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In vivo transcostal histotripsy therapy without aberration correction.

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Transcostal histotripsy effectively treats liver tissue in vivo through the ribcage without aberration correction. This non-invasive method shows minimal thermal impact on overlying tissues, offering new therapeutic possibilities.

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Area of Science:

  • Medical physics
  • Biomedical engineering
  • Non-invasive therapies

Background:

  • Histotripsy is a non-invasive therapeutic technology using focused ultrasound.
  • Transcostal treatments face challenges due to ribcage interference and potential thermal damage.
  • Evaluating histotripsy's efficacy and safety through the ribcage is crucial for expanding its clinical applications.

Purpose of the Study:

  • To assess the in vivo therapeutic efficacy of transcostal histotripsy without aberration correction.
  • To evaluate the thermal impact of transcostal histotripsy on overlying tissues, including the ribcage.
  • To compare transcostal histotripsy with transabdominal histotripsy in terms of ablation volume and thermal effects.

Main Methods:

  • Eight pigs underwent non-invasive liver treatments using a 750 kHz focused transducer.
  • Four lesions were created via transcostal windows (ribcage obstruction) and four via transabdominal windows.
  • Temperatures of overlying tissues were monitored using needle thermocouples during 40-minute treatments.

Main Results:

  • Statistically comparable ablation volumes were achieved in both transcostal (3.6 ± 1.7 cm³) and transabdominal (4.5 ± 2.0 cm³) treatments.
  • Transcostal treatments resulted in a moderate average temperature increase (3.9 ± 2.1 °C) compared to transabdominal (1.7 ± 1.3 °C).
  • No thermal damage was observed on the ribcage or other overlying tissues in the transcostal group.

Conclusions:

  • Histotripsy can effectively ablate liver tissue in vivo through the ribcage without aberration correction.
  • Transcostal histotripsy demonstrates a favorable safety profile with no significant thermal damage to overlying structures.
  • These findings support the potential of transcostal histotripsy for non-invasive therapeutic applications requiring transcostal access.