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World J Clin Oncol. Jan 10, 2011; 2(1): 8-27
Published online Jan 10, 2011. doi: 10.5306/wjco.v2.i1.8
High intensity focused ultrasound in clinical tumor ablation
Yu-Feng Zhou
Yu-Feng Zhou, Division of Engineering Mechanics, School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
Author contributions: Zhou YF solely contributed to this paper.
Correspondence to: Yu-Feng Zhou, PhD, Division of Engineering Mechanics, School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore. yfzhou@ntu.edu.sg
Telephone: +65-67904482 Fax: +65-67924062
Received: June 24, 2010
Revised: July 26, 2010
Accepted: August 2, 2010
Published online: January 10, 2011
Abstract

Recent advances in high intensity focused ultrasound (HIFU), which was developed in the 1940s as a viable thermal tissue ablation approach, have increased its popularity. In clinics, HIFU has been applied to treat a variety of solid malignant tumors in a well-defined volume, including the pancreas, liver, prostate, breast, uterine fibroids, and soft-tissue sarcomas. In comparison to conventional tumor/cancer treatment modalities, such as open surgery, radio- and chemo-therapy, HIFU has the advantages of non-invasion, non-ionization, and fewer complications after treatment. Over 100 000 cases have been treated throughout the world with great success. The fundamental principles of HIFU ablation are coagulative thermal necrosis due to the absorption of ultrasound energy during transmission in tissue and the induced cavitation damage. This paper reviews the clinical outcomes of HIFU ablation for applicable cancers, and then summarizes the recommendations for a satisfactory HIFU treatment according to clinical experience. In addition, the current challenges in HIFU for engineers and physicians are also included. More recent horizons have broadened the application of HIFU in tumor treatment, such as HIFU-mediated drug delivery, vessel occlusion, and soft tissue erosion (“histotripsy”). In summary, HIFU is likely to play a significant role in the future oncology practice.

Keywords: High intensity focused ultrasound; Thermal ablation; Image-guided therapy; Cancer; Bubble cavitation; Bioeffects