In the past decade, HIFU ablation has emerged as a modality for palliative treatment of pancreatic tumors. Multiple preclinical and non-randomized clinical trials. HIFU appears to be an effective tool for pain palliation in advanced pancreatic cancer. Studies assessing treatment in patients with pancreatic. Request PDF on ResearchGate | HIFU for Palliative Treatment of Pancreatic Cancer | High intensity focused ultrasound (HIFU) is a novel.
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Acoustic characterization of high intensity focused ultrasound fields: Opioid narcotics have undesired side-effects ranging from mild constipation to respiratory depression and altered mental status.
Concerning the symptoms, higher scores mark a higher level of symptomatology [ 10 ]. The tumor target was identified with the B-mode ultrasound imaging transducer, and the treatment plan was o.
HIFU for palliative treatment of pancreatic cancer
Cantore M et al Phase II study of hepatic intraarterial epirubicin and cisplatin, with systemic 5-fluorouracil in patients with unresectable biliary tract tumors Cancer 7 —7 DOI: Pqncreatic Center Support Center. Our decision was also supported by a previous case of cavernous vein thrombosis after HIFU ablation in PC, described in the literature [ 8 ].
Because of the particular pattern of progression, which was mainly locoregional, with expansive rather than infiltrating picture and it being locally symptomatic, a locoregional treatment was thought would add something in terms of both local tumour growth control and quality of life QoL improvement. This study demonstrates that there were no severe complications or adverse events related to HIFU therapy seen in any of the patients treated.
Chemotherapy was well tolerated and is still ongoing. Current status of HIFU and cryotherapy in prostate cancer–a review.
HIFU for palliative treatment of pancreatic cancer
In order to relieve the symptoms and provide better quality of life, palliative procedures and chemotherapy are usually offered to patients who are not appropriate for curative surgery. The pancreatic tumor had infiltrated the superior mesenteric artery and showed slight volume increase Figure 2b and Figure 3.
Pain control is an important component of palliation and is commonly performed using opioid therapy and celiac plexus neurolysis. All the preclinical in vivo studies of HIFU ablation of the pancreas utilized the swine model because of its size and anatomy relevance to humans 46 – Inertial cavitation is a more violent phenomenon, in which the bubble grows during the rarefaction phase and then rapidly collapses which leads to its destruction.
In apoptotic cells, the nucleus of the cell self-destructs, with rapid degradation of DNA by endonucleases. The median survival in these groups is about 10 and 6 months, respectively [ 1 ]. Figure 3A shows an example of a lesion with coagulation necrosis after a single treatment with a 1 MHz HIFU device in ex vivo bovine liver. A recent study also reveals encouraging results for the overall survival of PC patients after HIFU treatment, which in some cases can reach as long as Radiation force and streaming Radiation force is exerted on an object when a wave is either absorbed or reflected from that object.
B In a phased-array HIFU transducer the position of the focus can be steered electronically by shifting the phases of the ultrasound waves radiated by each element without moving the transducer. A forty eight-year old, male patient with significant weight loss and dyspepsia underwent diagnostic CT scan in July which revealed a tumor mass in the body of the pancreas.
Results In the clinical treatments in humans the following local tumor control was seen: Contrast-enhanced ultrasound assessment ihfu tissue response to high-intensity focused ultrasound.
To perform safe and effective HIFU treatments, physicians need to understand the basics of HIFU physics, which differ substantially from diagnostic ultrasound. FEP-BY high intensity focused ultrasound device for treatmeng therapy.
Pain was relieved in 54 patients Furthermore, because of the particular pattern of progression expansive rather than infiltrating primary tumour growth and its local symptomaticity, a locoregional palliative procedure was discussed. Unfortunately, to date none of the monitoring methods can provide the image of the thermal lesion directly and in real time as it forms in tissue.
The ablated tumor mass P shrunk to 32mm in size and it was not enhancing. Respiratory motion of the tumor during the treatment leads to redistribution of acoustic energy over the area larger than the focal region and may result in incomplete treatment of the target and damage to adjacent tissues.
In such treatments the thermal effect is usually to be avoided, therefore, short bursts of very high amplitude ultrasound of low frequency usually below 2 MHz are used. A high intensity ultrasound beam is generated and focused by a special transducer in the target zone of the tumor, which could be as small as a few millimeters.
Because of focusing, the acoustic intensities are high only within the focal region; however, outside the focal region the acoustic intensities are substantially lower, minimizing the risk of unintended injury to tissue outside the focal region. Select your language of interest to view the total content in your interested language.