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device types

Device types

There are currently three families of devices using focused ultrasound to perform thermal ablations:

  • endocavitary devices in which the transducer comes in close contact to the targeted organ (typically prostate). These devices are usually US controlled as the target is within centimeters of the transducer. Clinical results have been shown to be excellent [1,2]. These devices are typically organ specific. A recent development shows that MR guided conformal thermal therapy of prostate with planar trans-urethral ultrasound heating applicators, is a promising approach [3,4]. Exciting work has been done to show that focused ultrasound could eventually be used to treat heart arrhythmia both with a trans-esophageal approach [5] and with an intra-vascular, catheter based approach [6-7].
  • echosonography (US) controlled extra-corporeal devices. These devices are mainly built and used in China where a large patient population with various pathologies has been already treated with such devices [8].
  • MR guided extra-corporeal devices (MRgFUS). There is currently one FDA approved MRgFUS device for treating uterine fibromas, a benign tumor [9,10]. The device is manufactured and sold by Insightec. Pre clinical and clinical trials are ongoing for other indications like breast tumors [11-13], bone metastasis [14], brain tumors [15,16],... US guided FUS for prostate cancer. US guided FUS for prostate cancer. First company to obtain FDA approval for MR guided FUS. Atrial fibrillation treatment with FUS. US guided extra-corporeal FUS system. US guided extra-corporeal FUS system.

  1. Murat FJ, Poissonnier L, Pasticier G, Gelet A. "High-intensity focused ultrasound (HIFU) for prostate cancer." Cancer Control. 2007 Jul;14(3):244–9.
  2. Blana A, Walter B, Rogenhofer S, Wieland WF. "High-intensity focused ultrasound for the treatment of localized prostate cancer: 5-year experience." Urology. 2004 Feb;63(2):297–300.
  3. Chopra R, Burtnyk M, Haider MA, Bronskill MJ. "Method for MRI-guided conformal thermal therapy of prostate with planar transurethral ultrasound heating applicators." Phys Med Biol. 2005 Nov 7;50(21):4957–75.
  4. Boyes A, Tang K, Yaffe M, Sugar L, Chopra R, Bronskill M. "Prostate tissue analysis immediately following magnetic resonance imaging guided transurethral ultrasound thermal therapy." J Urol. 2007 Sep;178(3 Pt 1):1080–5.
  5. Pichardo S, Hynynen K. "Circumferential lesion formation around the pulmonary veins in the left atrium with focused ultrasound using a 2D-array endoesophageal device: a numerical study." Phys Med Biol. 2007 Aug 21;52(16):4923–42.
  6. Wong T, Markides V, Peters NS, Davies DW. "Anatomic left atrial circumferential ablation to electrically isolate pulmonary veins using a novel focused ultrasound balloon catheter." Heart Rhythm. 2006 Mar;3(3):370–1.
  7. Schmidt B, Antz M, Ernst S, Ouyang F, Falk P, Chun JK, Kuck KH. "Pulmonary vein isolation by high-intensity focused ultrasound: first-in-man study with a steerable balloon catheter." Heart Rhythm. 2007 May;4(5):575–84.
  8. Wu F, Wang ZB, Chen WZ, Zou JZ, Bai J, Zhu H, Li KQ, Xie FL, Jin CB, Su HB, Gao GW. "Extracorporeal focused ultrasound surgery for treatment of human solid carcinomas: early Chinese clinical experience." Ultrasound Med Biol. 2004 Feb;30(2):245–60.
  9. Hindley J, Gedroyc WM, Regan L, Stewart E, Tempany C, Hynyen K, Mcdannold N, Inbar Y, Itzchak Y, Rabinovici J, Kim HS, Geschwind JF, Hesley G, Gostout B, Ehrenstein T, Hengst S, Sklair-Levy M, Shushan A, Jolesz F. "MRI guidance of focused ultrasound therapy of uterine fibroids: early results." AJR Am J Roentgenol. 2004 Dec;183(6):1713–9.
  10. McDannold N, Tempany CM, Fennessy FM, So MJ, Rybicki FJ, Stewart EA, Jolesz FA, Hynynen K. Uterine leiomyomas: MR imaging-based thermometry and thermal dosimetry during focused ultrasound thermal ablation. Radiology. 2006 Jul;240(1):263–72.
  11. Hynynen K, Pomeroy O, Smith DN, Huber PE, McDannold NJ, Kettenbach J, Baum J, Singer S, Jolesz FA."MR imaging-guided focused ultrasound surgery of fibroadenomas in the breast: a feasibility study." Radiology. 2001 Apr;219(1):176–85.
  12. Huber PE, Jenne JW, Rastert R, Simiantonakis I, Sinn HP, Strittmatter HJ, von Fournier D, Wannenmacher MF, Debus J. "A new noninvasive approach in breast cancer therapy using magnetic resonance imaging-guided focused ultrasound surgery." Cancer Res. 2001 Dec 1;61(23):8441–7.
  13. Zippel DB, Papa MZ. "The use of MR imaging guided focused ultrasound in breast cancer patients; a preliminary phase one study and review." Breast Cancer. 2005;12(1):32–8.
  14. Catane R, Beck A, Inbar Y, Rabin T, Shabshin N, Hengst S, Pfeffer RM, Hanannel A, Dogadkin O, Liberman B, Kopelman D. "MR-guided focused ultrasound surgery (MRgFUS) for the palliation of pain in patients with bone metastases – preliminary clinical experience." Ann Oncol. 2007 Jan;18(1):163–7.
  15. Marquet F, Pernot M, Aubry JF, Montaldo G, Tanter M, Fink M. "Non-invasive transcranial ultrasound therapy guided by CT-scans." Conf Proc IEEE Eng Med Biol Soc. 2006;1:683–7.
  16. Hynynen K, Clement G. "Clinical applications of focused ultrasound-the brain." Int J Hyperthermia. 2007 Mar;23(2):193–202.