High-intensity focused ultrasound (HiFu) in medicine: Precise tissue destruction without surgery.

High-intensity focused ultrasound (HiFu) is a non-invasive medical technology that uses focused ultrasound waves to precisely destroy pathological tissues. This method is widely used in oncology and other medical fields, offering an alternative to traditional surgical and radiotherapy approaches.

HiFu working principle

HiFu works by focusing ultrasound waves at a specific point in the body, where high temperatures (over 55°C) are generated, leading to coagulative necrosis of the tissues. This process allows the destruction of target cells without damaging the surrounding healthy tissues. In addition to the thermal effect, HiFu can cause mechanical effects such as cavitation, which contributes to the destruction of tissues by the formation and collapse of microbubbles in the cellular structure.

Medical applications of HiFu

Oncology

HiFu has been successfully used to treat various types of tumors, including:

• Prostate cancer: HiFu is an approved method for treating localized prostate cancer, offering an alternative to surgical prostatectomy.
• Hepatocellular carcinoma: Studies have shown that HiFu can achieve complete ablation of tumors in the liver, especially when combined with other therapies such as transarterial chemoembolization (TACE). ​PubMed
• Tumors of the pancreas and kidneys: HiFu is being investigated as a treatment option for hard-to-reach tumors where traditional surgery is risky or impossible.

Palliative treatment

HiFu is also used to relieve pain in patients with bone metastases, offering rapid relief compared to traditional radiotherapy. pubs.rsna.org

Advantages of HiFu

• Non-invasiveness: The procedure does not require surgical incisions, which reduces the risk of infections and complications.
• Precision: HiFu allows precise targeting of pathological tissue, minimizing damage to surrounding healthy structures.
• Quick recovery: Patients typically recover faster compared to traditional surgical methods.

Limitations and challenges

Despite its advantages, HiFu also has some limitations:

• Limited penetration depth: The effectiveness of HiFu may be limited in deeply located tumors.
• Need for accurate visualization: Successful application of HiFu requires precise imaging of the target tissue via ultrasound or MRI.
• Risk of thermal damage: If incorrectly aimed or adjusted, HiFu can cause unwanted damage to healthy tissues.