A Review of High-Intensity Focused Ultrasound

Ben Turner, David Cranston
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Abstract

For 80 years, high-intensity focused ultrasound (HIFU) has been the subject of interest in medical research. It is a non-invasive procedure that causes the death of cells in a very select area through one of two mechanisms, either heat or cavitation. While diagnostic ultrasound is well known in the medical profession and ultrasound is also used in physiotherapy, high-intensity focused ultrasound is less known but is becoming increasingly important as a non-invasive tool that can be used in many ways, including in the treatment of several cancers as well as benign uterine fibroids. Other interesting developments are underway, including its use in the treatment through an intact skull of essential tremors and the tremor associated with Parkinson’s disease, and in a modified form, it is used to target drug delivery to the brain due to its potential opening of the blood–brain barrier. The depth of penetration of HIFU is variable depending on the type of transducer used and the distance from it. Clinical trials of abdominal malignancies and benign uterine fibroids are reviewed in this article along with potential side effects of the procedure. Over the past two decades, the technology has improved considerably, and the clinical indications have broadened. The current limitations of the technology are also discussed, along with the potential advances in the field that may be made over the next decade.
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高强度聚焦超声回顾
80 年来,高强度聚焦超声(HIFU)一直是医学研究的热点。它是一种非侵入性治疗方法,通过热效应或空化效应两种机制中的一种,使特定区域的细胞死亡。超声诊断在医学界广为人知,超声也被用于物理治疗,而高强度聚焦超声却鲜为人知,但作为一种非侵入性工具,它正变得越来越重要,可用于多种用途,包括治疗多种癌症和良性子宫肌瘤。其他有趣的发展也在进行之中,包括通过完整的头骨治疗本质性震颤和与帕金森病有关的震颤,以及通过其潜在的血脑屏障开放功能,以改良的形式将药物靶向输送到大脑。HIFU 的穿透深度因所用换能器的类型和距离而异。本文回顾了腹部恶性肿瘤和良性子宫肌瘤的临床试验以及该疗法的潜在副作用。在过去的二十年里,这项技术有了长足的进步,临床适应症也有所扩大。本文还讨论了该技术目前的局限性,以及未来十年该领域可能取得的进展。
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