenomyosis. Curr Opin Obstet Gynecol 2010; 22: 326-330
- 5 Wang Y, Wang W, Wang L et al. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: preliminary results. Eur J Radiol 2011; 79: 56-59
- 6 Izumi M, Ikeuchi M, Kawasaki M et al. MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain. BMC Musculoskelet Disord 2013; 14: 267
- 7 Zhu J, Zhu H, Mei Z et al. High-intensity focused ultrasound ablation for treatment of hepatocellular carcinoma and hypersplenism: preliminary study. J Ultrasound Med 2013; 32: 1855-1862
- 8 Geiger D, Napoli A, Conchiglia A et al. MR-guided focused ultrasound (MRgFUS) ablation for the treatment of nonspinal osteoid osteoma: a prospective multicenter evaluation. J Bone Joint Surg Am 2014; 96: 743-751
- 9 Wang S, Yang C, Zhang J et al. First experience of high-intensity focused ultrasound combined with transcatheter arterial embolization as local control for hepatoblastoma. Hepatology 2014; 59: 170-177
- 10 Dubinsky TJ, Cuevas C, Dighe MK et al. High-intensity focused ultrasound: current potential and oncologic applications. AJR Am J Roentgenol 2008; 190: 191-199
- 11 Shehata IA. Treatment with high intensity focused ultrasound: secrets revealed. Eur J Radiol 2012; 81: 534-541
- 12 Wu F, Zhou L, Chen WR. Host antitumour immune responses to HIFU ablation. Int J Hyperthermia 2007; 23: 165-171
- 13 Wu F, Wang ZB, Chen WZ et al. Advanced hepatocellular carcinoma: treatment with high-intensity focused ultrasound ablation combined with transcatheter arterial embolization. Radiology 2005; 235: 659-667
- 14 Wu F, Wang ZB, Zhu H et al. Feasibility of US-guided high-intensity focused ultrasound treatment in patients with advanced pancreatic cancer: initial experience. Radiology 2005; 236: 1034-1040
- 15 Wang X, Sun J. High-intensity focused ultrasound in patients with late-stage pancreatic carcinoma. Chin Med J (Engl) 2002; 115: 1332-1335
- 16 Orsi F, Zhang L, Arnone P et al. High-intensity focused ultrasound ablation: effective and safe therapy for solid tumors in difficult locations. AJR Am J Roentgenol 2010; 195: W245-252
- 17 Xiong LL, Hwang JH, Huang XB et al. Early clinical experience using high intensity focused ultrasound for palliation of inoperable pancreatic cancer. JOP 2009; 10: 123-129
- 18 Sung HY, Jung SE, Cho SH et al. Long-term outcome of high-intensity focused ultrasound in advanced pancreatic cancer. Pancreas 2011; 40: 1080-1086
- 19 Zhao H, Yang G, Wang D et al. Concurrent gemcitabine and high-intensity focused ultrasound therapy in patients with locally advanced pancreatic cancer. Anticancer Drugs 2010; 21: 447-452
- 20 Wang Y, Wang W, Tang J. Ultrasound-guided high intensity focused ultrasound treatment for extra-abdominal desmoid tumours: preliminary results. Int J Hyperthermia 2011; 27: 648-653
- 21 Li PZ, Zhu SH, He W et al. High-intensity focused ultrasound treatment for patients with unresectable pancreatic cancer. Hepatobiliary Pancreat Dis Int 2012; 11: 655-660
- 22 Gao HF, Wang K, Meng ZQ et al. High intensity focused ultrasound treatment for patients with local advanced pancreatic cancer. Hepatogastroenterology 2013; 60: 1906-1910
- 23 Vallancien G, Chartier-Kastler E, Harouni M et al. Focused extracorporeal pyrotherapy: experimental study and feasibility in man. Semin Urol 1993; 11: 7-9
- 24 Jin C, Zhu H, Wang Z et al. High-intensity focused ultrasound combined with transarterial chemoembolization for unresectable hepatocellular carcinoma: long-term follow-up and clinical analysis. Eur J Radiol 2011; 80: 662-669
- 25 Zhang L, Zhu H, Jin C et al. High-intensity focused ultrasound (HIFU): effective and safe therapy for hepatocellular carcinoma adjacent to major hepatic veins. Eur Radiol 2009; 19: 437-445
- 26 Chan AC, Cheung TT, Fan ST et al. Survival analysis of high-intensity focused ultrasound therapy versus radiofrequency ablation in the treatment of recurrent hepatocellular carcinoma. Ann Surg 2013; 257: 686-692
- 27 Wu F, Wang ZB, Chen WZ et al. Extracorporeal high intensity focused ultrasound ablation in the treatment of patients with large hepatocellular carcinoma. Ann Surg Oncol 2004; 11: 1061-1069
- 28 Li YY, Sha WH, Zhou YJ et al. Short and long term efficacy of high intensity focused ultrasound therapy for advanced hepatocellular carcinoma. J Gastroenterol Hepatol 2007; 22: 2148-2154
- 29 Ng KK, Poon RT, Chan SC et al. High-intensity focused ultrasound for hepatocellular carcinoma: a single-center experience. Ann Surg 2011; 253: 981-987
- 30 Wu F, Wang ZB, Chen WZ et al. Extracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience. Ultrasound Med Biol 2004; 30: 245-260
- 31 Vollenhoven BJ, Lawrence AS, Healy DL. Uterine fibroids: a clinical review. Br J Obstet Gynaecol 1990; 97: 285-298
- 32 Zhang L, Wang ZB. High-intensity focused ultrasound tumor ablation: review of ten years of clinical experience. Front Med China 2010; 4: 294-302
- 33 Stewart EA, Gedroyc WM, Tempany CM et al. Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive thermoablative technique. Am J Obstet Gynecol 2003; 189: 48-54
- 34 Wang W, Wang Y, Wang T et al. Safety and efficacy of US-guided high-intensity focused ultrasound for treatment of submucosal fibroids. Eur Radiol 2012; 22: 2553-2558
- 35 Qin J, Chen JY, Zhao WP et al. Outcome of unintended pregnancy after ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids. Int J Gynaecol Obstet 2012; 117: 273-277
- 36 Wang F, Tang L, Wang L et al. Ultrasound-guided high-intensity focused ultrasound vs laparoscopic myomectomy for symptomatic uterine myomas. J Minim Invasive Gynecol 2014; 21: 279-284
- 37 Hindley J, Gedroyc WM, Regan L et al. MRI guidance of focused ultrasound therapy of uterine fibroids: early results. AJR Am J Roentgenol 2004; 183: 1713-1719
- 38 Stewart EA, Rabinovici J, Tempany CM et al. Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids. Fertil Steril 2006; 85: 22-29
- 39 Rabinovici J, Inbar Y, Revel A et al. Clinical improvement and shrinkage of uterine fibroids after thermal ablation by magnetic resonance-guided focused ultrasound surgery. Ultrasound Obstet Gynecol 2007; 30: 771-777
- 40 Funaki K, Fukunishi H, Sawada K. Clinical outcomes of magnetic resonance-guided focused ultrasound surgery for uterine myomas: 24-month follow-up. Ultrasound Obstet Gynecol 2009; 34: 584-589
- 41 Behera MA, Leong M, Johnson L et al. Eligibility and accessibility of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment of uterine leiomyomas. Fertil Steril 2010; 94: 1864-1868
- 42 Dobrotwir A, Pun E. Clinical 24 month experience of the first MRgFUS unit for treatment of uterine fibroids in Australia. J Med Imaging Radiat Oncol 2012; 56: 409-416
- 43 Peng S, Xiong Y, Li K et al. Clinical utility of a microbubble-enhancing contrast (“SonoVue”) in treatment of uterine fibroids with high intensity focused ultrasound: a retrospective study. Eur J Radiol 2012; 81: 3832-3838
- 44 Zhao WP, Chen JY, Zhang L et al. Feasibility of ultrasound-guided high intensity focused ultrasound ablating uterine fibroids with hyperintense on T2-weighted MR imaging. Eur J Radiol 2013; 82: e43-49
- 45 Froeling V, Meckelburg K, Schreiter NF et al. Outcome of uterine artery embolization versus MR-guided high-intensity focused ultrasound treatment for uterine fibroids: long-term results. Eur J Radiol 2013; 82: 2265-2269
- 46 Froling V, Kroncke TJ, Schreiter NF et al. Technical eligibility for treatment of magnetic resonance-guided focused ultrasound surgery. Cardiovasc Intervent Radiol 2014; 37: 445-450
- 47 Bouwsma EV, Hesley GK, Woodrum DA et al. Comparing focused ultrasound and uterine artery embolization for uterine fibroids-rationale and design of the Fibroid Interventions: reducing symptoms today and tomorrow (FIRSTT) trial. Fertil Steril 2011; 96: 704-710
- 48 Yang Z, Cao YD, Hu LN et al. Feasibility of laparoscopic high-intensity focused ultrasound treatment for patients with uterine localized adenomyosis. Fertil Steril 2009; 91: 2338-2343
- 49 Zhang X, Li K, Xie B et al. Effective ablation therapy of adenomyosis with ultrasound-guided high-intensity focused ultrasound. Int J Gynaecol Obstet 2014; 124: 207-211
- 50 Fukunishi H, Funaki K, Sawada K et al. Early results of magnetic resonance-guided focused ultrasound surgery of adenomyosis: analysis of 20 cases. J Minim Invasive Gynecol 2008; 15: 571-579
- 51 Gianfelice D, Khiat A, Boulanger Y et al. Feasibility of magnetic resonance imaging-guided focused ultrasound surgery as an adjunct to tamoxifen therapy in high-risk surgical patients with breast carcinoma. J Vasc Interv Radiol 2003; 14: 1275-1282
- 52 Furusawa H, Namba K, Nakahara H et al. The evolving non-surgical ablation of breast cancer: MR guided focused ultrasound (MRgFUS). Breast Cancer 2007; 14: 55-58
- 53 Wu F, Wang ZB, Zhu H et al. Extracorporeal high intensity focused ultrasound treatment for patients with breast cancer. Breast Cancer Res Treat 2005; 92: 51-60
- 54 Hynynen K, Pomeroy O, Smith DN et al. MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast: a feasibility study. Radiology 2001; 219: 176-185
- 55 Wu F, Wang ZB, Chen WZ et al. Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy. J Urol 2003; 170: 2237-2240
- 56 Illing RO, Kennedy JE, Wu F et al. The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population. Br J Cancer 2005; 93: 890-895
- 57 Luetke A, Meyers PA, Lewis I et al. Osteosarcoma treatment – where do we stand? A state of the art review. Cancer Treat Rev 2014; 40: 523-532
- 58 Napoli A, Anzidei M, Marincola BC et al. MR imaging-guided focused ultrasound for treatment of bone metastasis. Radiographics 2013; 33: 1555-1568
- 59 Wu F, Chen WZ, Bai J et al. Pathological changes in human malignant carcinoma treated with high-intensity focused ultrasound. Ultrasound Med Biol 2001; 27: 1099-1106
- 60 Chen W, Zhu H, Zhang L et al. Primary bone malignancy: effective treatment with high-intensity focused ultrasound ablation. Radiology 2010; 255: 967-978
- 61 Li JJ, Xu GL, Gu MF et al. Complications of high intensity focused ultrasound in patients with recurrent and metastatic abdominal tumors. World J Gastroenterol 2007; 13: 2747-2751