系列一 什么是HIFU?

from:http://en.wikipedia.org/wiki/High-intensity_focused_ultrasound

 

HIFU (high-Intensity Focused Ultrasound) (sometimes FUS or HIFUS) is a highly precise medical procedure using high-intensity focused ultrasound medical device to heat and destroy pathogenic tissue rapidly. It is one modality of therapeutic ultrasound, and, although it induces hyperthermia, it should not be confused with this technique, which heats much less rapidly and to much lower therapeutic temperatures (in general < 45°C).

This is under ultrasonography or computerized MRI. When MRI is used it is sometimes called Magnetic Resonance-guided Focused Ultrasound, often shortened to MRgFUS. When ultrasonography is used it is sometimes called Ultrasound-guided Focused Ultrasound, often shortened to USgFUS. Magnetic resonance imaging (MRI) is used to identify tumors or fibroids in the body, before they are destroyed by the ultrasound. MRgFUS is currently used in Australia, the United States, Canada, Israel, Europe, and Asia to treat uterine fibroids. And ultrasonography guided HIFU is currently used in the United Kingdom, Italy, Spain, Korea, Japan, Hong Kong, Malaysia, Russia, China, Romania and Bulgaria. Current clinical trials are underway, examining the possible use of the technique in the treatment of cancers of the brain, breast, liver, bone, and prostate.

Therapeutic ultrasound is a minimally invasive or non-invasive method to deposit acoustic energy into tissue. Applications include tissue ablation (HIFU) (for tumor treatments, for example), hyperthermia treatments (low-level heating combined with radiation or chemotherapy), or the activation or enhanced delivery of drugs.

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History

The first investigations of HIFU for non-invasive ablation were reported by Lynn et al. in the early 1940s. Extensive important early work was performed in the 1950s and 1960s by William Fry and Francis Fry at the University of Illinois and Carl Townsend, Howard White and George Gardner at the Interscience Research Institute of Champaign, Ill., culminating in clinical treatments of neurological disorders. In particular High Intensity ultrasound and ultrasound visualization was accomplished stereotaxically with a Cincinnati precision milling machine to perform accurate ablation of brain tumors. Until recently, clinical trials of HIFU for ablation were few (although significant work in hyperthermia was performed with ultrasonic heating), perhaps due to the complexity of the treatments and the difficulty of targeting the beam noninvasively. With recent advances in medical imaging and ultrasound technology, interest in HIFU ablation of tumors has increased.

The first commercial HIFU machine, called the Sonablate 200, was developed by the American company Focus Surgery, Inc. (Milipitas, CA) and launched in Europe in 1994 after receiving CE approval, bringing a first medical validation of the technology for benign prostatic hyperplasia (BPH). Comprehensive studies by practitioners at more than one site using the device demonstrated clinical efficacy for the destruction of prostatic tissue without bloodloss or long term side effects. Later studies on localized prostate cancer by Murat and colleagues at the Edouard Herriot Hospital in Lyon in 2006 showed that after treatment with the Ablatherm (EDAP TMS, Lyon, France), progression-free survival rates are very high for low- and intermediate- risk patients with recurrent prostate cancer (70% and 50% respectively)^[5] HIFU treatment of prostate cancer is currently an approved therapy in Europe, Canada, South Korea, Australia, and elsewhere. Clinical trials in the United States are expected to begin in 2006. Prostate cancer trials for the new Sonablate 500 are ongoing in the U.S.A. currently. Magnetic Resonance Guided Focused Ultrasound MRgFUS was first developed by Harvey Cline and Ronald Watkins at GE Corporate R&D lab in Niskayuna NY and Kullervo Hynynen at the University of Arizona, Tucson AZ. starting in 1991. This is described in U.S. Patent #5247935.(1992) The technology was later transferred to InsighTec in Haifa Israel in 2000. The InsighTec ExAblate 2000 was the first MR Guided focused ultrasound system to obtain FDA market approval and sold commercially in the United States. Haifu Model JC and JC200 by ChongQing Haifu Ltd. are complete ultrasound guided tumor treatment systems, and they are only CE approved for beningn and malignant tumors. HIFU-2001(By Sumo Corporation Ltd) is an enhanced technology treatment system that does not require anesthesia since 2001, which are famous in Asia countries. The treatment area included Liver/Pancreas/Bladder/Uterus/Kidney.