Focused Ultrasound: Noninvasive Image-Guided Therapy
Chrit T W Moonen1, Joseph P Kilroy, Alexander L Klibanov
1From the Focused Ultrasound Foundation, Charlottesville, VA (C.T.W.M., J.P.K.); and Cardiovascular Division (Department of Medicine) and Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA (A.L.K.).
Investigative Radiology
|August 20, 2024
Summary
Focused ultrasound therapy offers a noninvasive approach to treat diseases, utilizing advanced imaging for precise targeting and monitoring. This method enhances safety and recovery by avoiding surgery and enabling targeted drug delivery, even across the blood-brain barrier.
Area of Science:
- Interventional Radiology
- Medical Imaging
- Acoustic Medicine
Background:
- Traditional surgery for tumor removal is invasive, carrying risks and extended recovery times.
- Minimally invasive techniques like laparoscopy and catheter-based procedures have improved patient outcomes.
- Completely noninvasive methods offer further advantages in reducing risks, procedure duration, and recovery periods.
Purpose of the Study:
- To review imaging capabilities and approaches for image-guided focused ultrasound interventions.
- To highlight the integration of imaging in planning, real-time monitoring, and efficacy evaluation of focused ultrasound treatments.
- To discuss the role of sonosensitive nanoparticles in enhancing focused ultrasound therapies.
Main Methods:
- Emphasis on magnetic resonance imaging (MRI) and ultrasound for guidance and monitoring.
- Integration of imaging for treatment planning, defining target regions, and identifying organs at risk.
- Real-time monitoring using thermometry, cavitation feedback, and motion control for safety and accuracy.
- Evaluation of treatment efficacy through ablation assessment and physiological parameter monitoring (e.g., blood supply).
Main Results:
- Focused ultrasound enables noninvasive localized hyperthermia, mechanical ablation, and targeted drug delivery.
- Advanced imaging, particularly MRI and ultrasound, is crucial for planning, guiding, and monitoring focused ultrasound procedures.
- Sonosensitive microparticles and nanoparticles enhance ultrasound energy deposition, enabling microvascular interventions and targeted drug/gene delivery.
- Noninvasive opening of the blood-brain barrier for targeted drug delivery in the brain is a significant advancement.
Conclusions:
- Image-guided focused ultrasound is a rapidly evolving, noninvasive tool for disease treatment.
- It offers significant advantages over traditional and minimally invasive surgical approaches.
- Further development promises broader clinical applications in interventional radiology.
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