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Laser ablation propulsion and orbit cleaning are developing areas of research. The general aim of laser-based techniques applied to this field is to maximize the momentum transfer produced by a laser shot. This work presents results from ballistic pendulum experiments under vacuum on aluminum, copper, tin, gold, and porous graphite targets. The work has focused on the metrology of the laser experiments to ensure good stability over a wide range of laser parameters (laser intensity ranging from 4 GW/cm 2 to 8.7 TW/cm 2 , pulse duration from 80 ps to 15 ns, and wavelengths of 528 or 1057 nm). The results presented compile data from three experimental campaigns spanning from 2018 to 2021 on two different laser platforms and using different pulse durations, energies, and wavelengths. The study is complemented by the simulation of the momentum from the mono-dimensional Lagrangian code ESTHER. The first part of this work gives a detailed description of the experimental setup used, the ESTHER code, and the treatment of the simulations. The second part focuses on the experimental results. The third part describes the simulation results and provides a comparison with the experimental data. The last part presents possible improvements for future work on the subject. [ABSTRACT FROM AUTHOR]

Magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive, incisionless, radiation-free technology used to ablate tissue deep within the body. This technique has gained increased popularity following FDA approval for treatment of pain related to bone metastases and limited approval for treatment of osteoid osteoma. MRgFUS delivers superior visualization of soft tissue targets in unlimited imaging planes and precision in targeting and delivery of thermal dose which is all provided during real-time monitoring using MR thermometry. This paper provides an overview of the common musculoskeletal applications of MRgFUS along with updates on clinical outcomes and discussion of future applications.

Clinical evidence suggests that high‐intensity focused ultrasound (HIFU) is emerging as an increasingly viable non‐invasive treatment for various gynecological diseases, demonstrating both high safety and effectiveness. Nevertheless, HIFU presents challenges in terms of energy dissipation and prolonged treatment time during the therapeutic process. In this study, liposomes containing ammonium bicarbonate (NH4HCO3) and paclitaxel (PTX), a first‐line chemotherapy drug, are utilized to enhance HIFU imaging and therapy. During HIFU treatment, the NH4HCO3 and PTX‐loaded liposomes (PTN@Lip) can release CO2 and NH3 in the tumor's acidic environment. These not only improve HIFU imaging but also regulate the tumor's acidic environment, thereby enhancing the uptake of PTX by tumor cells. Notably, the implementation of PTN@Lip and HIFU activates the immune system, leading to tumor inhibition or even elimination ultimately. This approach has the potential to address existing clinical treatment challenges and lay the groundwork for new directions in the treatment of gynecological tumors. [ABSTRACT FROM AUTHOR]

To assess the feasibility and efficacy of a deep learning-based three-dimensional (3D) super-resolution diffusion-weighted imaging (DWI) radiomics model in predicting the prognosis of high-intensity focused ultrasound (HIFU) ablation of uterine fibroids. This retrospective study included 360 patients with uterine fibroids who received HIFU treatment, including Center A (training set: N = 240; internal testing set: N = 60) and Center B (external testing set: N = 60) and were classified as having a favorable or unfavorable prognosis based on the postoperative non-perfusion volume ratio. A deep transfer learning approach was used to construct super-resolution DWI (SR-DWI) based on conventional high-resolution DWI (HR-DWI), and 1198 radiomics features were extracted from manually segmented regions of interest in both image types. Following data preprocessing and feature selection, radiomics models were constructed for HR-DWI and SR-DWI using Support Vector Machine (SVM), Random Forest (RF), and Light Gradient Boosting Machine (LightGBM) algorithms, with performance evaluated using area under the curve (AUC) and decision curves. All DWI radiomics models demonstrated superior AUC in predicting HIFU ablated uterine fibroids prognosis compared to expert radiologists (AUC: 0.706, 95% CI: 0.647–0.748). When utilizing different machine learning algorithms, the HR-DWI model achieved AUC values of 0.805 (95% CI: 0.679–0.931) with SVM, 0.797 (95% CI: 0.672–0.921) with RF, and 0.770 (95% CI: 0.631–0.908) with LightGBM. Meanwhile, the SR-DWI model outperformed the HR-DWI model (P < 0.05) across all algorithms, with AUC values of 0.868 (95% CI: 0.775–0.960) with SVM, 0.824 (95% CI: 0.715–0.934) with RF, and 0.821 (95% CI: 0.709–0.933) with LightGBM. And decision curve analysis further confirmed the good clinical value of the models. Deep learning-based 3D SR-DWI radiomics model demonstrated favorable feasibility and effectiveness in predicting the prognosis of HIFU ablated uterine fibroids, which was superior to HR-DWI model and assessment by expert radiologists. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to develop an ultrasound‐guided high‐intensity‐focused ultrasound (USgHIFU) probe for arterial sonication and to evaluate vascular contraction. Methods: The USgHIFU probe comprised two confocal spherical transducers for sonication and a US color Doppler flow imaging probe for guidance. A vessel‐mimicking phantom was sonicated in two directions. In the vascular radial direction, an isolated rabbit aorta embedded in ex vivo pork liver was sonicated at different acoustic powers (245 and 519 W), flow rates (25, 30, and 50 mL/minute), and sonication energies (519, 980, and 1038 J). Changes in the postsonication vessels were evaluated using US imaging, microscopic observation, and histopathological analysis. Results: Beam focusing along the vascular radial direction caused significant deformation of both tube walls (n = 4), whereas focusing along the axial direction only affected the contraction of the anterior wall (n = 4). The contraction index (Dc) of the vessel sonicated at 245 W and 980 J was 56.2 ± 9.7% (n = 12) with 25 mL/minute. The Dc of the vessel sonicated at 519 W and 1038 J was 56.5 ± 7.8% (n = 17). The Dc of the vessel sonicated at 519 J total energy was 18.3 ± 5.1% (n = 12). Conclusion: The developed USgHIFU probe induced greater vascular contractions by covering a larger area of the vessel wall in the radial direction. Sonication energy affects vascular contraction through temperature elevation of the vessel wall. When the acoustic power was high, an increase in acoustic power, even with comparable sonication energy, did not result in greater vessel contraction. [ABSTRACT FROM AUTHOR]

The skull has long been an obstacle for transcranial ultrasound therapy and neuromodulation, leading to waveform distortion and focal points misalignment. In this work, we propose a dual-focus transcranial ultrasound focusing method for ex vivo human skulls to bridge this barrier, which is demonstrated by using a 2 MHz single-element transducer placed outside the occipital bone, coupled to a 3D-printed acoustic holographic lens. The experimental results show that the proposed method allows for achieving high-precision single- and dual-focus ultrasound focusing through human skulls with the maximum target registration error less than one wavelength in water. The in-target ratio spans a range from 72% to 92%, with an average of 80.7%, while the out-of-target ratio varies from 0% to 43.9%, with an average of 18.3%. Additionally, the focal spots are substantially free of the skull-induced distortion, closely matching the ideal ones, and maintain a clearly identifiable circular focus shape. The method opens up a route toward the subsequent applications in clinical research and may enable to implement transcranial ultrasound therapy and neuromodulation. [ABSTRACT FROM AUTHOR]

The management of adenomyosis has undergone significant evolution, moving from traditional surgical interventions like hysterectomy to more conservative methods aimed at preserving fertility. Essential roles have been played by uterine-sparing surgeries and uterine artery embolization. Despite these advancements, there is a growing interest in less invasive alternatives. This review delves into the potential of high-intensity focused ultrasound (HIFU). HIFU employs focused ultrasound waves for precise ablation of adenomyotic lesions. The review conducts a thorough analysis of HIFU principles, safety, efficacy, and its possible synergies with other therapies. HIFU seems to be effective for adenomyosis treatment, demonstrating a favorable adverse effect profile and suitability for fertility preservation. Combining HIFU with hormonal treatment appears to enhance long-term symptom control, presenting a promising and comprehensive approach for managing adenomyosis. The goal of this article is to develop a comprehensive understanding of HIFU's role in contemporary adenomyosis management and to explore areas requiring further research. [ABSTRACT FROM AUTHOR]

Background and Purpose: Sonothrombolysis is a potential adjunctive therapy for large vessel occlusion (LVO) stroke. Bedside ultrasound image‐guided high‐intensity focused ultrasound (HIFU) therapy could deliver higher energy therapeutic ultrasound to the thrombus with higher precision than what was previously accomplished in human trials. The aim is to test the feasibility of diagnostic transcranial contrast‐enhanced ultrasound (CEUS) to image the occlusion site and continuously maintain the guidance image on‐target for a sufficient exposure time for HIFU to be effective during LVO stroke evaluation and treatment. Methods: This prospective, single center, observational cohort study included adult patients, presenting within 6 hours of stroke symptom onset, with LVO identified on computed tomography angiography (CTA). A hand‐held CEUS imaging study was initiated following CTA and lasted up to 30 minutes. The primary outcome is the proportion of patients where a guidance CEUS image of the occlusion was achieved. Results: A CEUS image of the occluded artery was obtained in 32/35 of the included patients. The median total imaging time was 23 minutes (interquartile range 15‐30). Patients undergoing thrombectomy had a lower total imaging time (17 vs. 29.5 minutes, p =.002). When imaging was successful, on‐target image was maintained for only 58% (standard deviation 23.8%) of total imaging time. No complications related to CEUS were observed. Conclusions: This feasibility study explored the use of diagnostic transcranial CEUS for continuous imaging of occlusion sites in LVO strokes. Challenges in maintaining target image during HIFU were identified, highlighting the need for technical advances for clinical application. [ABSTRACT FROM AUTHOR]

The editorial in the Journal of Clinical Medicine discusses the advancements in minimally invasive urologic surgery, focusing on robotic technology, high-intensity focused ultrasound (HIFU) for prostate cancer, laparoscopic versus open adrenalectomy, Thulium laser for kidney stone management, and predictors of ureteral strictures. The studies presented highlight the benefits of these technologies in improving surgical outcomes, reducing complications, and enhancing patient recovery. The future of urologic surgery is seen as minimally invasive, with robotics playing a key role in providing precise, effective, and patient-centered care. [Extracted from the article]

Background: Although B‐mode imaging has been widely used in ultrasound‐guided high‐intensity focused ultrasound (HIFU) treatment, challenges remain in improving its quality and sensitivity for monitoring the thermal dose. Recently, quantitative ultrasound (QUS) imaging has been recognized with the potential to better sense the changes in the microstructure of ablated tissues. Purpose: This study proposed to use a QUS method called weighted ultrasound entropy (WUE) imaging to monitor the HIFU ablation. Methods: Based on ex‐vivo and in‐vivo experiments, WUE images reflecting tissue changes during HIFU treatment under different acoustic power levels (174–308 W) were reconstructed with a newly established imaging framework. The performance of the proposed WUE imaging in the monitoring of HIFU treatment was compared with the corresponding B‐mode images in terms of their contrast‐to‐noise ratios (CNRs) between the focal region and the background. Results: It was found that HIFU irradiation with higher power generated larger WUE values in the focal region, and the bright spots grew in size as the acoustic sonication proceeded. Compared with the in‐situ B‐mode images, the WUE images had higher image quality in indicating lesion formation, with a 39.2%–53.4% improvement in the CNR at different stages. Meanwhile, a correlation (R = 0.84) between the damage area estimated in WUE images and that measured from the dissected ex‐vivo tissue samples was found. Conclusions: WUE imaging is more sensitive and accurate than B‐mode imaging in monitoring HIFU therapy. These findings suggest that WUE imaging could be a promising technique for assisting ultrasound‐guided HIFU ablation. [ABSTRACT FROM AUTHOR]

Over the past decade, ultrasound (US) has gathered significant attention and research focus in the realm of medical treatments, particularly within the domain of anti-cancer therapies. This growing interest can be attributed to its non-invasive nature, precision in delivery, availability, and safety. While the conventional objective of US-based treatments to treat breast, prostate, and liver cancer is the ablation of target tissues, the introduction of the concept of immunogenic cell death (ICD) has made clear that inducing cell death can take different non-binary pathways through the activation of the patient's anti-tumor immunity. Here, we investigate high-intensity focused ultrasound (HIFU) to induce ICD by unraveling the underlying physical phenomena and resulting biological effects associated with HIFU therapy using an automated and fully controlled experimental setup. Our in-vitro approach enables the treatment of adherent cancer cells (B16F10 and CT26), analysis for ICD hallmarks and allows to monitor and characterize in real time the US-induced cavitation activity through passive cavitation detection (PCD). We demonstrate HIFU-induced cell death, CRT exposure, HMGB1 secretion and antigen release. This approach holds great promise in advancing our understanding of the therapeutic potential of HIFU for anti-cancer strategies. A dedicated HIFU set-up was developed that allows to monitor and correlate HIFU induced cavitation with the biological outcomes focusing on cancer cell death, antigenicity and adjuvanticity (ICD hallmarks). This set-up allows the successful in vitro treatment of adherent cells with US as well as collection of the samples for analysis without any form of contamination. The inclusion of a broadband backscatter transducer allowed passive cavitation detection during the HIFU treatment in two or three dimensions, depending on the need. [Display omitted] • Ultrasound provides significant beneficial traits in cancer treatments due to its non-invasiveness, precision, and safety. • PCD enables automated, controlled in vitro cancer cell treatment with real-time monitoring of US-induced cavitation. • Key biological effects observed include HIFU-induced cell death, CALR exposure, HMGB1 secretion, and antigen release. • Using HIFU to induce immunogenic cell death and stimulate anti-tumor immunity presents a promising cancer treatment strategy. [ABSTRACT FROM AUTHOR]

Background: A new intervention called high-intensity focused ultrasound (HIFU) targets fibroids with high-intensity ultrasound pulses using ultrasound probes. This noninvasive method, which can be carried out with either magnetic resonance imaging or ultrasound guidance, results in immediate coagulated necrosis within a clearly defined area a few millimeters in diameter. Methods: This systematic review evaluated the safety of HIFU in the treatment of uterine fibroids regardless of site or size. We specifically aimed to determine the incidence of side effects that can occur during and after HIFU. We searched the PubMed, Scopus, ScienceDirect, and Mendeley archive using only the terms HIFU and fibroid. After identifying 1077 studies of different types from 2014 to March 2024, 300 studies were screened and 60 included. Results: According to Society of Interventional Radiology guidelines, class A adverse events (AEs) showed no significant results, and individuals with these AEs required no treatment and had no long-term consequences. Similarly, there were no class B significant results. However, 3943 of 10,204 patients (38%) complained of lower abdominal pain after the procedure, a class B AE, which resolved by analgesics. Further, 153 of 24,700 patients (0.6%) had skin burns, blisters, or nodules, and these issues resolved with conservative treatment. Additionally, 74 of 23,741 patients (0.3%) had hematuria; 882 of 5970 patients (14.7%) had abnormal vaginal discharge; 414 of 23,449 (1.7%) had vaginal bleeding; and 267 of 7598 (3.5%) had leg paresthesia. Major AEs (class C and D) were almost nonexistent, and the incidence of death in our study was zero. Conclusion: HIFU ablation of uterine fibroids is generally safe, causing mostly mild side effects and very few severe complications. The relative safety of HIFU compared to other minimally invasive techniques, such as uterine artery embolization, still needs further evaluation. [ABSTRACT FROM AUTHOR]

Low-intensity transcranial focused ultrasound stimulation (TUS) is a novel technique for noninvasive brain stimulation (NIBS). TUS delivered in a theta (5 Hz) burst pattern (tbTUS) induces plasticity in the human primary motor cortex (M1) for 30–60 min, showing promise for therapeutic development. Metaplasticity refers to activity-dependent changes in neural functions governing synaptic plasticity; depotentiation is the reversal of long-term potentiation (LTP) by a subsequent protocol with no effect alone. Metaplasticity can enhance plasticity induction and clinical efficacy of NIBS protocols. In our study, we compared four NIBS protocol combinations to investigate metaplasticity on tbTUS in humans of either sex. We delivered four interventions: (1) sham continuous theta burst stimulation with 150 pulses (cTBS150) followed by real tbTUS (tbTUS only), (2) real cTBS150 followed by sham tbTUS (cTBS only), (3) real cTBS150 followed by real tbTUS (metaplasticity), and (4) real tbTUS followed by real cTBS150 (depotentiation). We measured motor-evoked potential amplitude, short-interval intracortical inhibition, long-interval intracortical inhibition, intracortical facilitation (ICF), and short-interval intracortical facilitation before and up to 90 min after plasticity intervention. Plasticity effects lasted at least 60 min longer when tbTUS was primed with cTBS150 compared with tbTUS alone. Plasticity was abolished when cTBS150 was delivered after tbTUS. cTBS150 alone had no significant effect. No changes in M1 intracortical circuits were observed. Plasticity induction by tbTUS can be modified in manners consistent with homeostatic metaplasticity and depotentiation. This substantiates evidence that tbTUS induces LTP-like processes and suggests that metaplasticity can be harnessed in the therapeutic development of TUS. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) is the most common primary renal malignancy. Prevalence of RCC in developed countries has slowly increased. Although partial or total nephrectomy has been the first-line treatment for early-stage RCC, improved or similar safety and treatment outcomes with locoregional therapies have challenged this paradigm. In this review, we explore locoregional techniques for early-stage RCC, including radiofrequency ablation, cryoablation, and microwave ablation with a focus on procedural technique, patient selection, and safety/treatment outcomes. Furthermore, we discuss future advances and novel techniques, including radiomics, combination therapy, high-intensity focused ultrasound, and catheter-directed techniques. [ABSTRACT FROM AUTHOR]

Background: High‐intensity focused ultrasound (HIFU) is a promising minimally invasive treatment for liver cancer; however, its efficacy is often limited by the attenuation of ultrasonic energy. This study investigates the effectiveness of B7‐H3‐targeted microbubbles (T‐MBs) in enhancing HIFU ablation of liver cancer and explores their potential for clinical translation. Methods: T‐MBs and isotype control microbubbles (I‐MBs) were synthesized through the conjugation of biotinylated anti‐B7‐H3 antibody and isotype control antibody to the microbubble surface, respectively. Contrast‐enhanced ultrasound imaging was performed to compare the accumulation of T‐MBs and I‐MBs in liver cancer at various time points. The efficacy of T‐MBs in enhancing HIFU treatment was evaluated by measuring the immediate tumor ablation rate and long‐term tumor growth suppression. Additionally, the induced antitumor immune response was assessed through cytokine quantification in serum and tumor tissue, along with immunofluorescence staining conducted on days 1, 3, and 7 post‐treatment. Results: T‐MBs demonstrated superior liver cancer‐specific accumulation, characterized by higher concentrations and prolonged retention compared to I‐MBs. The combination of T‐MBs with HIFU resulted in significantly enhanced tumor ablation rates and superior tumor growth suppression. Post‐treatment analysis revealed a gradual uptick in cytokine levels within the tumor microenvironment, along with progressive infiltration of antitumor immune cells. Conclusion: T‐MBs effectively enhance the therapeutic efficacy of HIFU for liver cancer treatment while simultaneously promoting an antitumor immune response. These findings provide a strong experimental foundation for the clinical translation of ultrasound molecular imaging combined with HIFU as a novel approach for tumor therapy. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC), the most prevalent form of liver cancer, represents a significant global health challenge due to its rising incidence, complex management, as well as recurrence rates of up to 70% or more. Early and accurate imaging diagnosis, through modalities such as ultrasound, CT, and MRI, is crucial for effective treatment. Minimally invasive therapies, including thermal ablation methods such as radiofrequency ablation, microwave ablation, laser ablation, high-intensity focused ultrasound, and cryoablation, as well as non-thermal methods like percutaneous ethanol injection and irreversible electroporation, have shown promise in treating early and intermediate stages of HCC. Some studies have reported complete response in more than 90% of nodules and survival rates of up to 60–85% at 5 years after the procedure. These therapies are increasingly employed and induce specific morphological and physiological changes in the tumor and surrounding liver tissue, which are critical to monitor for assessing treatment efficacy and detecting recurrence. This review highlights the imaging characteristics of HCC following non-surgical treatments, focusing on the common features, challenges in post-treatment evaluation, and the importance of standardized imaging protocols such as the Liver Imaging Reporting and Data System. Understanding these imaging features is essential for radiologists to accurately assess tumor viability and guide further therapeutic decisions, ultimately improving patient outcomes. [ABSTRACT FROM AUTHOR]

High-intensity focused ultrasound (HIFU) thermal therapies utilize concentrated sound waves to ablate diseased tissue at precise locations within the body. Computational simulations of HIFU can assist clinicians by predicting the death of target tissues, identifying sensitive healthy tissues that risk thermal damage, and optimizing acoustic power delivery to minimize treatment times and maximize treatment efficacy. Accurate simulations require accurate inputs, and many computational solvers neglect property changes induced by tissue heating during treatment. Additionally, temperature-dependent tissue property data in the literature are relatively scarce. This study presents methodology for characterizing temperature-dependent acoustic and thermal properties in ex vivo porcine muscle tissue. From 20 – 50 °C, speed of sound is found to increase from approximately 1580 – 1620 m/s. The acoustic attenuation coefficient increases for 20 – 50 °C from 0.09 – 0.24 Np/cm at 0.5 MHz and 0.16 – 0.37 Np/cm at 1.6 MHz. Thermal conductivity and thermal diffusivity increase from 0.52 – 0.55 W/m °C and 0.147 – 0.158 mm2/s, respectively, over 20 – 60 °C. Specific heat capacity increases from approximately 3500 – 3800 J/kg °C, over 20 – 80 °C. Each property is consistent with data found in the literature, extends the literature to a larger temperature range, and, for acoustic properties, extends to unique frequencies. Temperature-dependent predictive models are also developed for each of the five properties. This study's property measurement methodologies can be used to characterize other biological tissues, and the predictive models developed herein will facilitate future efforts in temperature-dependent modeling and uncertainty quantification of HIFU thermal therapies. [ABSTRACT FROM AUTHOR]

Background: Focused ultrasound therapy has been widely used for the treatment of various diseases, employing different types of transducers. The focused ultrasound pressure fields inevitably exhibit nonlinear effects, which can influence the ablation region. However, the nonlinear effects exhibit noticeable variations across different applications. The characterization of the nonlinear pressure fields of ultrasound is important for the effective implementation of focused ultrasound therapy. Purpose: The traditional angular spectrum method (ASM) was extended to accurately and efficiently simulate the propagation of weakly nonlinear ultrasound in heterogeneous mediums of clinical model. The nonlinear effects were further analyzed in relationship to the transducer parameters that are different in various applications. Methods: The pressure fields were simulated using the extended ASM, incorporating calculations for phase aberration in the frequency domain and magnitude compensation in the spatial domain to account for heterogeneous acoustic impedance mismatch. Validation was performed by comparison to k‐Wave simulation results using two simplified clinical models, an abdominal soft tissue and a transcranial skull model. The nonlinear effects were then analyzed in relation to the transducer parameters of f‐number and effective source area based on the same acoustic output power. The analysis of nonlinear effects was conducted under both homogeneous medium and the clinical models. Results: The simulation results demonstrated a maximum error of 3.93% in the calculated harmonic pressure of the abdominal model, and a maximum error of 4.89% within the transcranial model when comparing the extended ASM simulation results to those obtained from k‐Wave simulations. The characterization of the nonlinear effects reveals a strong correlation with the transducer parameters. Specifically, the results indicate that the nonlinear effects intensify with an increase in the effective source area and f‐number, under the same acoustic output power of the transducer. However, the clinical model also showed an influence on the nonlinear effects in relation to the f‐number. Conclusion: The extended ASM was demonstrated as an accurate and efficient simulation tool, and the simulation results provide a reference for evaluating the intensity of nonlinear effects in various transducer designs. [ABSTRACT FROM AUTHOR]

Background/Objectives: Adenomyosis is a debilitating gynecologic condition that affects both multiparous older women and nulliparous younger women, inducing a variety of symptoms such as dysmenorrhea, menorrhagia, and infertility. Thermal ablation techniques are new procedures that have been proposed for the treatment of adenomyosis. They include high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA), and radiofrequency ablation (RFA). Because thermal ablation techniques are minimally invasive or noninvasive, fertility is not impaired while symptoms improve. In addition, hospital stays and financial costs are generally reduced, increasing the interest in these alternative management options. Methods: In this narrative review, we conducted a thorough literature search of PubMed/Medline from the database inception to September 2022. In our search, we focused on noninvasive treatment methods such as HIFU ablation, RFA ablation, and PMWA as well as adenomyosis-specific terms and noninvasive techniques (ultrasonography, ultrasound, or magnetic resonance imaging). The queries were a combination of MeSH terms and keywords. The search was limited to the English language. Abstracts were screened according to their content, and relevant articles were selected. Results: Overall, the results showed that the above-mentioned ablation techniques are effective and safe in providing adenomyosis treatment. Lesion size and uterus volume are reduced, leading to considerable symptom alleviation with all three methods. Positive results concerning safety and fertility preservation have been described as well. Conclusions: Nonetheless, more research is required in this field to compare the efficacy and safety of different ablation techniques with traditional therapies. Such research will help improve these procedures and their associated decision-making processes. [ABSTRACT FROM AUTHOR]

High-Intensity Focused Ultrasound (HIFU) as a promising and impactful modality for breast tumor ablation, entails the precise focalization of high-intensity ultrasonic waves onto the tumor site, culminating in the generation of extreme heat, thus ablation of malignant tissues. In this paper, a comprehensive three-dimensional (3D) Finite Element Method (FEM)-based numerical procedure is introduced, which provides exceptional capacity for simulating the intricate multiphysics phenomena associated with HIFU. Furthermore, the application of numerical procedures to an anatomically realistic breast phantom (ARBP) has not been explored before. The integrity of the present numerical procedure has been established through rigorous validation, incorporating comparative assessments with previous two-dimensional (2D) simulations and empirical data. For ARBP ablation, the administration of a 0.1 MPa pressure input pulse at a frequency of 1.5 MHz, sustained at the focal point for 10 seconds, manifests an ensuing temperature elevation to 80°C. It is noteworthy that, in contrast, the prior 2D simulation using a 2D phantom geometry reached just 72°C temperature under the identical treatment regimen, underscoring the insufficiency of 2D models, ascribed to their inherent limitations in spatially representing acoustic energy, which compromises their overall effectiveness. To underscore the versatility of this numerical platform, a simulation of a more clinically relevant HIFU therapy procedure has been conducted. This scenario involves the repositioning of the ultrasound focal point to three separate lesions, each spaced at 3 mm intervals, with ultrasound exposure durations of 6 seconds each and a 5-second interval for movement between focal points. This approach resulted in a more uniform high-temperature distribution at different areas of the tumour, leading to the ablation of almost all parts of the tumour, including its verges. In the end, the effects of different abnormal tissue shapes are investigated briefly as well. For solid mass tumors, 67.67% was successfully ablated with one lesion, while rim-enhancing tumors showed only 34.48% ablation and non-mass enhancement tumors exhibited 20.32% ablation, underscoring the need for multiple lesions and tailored treatment plans for more complex cases. [ABSTRACT FROM AUTHOR]

Thyroid nodules are very frequent in the iodine deficiency regions of central Europe and some of the affected patients are referred for definitive treatment, such as surgery and radioiodine treatment. In recent years nonsurgical and non-radioiodine techniques have been introduced to treat thyroid gland pathologies. These techniques include the probe-based techniques of radiofrequency, microwave and laser application. The only noninvasive technique is high-intensity focused ultrasound. All mentioned techniques have the goal to reduce the volume of the thyroid nodule by application of energy/heat. The knowledge of all techniques and their advantages and risks is necessary to help physicians and patients in making decisions for the appropriate method of treatment of thyroid nodules. [ABSTRACT FROM AUTHOR]

To investigate the safety and efficacy of high-intensity focused ultrasound (HIFU) ablation combined with pharmacogenomic-guided chemotherapy in treating patients with advanced pancreatic cancer (PC). Thirty-one patients with unresectable PC (stage III 17, stage IV 14) were enrolled in this study. The patients were divided into group A (pharmacogenomic-guided chemotherapy following HIFU treatment, n = 13) and group B (traditional chemotherapy following HIFU treatment, n = 18). Contrast-enhanced computed tomography and magnetic resonance imaging were used to evaluate tumor response. Pain intensity was assessed using the numerical rating scale. The Kaplan–Meier method and log-rank test were used to analyze survival. The mean pain intensity score in 18 patients decreased from 6.6 ± 2.2 before HIFU to 3.3 ± 1.0 after HIFU (p = 0.000). The mean duration of pain relief was 5.2 ± 3.2 mo in group A and 2.4 ± 1.3 mo in group B (p = 0.026). There was no significant difference of the non-perfused volume ratio (83.5% ± 22.3% in group A and 85.3% ± 16.8% in group B) between the two groups. The median survival time was 14 mo in group A and 5 mo in group B. The 6 and 12-mo survival rates were 74.1% and 59.3% in group A, and 32.4% and 19.4% in group B, respectively. The difference in survival between the two groups was significant (p = 0.04). No severe complications (≥grade 3) related to HIFU were observed. Bone marrow depression was the main adverse reaction related to chemotherapy, with grade 3 bone marrow depression observed 2 (15.4%) patients in group A and 7 (38.9%) patients in group B. HIFU combined with pharmacogenomic-guided chemotherapy is safe and effective in treating patients with advanced PC. It provides better clinical outcomes in pain relief, quality of life and survival benefits for patients with advanced PC compared to HIFU combined with traditional chemotherapy. This combined approach may have the potential to become an important supplement to the treatment of advanced PC. [ABSTRACT FROM AUTHOR]

Objective: We aimed to analyze the effect of high‐intensity focused ultrasound (HIFU) on different types of adenomyosis (AM) based on magnetic resonance imaging (MRI) classification. Methods: A total of 206 AM patients who underwent HIFU between January 2017 and December 2021 were included in this retrospective study. The size and location of AM were evaluated based on T2‐weighted imaging (T2WI) of MRI. Patients were divided into internal (subtype I), external (subtype II), intramural (subtype III), and full‐thickness (subtype IV) AM groups. All patients underwent an MRI examination before and one day after HIFU. After ultrasound‐guided HIFU ablation, the parameters of ultrasonic energy input during HIFU treatment among different groups were recorded and compared. The adverse reactions and complications among different groups were compared. Results: The lesion volume in the subtype IV group was significantly larger than the subtype II and III groups (P <.05). The HIFU irradiation time, treatment time, and total energy input in the subtype IV group were significantly higher than the subtype I and III groups (P <.05). The number of cases of abdominal pain and vaginal fluid in the treatment area in the subtype IV group was significantly higher than in the subtype II group. Conclusion: Although HIFU has different treatment strategies and parameters for different subtypes of AM, it can achieve a satisfactory ablation rate, which is safe and effective. [ABSTRACT FROM AUTHOR]

Objectives: High-intensity focused ultrasound (HIFU) is widely used to treat uterine fibroids. HIFU preoperative localization of uterine fibroids can be used to determine whether the patient is a suitable candidate for HIFU treatment. This study investigated the clinical significance of bladder training in improving the success rate of HIFU preoperative localization uterine fibroids. Material and methods: Our sample consists of patients who planned to undergo HIFU treatment in our hospital but who were failed in previous HIFU preoperative localization. They were recruited between July 2021 and April 2022, and randomly divided into experimental and control groups. A total of 150 patients were enrolled. Each group consisted of 75 patients. The patients in the experimental group adopted the procedure of drinking water multiple times and retaining urine. The training program lasted three days. The patients in the control group were required to keep regular drinking and urination habits without any special instructions or requirements. Results: There were no statistically significant differences between the two groups in maximum bladder capacity, residual urine volume of bladder, bladder filling levels, and bladder shape change. After bladder training, the maximum bladder capacity and the degree bladder shape change of the patients in the experimental group were improved significantly. The success rate of HIFU preoperative localization in the patients in the experimental group was significantly higher than that of the control group. Conclusions: Bladder training can effectively improve the success rate of HIFU preoperative localization of uterine fibroids. [ABSTRACT FROM AUTHOR]

Abstract Objectives To investigate whether the signal intensity (SI) ratio of residual fibroid (RF) to myometrium using Contrast-Enhanced Magnetic Resonance Imaging (CE-MRI) could predict fibroid regrowth after high-intensity focused ultrasound (HIFU) treatment. Materials and methods A retrospective analysis was conducted among 164 patients with uterine fibroids who underwent HIFU. To predict the RF regrowth, the SI perfusion parameters were quantified using the RF-myometrium SI ratio on CE-MRI on day 1 post-HIFU and then compared with the fibroid-myometrium SI ratio on the T2-weighted image (T2WI) and Funaki classification 1 year later. Thirty cases from another center were used as an external validation set to evaluate the performance of RF-myometrium SI ratio. Results The predictive performance of the RF-myometrium SI ratio on CE-MRI on day 1 post-HIFU (Area Under Curve, AUC: 0.869) was superior to that of the preoperative and postoperative fibroid-myometrium SI ratios on the T2WI (AUC: 0.724, 0.696) and Funaki classification (AUC: 0.663, 0.623). Multivariate analysis showed that the RF- myometrium SI ratio and RF thickness were independent factors. The RF-myometrium SI ratio reflects the long-term rate of re-intervention (r = 0.455, p

Prostate cancer (PCa) is a significant health concern globally, necessitating effective treatment options. Typical treatment methods for early stage, particularly localized PCa, encompass radical procedures, such as radical prostatectomy (RP) and radiotherapy (RT), and nonradical focal therapy (FT). FT is a focused approach mainly used for treating small lesions limited to a specific zone of the prostate. Its objective is to achieve cancer control when minimizing damage to benign tissue. High-intensity focused ultrasound (HIFU) is one of the most used modalities in FT for the management of PCa. The progress in HIFU technology showcases continuous advancements, offering clinicians a variety of strategies to cater to diverse patient requirements. The advancements include the development of transrectal and transurethral HIFU machines that offer enhanced treatment distances, magnetic resonance imaging (MRI) fusion capabilities, real-time monitoring, and precise ablation. These improvements contribute to increased treatment effectiveness and better outcomes for patients. This narrative review aims to summarize the use of HIFU technology and its evolution, offering diverse options to clinicians, and explores the safety, effectiveness, and quality of different HIFU strategies, such as whole-gland ablation, hemigland ablation, and focal ablation. We conclude that nonwhole-gland HIFU offers similar cancer control with better short-term functional outcomes and fewer complications compared to whole-gland ablation. Combining HIFU with transurethral resection of the prostate (TURP) improves urinary function and reduces catheterization time. Focal ablation and hemigland ablation show promise in achieving cancer control when preserving continence and potency.

We present a surface sampling method for the chemical analysis of liquid-immersed solid samples. Liquid immersion allows samples to be kept in a hydrated state. We employed cavitation generated by high-intensity focused ultrasound for localized material removal. The appropriate transducer–sample distance was determined using the actuating ultrasound transducer prior to sampling, allowing sonication in focus despite surface height variation. We demonstrate the proposed surface sampling method on water-submerged glass cover slides painted with permanent markers, achieving sampling with tunable spot size down to 500 μ m. The removed and collected material was transferred for chemical analysis by electrospray ionization mass spectrometry, which showed mass peaks characteristic to the permanent markers. [ABSTRACT FROM AUTHOR]

Focused ultrasound ablation provides a truly noninvasive tumor treatment option with clinically proven feasibility and safety. However, the frequently required long treatment duration hinders its clinical applicability. In this work, we compared the thermal ablation induced by conventional focused ultrasound (cFUS), split-focus ultrasound (sFUS), and acoustic vortex (AV) in tissue phantoms containing phase-change nanodroplets and mouse tumors. The results indicated that AV could substantially enhance the thermal ablation efficiency compared with cFUS, which was attributed to the larger focal region in the former. Additionally, the ablation region appeared as a unique cylindrical area with a smaller length-to-width ratio in AV than that in cFUS. Though the efficiency could also be improved in sFUS compared with cFUS, the ablation region was irregular and non-ablated tissues were present. Furthermore, in vivo experiments demonstrated that the tumor volume decreased faster and the mice survived longer after AV treatment compared with cFUS. The cavitation activity was also found to be more intense in AV ablation. The proposed method may solve the general issue of low efficiency often observed in cFUS ablation and further promote the development of other ultrasound treatments. [ABSTRACT FROM AUTHOR]

Aging and face sagging have many causes, and various techniques are used for treatment, including noninvasive procedures, such as focused ultrasound, which uses the principle of collagen regeneration by coagulative necrosis of the dermis layers using radiofrequency, but this procedure has complications. We reported a case of a 54-year-old female patient who complained of poor visual acuity in her right eye three days after a focused ultrasound facial aesthetic procedure, with the best visual acuity of 20/60. Biomicroscopy of the right eye revealed an acute cataract with three points of fibrosis extending from the posterior to the anterior capsule. The patient underwent phacoemulsification surgery with visual rehabilitation and improved vision of 20/20. We hypothesized that the occurrence of acute cataract was related to the inappropriate use of focused ultrasound. [ABSTRACT FROM AUTHOR]

Phased arrays of airborne ultrasound transducers are widely utilized as a key technology to achieve mid-air convergence of intense ultrasound, which is applied to a variety of systems, such as contactless tactile presentation, acoustic levitation and its application, mid-air-flow acceleration, etc. However, it requires considerably precise phase control with temporally severe synchronization between elements, which leads to difficulty in scaling up the entire system beyond the tabletop size as most of the current application systems. Here, we propose a much simpler and easier scaling-up method of airborne ultrasound convergence, where a binary amplitude mask that serves as a Fresnel Zone Plate (FZP) is placed on the planar in-phase ultrasound sources. We experimentally demonstrate that the FZP-based ultrasound focusing achieved a spatial resolution that is comparable to conventional methods, based on the use of phase-controlled transducers. The ultrasound foci created using FZPs are sufficiently intense for most application scenarios that are currently in practical use. We also determine favorable side effects of our method suppressing grating lobes, which is inevitable with the conventional phase-controlling method. The FZPs and planar ultrasound sources are both readily implemented with inexpensive ingredients and components. The result of our study contributes to upsizing dimensions in which a mid-air convergent ultrasound field is successfully generated. Accordingly, unprecedented application scenarios that target the entire room as the workspace will be possible. [ABSTRACT FROM AUTHOR]

Aim: Phantoms are often utilized for the preclinical evaluation of novel high-intensity focused ultrasound (HIFU) systems, serving as valuable tools for validating efficacy. In the present study, the feasibility of a homogeneous agar-based breast-shaped phantom as a tool for the preclinical evaluation of HIFU systems dedicated to breast cancer was assessed. Specifically, the effect of the increased phantom curvature on temperature increase was examined through sonications executed on two sides having varied curvatures. Materials and Methods: Assessment was performed utilizing a 1.1 MHz focused transducer. Sonications on the two phantom sides were executed at varied acoustical power in both a laboratory setting and inside a 1.5 T magnetic resonance imaging scanner. Sonications were independently performed on two identical phantoms for repeatability purposes. Results: Temperature changes between 7.1°C–34.3°C and 5.1°C–21.5°C were recorded within the decreased and increased curvature sides, respectively, for acoustical power of 3.75–10 W. High-power sonications created lesions which were approximately symmetrically formed around the focal point at the decreased curvature side, while they were shifted away from the focal point at the increased curvature side. Conclusions: The present findings indicate that increased curvature of the breast phantom results in deformed focal shapes and decreased temperatures induced at the focal area, thus suggesting treatment correction requirements in the form of focus control or accurate robotic movement. The developed breast-shaped phantom can be utilized as an evaluation tool of HIFU systems dedicated to breast cancer since it can visually verify the efficacy of any system.

Abstract Focal therapy, a minimally invasive strategy for localized prostate cancer, has been widely employed in the targeted treatment of localized prostate cancer in recent years. We analyzed 1312 relevant papers from the last decade using Web of Science Core Collection data. Our analysis covered countries, institutions, journals, authors, keywords, and references to offer a multifaceted perspective on the development of this field. The U.S. led in publications, contributing over half of the top 10 institutions. Emberton, M from University College London was the most published and cited author. “EUROPEAN UROLOGY” was the top journal by impact factor in 2022. Analysis of references and keywords suggests the prevalence of brachytherapy-related research, while high-intensity focused ultrasound (HIFU), cryotherapy, and irreversible electroporation (IRE) are emerging as new research focuses. Consequently, more high-quality evidence is necessary to evaluate the long-term effectiveness and safety of these novel therapeutic methods.

Qing Zhang,1,2,&ast; Xiaowen Liang,1,2,&ast; Zhiyi Chen1– 3 1Key Laboratory of Medical Imaging Precision Theranostics and Radiation Protection, College of Hunan Province, the Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, People’s Republic of China; 2Institute of Medical Imaging, Hengyang Medical School, University of South China, Hengyang, People’s Republic of China; 3Department of Medical Imaging, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhiyi Chen, Key Laboratory of Medical Imaging Precision Theranostics and Radiation Protection, the Affiliated Changsha Central Hospital, 161 Shaoshan Road, Changsha, 410004, Hunan, People’s Republic of China, Email zhiyi_chen@usc.edu.cnAbstract: There is a growing trend towards minimally invasive or noninvasive alternatives for gynecological disorders due to their rapid alleviation of symptom, expedited recovery, and minimal risks of postoperative complications. Thermal ablation technology has been commonly advocated as a minimally invasive therapeutic methods in recent years, including microwave ablation, radiofrequency ablation, and high-intensity focused ultrasound. The increasing application scenarios require updated and systematic research, and more evidence to promote their appropriate use. The objective of this review is to summarize the latest views of ablation from a prospective of fertility protection, endeavor to clarify the clinical value of thermal ablation technology in protecting fertility by assessing parameters such as ablation rates, alleviation of disease symptoms, re-intervention rates and post-treatment pregnancy rates. We review the clinical studies of ablation for uterine fibroids and adenomyosis treatment in the past 10 years, summarize the limitation and the prospects of its development in the treatment process, so as to provide clinicians with advice on the best practice. In the management of uterine fibroids and adenomyosis, thermal ablation technology offers improved fertility preservation and minimizes normal tissue injury compared to traditional surgical approaches for patients pursuing reproductive goals. In the future, thermal ablation technology will play a significantly enhanced role in preserving fertility for individuals requiring treatment for uterine fibroids and adenomyosis, guided by indications. But further research is still needed in the form of more extensive randomized prospective trials to provide stronger evidence supporting this perspective.Keywords: fertility protection, radiofrequency ablation, microwave ablation, high-intensity focused ultrasound, uterine fibroids, adenomyosis

Xiao-Ling Shen,1,&ast; Zhuo-Yi Li,1,&ast; Qing Li,1 Kai Wang2 1Department of Women Health Care, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361005, People’s Republic of China; 2Department of Aristogenesis, Women and Children’s Hospital, School of Medicine, Xiamen University, Xiamen, Fujian, 361005, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Kai Wang; Qing Li, Email wangkai111909@163.com; lq5090@126.comPurpose: To verify whether there is lower incidence of adverse pregnancy outcomes after high-intensity focused ultrasound (HIFU) treatment than loop electrosurgical excision procedure (LEEP) in young women of childbearing age.Patients and Methods: This retrospective cohort study enrolled 46 patients treated with HIFU and 46 patients treated with LEEP. To compare the differences between the two groups, Fisher’s exact test or the Kruskal–Wallis (K-W/H) test was used in the univariate analysis, while the logistic regression method was applied for further verification.Results: Basic characteristics showed no differences between the two groups (P > 0.05) except for parity (P < 0.001). Preterm birth rates were 6.52% and 0.00% in patients with cervical high-grade squamous intraepithelial lesions (HSIL) treated with LEEP and HIFU, respectively. The incidence rates of premature rupture of membranes (PROM) were respectively 15.22% and 21.74% in the two groups. There was no significant difference in pregnancy outcomes between the two groups (P > 0.05).Conclusion: This study is the first to compare the pregnancy outcomes of patients with cervical HSIL who treated with LEEP and HIFU procedures. Both HIFU treatment and LEEP are available options for patients of reproductive age with cervical HSIL. Therefore, it is necessary to conduct prospective single-center or multicenter randomized controlled studies.Keywords: cervical high-grade squamous intraepithelial lesions, high-intensity focused ultrasound, loop electrosurgical excision procedure, pregnancy outcome

Focal therapy, a minimally invasive strategy for localized prostate cancer, has been widely employed in the targeted treatment of localized prostate cancer in recent years. We analyzed 1312 relevant papers from the last decade using Web of Science Core Collection data. Our analysis covered countries, institutions, journals, authors, keywords, and references to offer a multifaceted perspective on the development of this field. The U.S. led in publications, contributing over half of the top 10 institutions. Emberton, M from University College London was the most published and cited author. "EUROPEAN UROLOGY" was the top journal by impact factor in 2022. Analysis of references and keywords suggests the prevalence of brachytherapy-related research, while high-intensity focused ultrasound (HIFU), cryotherapy, and irreversible electroporation (IRE) are emerging as new research focuses. Consequently, more high-quality evidence is necessary to evaluate the long-term effectiveness and safety of these novel therapeutic methods. [ABSTRACT FROM AUTHOR]

Purpose: Intraprostatic recurrence (IRR) of prostate cancer after radiation therapy is increasingly identified. Our objective was to review the literature to determine the optimal workup for identifying IRR, the management options, and practical considerations for the delivery of re-irradiation as salvage local therapy. Methods: We performed a systematic review of available publications and ongoing studies on the topics of IRR, with a focus on salvage re-irradiation. Results: Work up of biochemically recurrent prostate cancer includes PSMA PET/CT and multiparametric MRI, followed by biopsy to confirm IRR. Management options include continued surveillance, palliative hormonal therapy, and salvage local therapy. Salvage local therapy can be delivered using re-irradiation with low dose rate brachytherapy, high dose rate (HDR) brachytherapy, and stereotactic body radiotherapy (SBRT), as well as non-radiation modalities, such as cryotherapy, high-intensity focused ultrasound, irreversible electroporation and radical prostatectomy. Data demonstrate that HDR brachytherapy and SBRT have similar efficacy compared to the other salvage local therapy modalities, while having more favorable side effect profiles. Recommendations for radiation therapy planning and delivery using HDR and SBRT based on the available literature are discussed. Conclusion: Salvage re-irradiation is safe and effective and should be considered in patients with IRR. [ABSTRACT FROM AUTHOR]

High-Intensity Focused Ultrasound (HIFU) ablation represents a rapidly advancing non-invasive treatment modality that has achieved considerable success in addressing uterine fibroids, which constitute over 50% of benign gynecological tumors. Preoperative Magnetic Resonance Imaging (MRI) plays a pivotal role in the planning and guidance of HIFU surgery for uterine fibroids, wherein the segmentation of tumors holds critical significance. The segmentation process was previously manually executed by medical experts, entailing a time-consuming and labor-intensive procedure heavily reliant on clinical expertise. This study introduced deep learning-based nnU-Net models, offering a cost-effective approach for their application in the segmentation of uterine fibroids utilizing preoperative MRI images. Furthermore, 3D reconstruction of the segmented targets was implemented to guide HIFU surgery. The evaluation of segmentation and 3D reconstruction performance was conducted with a focus on enhancing the safety and effectiveness of HIFU surgery. Results demonstrated the nnU-Net's commendable performance in the segmentation of uterine fibroids and their surrounding organs. Specifically, 3D nnU-Net achieved Dice Similarity Coefficients (DSC) of 92.55% for the uterus, 95.63% for fibroids, 92.69% for the spine, 89.63% for the endometrium, 97.75% for the bladder, and 90.45% for the urethral orifice. Compared to other state-of-the-art methods such as HIFUNet, U-Net, R2U-Net, ConvUNeXt and 2D nnU-Net, 3D nnU-Net demonstrated significantly higher DSC values, highlighting its superior accuracy and robustness. In conclusion, the efficacy of the 3D nnU-Net model for automated segmentation of the uterus and its surrounding organs was robustly validated. When integrated with intra-operative ultrasound imaging, this segmentation method and 3D reconstruction hold substantial potential to enhance the safety and efficiency of HIFU surgery in the clinical treatment of uterine fibroids. [ABSTRACT FROM AUTHOR]

Background: The primary goal after open reduction and internal fixation of an established scaphoid nonunion is to achieve union. Low-intensity pulsed ultrasound (LIPUS) has been reported to increase the rate of union and to decrease the time to union for multiple fractures and nonunions in clinical and animal models. The evidence for LIPUS in the treatment of scaphoid nonunion, however, is sparse. The aim of this study was to assess whether active LIPUS (relative to sham LIPUS) accelerates the time to union following surgery for scaphoid nonunion. Methods: Adults with a scaphoid nonunion indicated for surgery were recruited for a multicenter, prospective, double-blinded randomized controlled trial. After surgery, patients self-administered activated or sham LIPUS units beginning at their first postoperative visit. The primary outcome was the time to union on serial computed tomography (CT) scans starting 6 to 8 weeks postoperatively. Secondary outcomes included patient-reported outcome measures, range of motion, and grip strength. Results: A total of 142 subjects completed the study (69 in the active LIPUS group and 73 in the sham group). The average age was 27 years, and the cohort was 88% male. There was no difference in time to union (p = 0.854; hazard ratio, 0.965; 95% confidence interval, 0.663 to 1.405). Likewise, there were no differences between the active LIPUS and sham groups with respect to any of the secondary outcomes, except for wrist flexion at baseline (p = 0.008) and at final follow-up (p = 0.043). Conclusions: Treatment with LIPUS had no effect on reducing time to union in patients who underwent surgical fixation of established scaphoid nonunions. [ABSTRACT FROM AUTHOR]

To evaluate the impact of high-intensity focused ultrasound (HIFU) ablation on the histopathological features of locally recurrent fibroids tissue. Patients who underwent transabdominal hysterectomy or myomectomy for uterine fibroids from January 1, 2021 to July 1, 2023 at a teaching hospital in China were enrolled in this prospective study. The patients who underwent surgery for local recurrence of uterine fibroids after HIFU ablation were categorized as the HIFU group, and patients who had not undergone HIFU ablation for uterine fibroids were the control group. Hematoxylin-eosin (HE) staining, Masson staining, and immunohistochemical staining were performed to analyze the counts of smooth muscle cells (SMCs), collagen content, microvascular count, and the expression levels of estrogen receptor (ER) and progesterone receptor (PR) in the fibroid tissue specimens. The mean SMC counts in the HIFU and control groups were 337.68/field and 328.52/field respectively. The mean collagen content in the HIFU group and control group were 46.06% and 41.69% respectively. The mean microvessel counts in the HIFU group and control group were 13.66/field and 14.08/field respectively. The mean ER scores in the HIFU and control groups were 6.9 and 7.47 respectively, and the mean PR scores were 7.3 and 7.56 respectively. Overall, there were no significant differences in the SMC counts, collagen content, microvascular counts, and the ER and PR expression levels between the HIFU group and control group (p > 0.05). HIFU ablation has no effect on the pathological characteristics of local recurrent fibroid tissue, and is an ideal non-invasive treatment option. [ABSTRACT FROM AUTHOR]

Background: High Intensity Macro and Micro Focused Ultrasound (HIFU) is a safe and effective method for the treatment of skin laxity. However, the application of high-intensity focused ultrasound energy on eyelids has been associated with potential ocular complications including traumatic cataract, iridocyclitis, and conjunctival hemorrhage, among others. Case presentation: A 40-year-old female developed blurred vision in her left eye after receiving HIFU treatment on binocular eyelids, and her left far vision was 20/66. The examination revealed left eye iris depigmentation and conjunctival hemorrhage. Both eyes exhibited multiple white streaking or tadpole-shaped opacities in the lenses. Conclusion: Excessive ultrasonic energy generated by HIFU can cause protein denaturation, leading to conditions such as traumatic cataract, visual impairment, injuries to the iris and conjunctiva when applied to the eyes. We recommend that individuals undergoing cosmetic treatment in the periorbital region should be highly aware of the possible ocular side effects. [ABSTRACT FROM AUTHOR]

The primary purpose of high-intensity focused ultrasound (HIFU), a non-invasive medical therapy, is to precisely target and ablate tumors by focusing high-frequency ultrasound from an external power source. A series of ablations must be performed in order to treat a big volume of tumors, as a single ablation can only remove a small amount of tissue. To maximize therapeutic efficacy while minimizing adverse side effects such as skin burns, preoperative treatment planning is essential in determining the focal site and sonication duration for each ablation. Here, we introduce a machine learning-based approach for designing HIFU treatment plans, which makes use of a map of the material characteristics unique to a patient alongside an accurate thermal simulation. A numerical model was employed to solve the governing equations of HIFU process and to simulate the HIFU absorption mechanism, including ensuing heat transfer process and the temperature rise during the sonication period. To validate the accuracy of this numerical model, a series of tests was conducted using ex vivo bovine liver. The findings indicate that the developed models properly represent the considerable variances observed in tumor geometrical shapes and proficiently generate well-defined closed treated regions based on imaging data. The proposed strategy facilitated the formulation of high-quality treatment plans, with an average tissue over- or under-treatment rate of less than 0.06%. The efficacy of the numerical model in accurately predicting the heating process of HIFU, when combined with machine learning techniques, was validated through quantitative comparison with experimental data. The proposed approach in cooperation with HIFU simulation holds the potential to enhance presurgical HIFU plan. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to identify the sonographic indicators that predict the ablation rate and efficiency of uterine fibroids during high-intensity focused ultrasound (HIFU) treatment. Methods: In this retrospective study, we analyzed the clinical data of patients with uterine fibroids who underwent HIFU treatment at Fujian Provincial Hospital between April 2019 and April 2022. Routine abdominal ultrasound examinations were performed to observe potential indicators before the HIFU treatment. After the treatment, enhanced magnetic resonance imaging (MRI) examination was performed within 2 weeks. The fibroid and non-perfused volumes (NPV) were determined, and the ablation rate and energy efficiency factor (EEF) were calculated. Results: A total of 75 patients (124 uterine fibroids) were included in this study. Uterine fibroids with a larger volume, high echogenicity, elliptical/diffuse leaf shape, and a posterior attenuation band had a higher HIFU ablation rate (p<0.05). Uterine fibroids with a larger volume and high echogenicity and without necrotic areas had a lower EEF (p<0.05). Multiple comparisons between fibroid types revealed statistically significant differences in EEF between subserosal and submucosal fibroids (p < 0.05) and between subserosal and mixed-type fibroids (p < 0.05). However, no statistically significant difference was observed between mixed-type and submucosal fibroids. The HIFU ablation rate and EEF showed no significant differences based on location within the wall and blood flow within the fibroids. Conclusion: Sonographic features of uterine fibroids can predict the rate and efficiency of HIFU ablation, providing useful guidance in selecting appropriate treatment for patients. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate changes in ovarian reserve and quality of life in women treated with ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids. Methods: In this single-center prospective study, a total of 69 patients with uterine fibroids treated with USgHIFU from October 2018 to November 2021 were enrolled. Fibroid volume, anti-Müllerian hormone (AMH) levels, uterine fibroid symptom scores, and uterine fibroid symptoms and quality of life (UFS-QOL) questionnaire scores before and 1, 3, and 6 months after USgHIFU treatment were analyzed. Correlations between AMH levels and age, fibroid type, and fibroid location were assessed. Results: Data from 54 of the 69 patients included in the present study were analyzed. The UFS-QOL scores at baseline and at 1 month and 6 months after USgHIFU treatment were 70 (50.75–87.50), 57 (44.75–80.00), and 52 (40.75–69.00) points, respectively (p < 0.001). The rate of fibroid volume reduction increased significantly at the 3-month follow-up compared with the 1-month follow-up (p < 0.001), and no significant change was observed between the 3-month and 6-month follow-ups (p > 0.99). The median AMH levels before and at 1, 3 and 6 months after treatment were 1.22 (0.16–3.28) ng/ml, 1.12 (0.18–2.52) ng/ml, 1.15 (0.19–2.08) ng/ml and 1.18 (0.36–2.43) ng/ml, respectively (p = 0.2). Multivariate linear regression analyses revealed that age was independently associated with AMH levels. Conclusions: USgHIFU treatment for uterine fibroids can significantly improve quality of life with minimal adverse effects on ovarian function. [ABSTRACT FROM AUTHOR]

AbstractThe major aim of this research hyperthermia and magnetic resonance-high intensity focused ultrasound (MR-HIFU) focused on investigating the potential of aloe vera leaf extract-mediated gold-coated iron oxide nanohybrids (Au-IONPs) as a modern theragnostic material for the treatment of uterine myoma. To assess the cytotoxicity of Au-IONPs, induce hyperthermia, and apply radiotherapy to determine the level of apoptosis in the human ht-UtLM cells. Subsequently, it evaluated the cytotoxicity of the nanoparticles on human ht-UtLM cells by exposing the cells to various concentrations of Au-IONPs for a 4-hour incubation period. Based on the results, concentrations of 10 and 15 µg/mL were selected for further investigation. The MTT assay and flow cytometry results demonstrated that Au-IONPs significantly induce cell apoptosis. It allows the Au-IONPs to turn as an effective development mediator in the ablation of high-intensity focused ultrasound (HIFU) treatment. Finally, it could be suggested to developed material have excellent systemic toxicity, which promises well for treatment of uterine fibroids.HIGHLIGHTSBiosynthesis of gold – iron oxide nanohybrids (Au-IONPs) through a green approach.Physio-chemical properties of Au-IONPs have been characterized through various techniques.Investigating the anti-tumor effects of Au-IONPs in combination with thermo-radiotherapy for uterine myoma.Determine the level of apoptosis in the human myoma cells by inducing hyperthermia and radiotherapy.Observed the correlation behavior between the dose of the cell viability and Au-IONP nanoparticles.Au-IONPs had a significant impact on enhancing the effects of both hyperthermia and radiation therapies.Biosynthesis of gold – iron oxide nanohybrids (Au-IONPs) through a green approach.Physio-chemical properties of Au-IONPs have been characterized through various techniques.Investigating the anti-tumor effects of Au-IONPs in combination with thermo-radiotherapy for uterine myoma.Determine the level of apoptosis in the human myoma cells by inducing hyperthermia and radiotherapy.Observed the correlation behavior between the dose of the cell viability and Au-IONP nanoparticles.Au-IONPs had a significant impact on enhancing the effects of both hyperthermia and radiation therapies. [ABSTRACT FROM AUTHOR]

Introduction: This study evaluated the efficacy and safety of ultrasound-guided high-intensity focused ultrasound (HIFU) in treating symptomatic uterine fibroids and adenomyosis. Methods: HIFU treatments performed in premenopausal women with symptomatic uterine fibroids and adenomyosis were analyzed retrospectively. Lesion volume reduction, change in symptoms of menstrual pain, and quality of life were examined. Major and minor complications, together with re-intervention rates, were evaluated. Results: Eighty-one HIFU treatments were performed in seventy-nine premenopausal women. The follow-up period was up to 95 months. A total of 65 women underwent treatment for uterine fibroids and 14 were treated for adenomyosis. For patients with uterine fibroids, the baseline fibroid volume median was 190.1 cm3 (18.5–1729.4 cm3). Fibroid volume was reduced by 50.1% (−26.2–97.8, p < 0.0001) at 6 months and 66.9% (−33.7–98.3, p < 0.0001) at 12 months after treatment. The modified Uterine Fibroid Symptom and Quality of Life (UFS-QOL) scores had decreased by 43.5% (0–62.5%, p < 0.0001) at 6 months and 50% (0–73%, p < 0.0001) at 12 months after treatment. In the adenomyosis arm, the median baseline uterine volume was 97.7 cm3 (43.7–367.4 m3). Uterine volume was reduced by 19.6% (range: 1.2–42.0, p = 0.28) at 6 months and 41.9% (18.9–69.2, p = 0.04) at 12 months after treatment. UFS-QOL scores were reduced by 38.1% (6–66.7%, p < 0.0001) at 6 months and 40% (0–70%, p < 0.0001) at 12s month after treatment. Fourteen (21.5%) patients with uterine fibroid and five (35.7%) patients with adenomyosis required subsequent interventions. Conclusions: HIFU provides symptomatic relief to most patients with uterine fibroids and adenomyosis. It is a promising uterus-sparing treatment for patients with these conditions. [ABSTRACT FROM AUTHOR]

The acoustic and electrical properties of a 128-element ultrasonic transducer designed to generate high-intensity focused ultrasound in air in the low-frequency ultrasonic range are investigated. To reduce parasitic grating maxima of the acoustic field, a spiral arrangement of piezoelectric elements on a spherical base was used. The operating frequency of the transducer was 35.5 kHz, and the diameter of the source and focal length were approximately 50 cm, significantly exceeding the wavelength (approximately 1 cm). This selection of parameters allowed for effective focusing, with localization of wave energy in a small focal region, thereby achieving extremely high levels of ultrasonic intensity. The parameters of the ultrasonic field were studied using a combined approach that included microphone recording of the acoustic pressure and measuring the acoustic radiation force acting on a conical reflector. Acoustic source parameters were determined from the two-dimensional spatial distribution of the acoustic pressure waveform, which was measured by scanning the microphone in a transverse plane in front of the source. Numerical modeling of nonlinear wave propagation was also used based on the Westervelt equation to simulate the behavior of intense waves. The acoustic pressure level reached 173 dB, with a focal spot size comparable to the wavelength. [ABSTRACT FROM AUTHOR]

Background: Salvage robot-assisted radical prostatectomy (sRARP) after PSA failure in patients who underwent initial radiotherapy or focal therapy has rarely been reported in Japan. We aimed to report the oncologic and functional outcomes of the first 10 cases of sRARP. Methods: Ten patients underwent sRARP after failing to respond to initial radiotherapy or focal therapy. Initial definitive treatment included volumetric modulated arc therapy, intensity-modulated radio therapy, stereotactic body radiotherapy, heavy-ion radiotherapy, low-dose-rate brachytherapy, and high-intensity focused ultrasound. We retrospectively investigated 10 cases on oncologic and functional outcomes of sRARP. Results: The median PSA level at sRARP, amount of blood loss, and console time were 2.17 ng/mL, 100 mL, and 136 min, respectively. Positive surgical margins were found in half of the cases. Median follow-up was 1.1 years. There were no 30-day major complications. No patients had erections after sRARP. Urinary continence and biochemical recurrence (BCR) rate were 40% and 30% at 1 year after sRARP, respectively. Conclusions: Salvage RARP may be a feasible option after PSA failure in patients who underwent radiotherapy or focal therapy as initial treatment, showing acceptable BCR rate. [ABSTRACT FROM AUTHOR]

Simple Summary: Boron neutron capture therapy (BNCT) is radiotherapy that depends on a nuclear reaction between boron-10 (10B) and neutrons. The neutron source has been changing from nuclear reactors to accelerators. Current BNCT using boronophenylalanine (BPA) as the boron compound has been shown to markedly reduce tumor sizes when used to treat recurrent head and neck cancer (HNC); however, early recurrence has been reported. Ultrasound, a safe diagnostic method, in combination with microbubbles, is expected to promote the uptake of BPA into tumor cells. Ultrasound also has the ability to increase the sensitivity of cancer cells to radiotherapy. Therefore, the combination of ultrasound needs to be promoted in order to improve the antitumor efficacy of BNCT for HNC. Boron neutron capture therapy (BNCT) is radiotherapy in which a nuclear reaction between boron-10 (10B) in tumor cells and neutrons produces alpha particles and recoiling 7Li nuclei with an extremely short range, leading to the destruction of the tumor cells. Although the neutron source has traditionally been a nuclear reactor, accelerators to generate neutron beams have been developed and commercialized. Therefore, this treatment will become more widespread. Recurrent head and neck cancer (HNC) close to the body surface is considered a candidate for BNCT using the boron compound boronophenylalanine (BPA) and has been found to be highly responsive to this treatment. However, some cases recur early after the completion of the treatment, which needs to be addressed. Ultrasound is a highly safe diagnostic method. Ultrasound with microbubbles is expected to promote the uptake of BPA into tumor cells. Ultrasound also has the ability to improve the sensitivity of tumor cells to radiotherapy. In addition, high-intensity focused ultrasound may improve the efficacy of BNCT via its thermal and mechanical effects. This review is not systematic but outlines the current status of BPA-based BNCT and proposes plans to reduce the recurrence rate of HNC after BNCT in combination with ultrasound. [ABSTRACT FROM AUTHOR]

Introduction: Focused ultrasound (FUS) is an innovative and emerging technology for the treatment of adult and pediatric brain tumors and illustrates the intersection of various specialized fields, including neurosurgery, neuro-oncology, radiation oncology, and biomedical engineering. Objective: The authors provide a comprehensive overview of the application and implications of FUS in treating pediatric brain tumors, with a special focus on pediatric low-grade gliomas (pLGGs) and the evolving landscape of this technology and its clinical utility. Methods: The fundamental principles of FUS include its ability to induce thermal ablation or enhance drug delivery through transient blood-brain barrier (BBB) disruption, emphasizing the adaptability of high-intensity focused ultrasound (HIFU) and low-intensity focused ultrasound (LIFU) applications. Results: Several ongoing clinical trials explore the potential of FUS in offering alternative therapeutic strategies for pathologies where conventional treatments fall short, specifically centrally-located benign CNS tumors and diffuse intrinsic pontine glioma (DIPG). A case illustration involving the use of HIFU for pilocytic astrocytoma is presented. Conclusion: Discussions regarding future applications of FUS for the treatment of gliomas include improved drug delivery, immunomodulation, radiosensitization, and other technological advancements. [ABSTRACT FROM AUTHOR]

AuroLase® Therapy—a nanoparticle-enabled focal therapy—has the potential to safely and effectively treat localized prostate cancer (PCa), preserving baseline functionality. This article presents a detailed case of localized PCa treated with AuroLase, providing insight on expectations from the diagnosis of PCa to one year post-treatment. AuroLase Therapy is a two-day treatment consisting of a systemic infusion of gold nanoshells (~150-nm hydrodynamic diameter) on Day 1, and sub-ablative laser treatment on Day 2. Multiparametric MRI (mpMRI) was used for tumor visualization, treatment planning, and therapy response assessment. The PCa was targeted with a MR/Ultrasound-fusion (MR/US) transperineal approach. Successful treatment was confirmed at 6 and 12 months post-treatment by the absence of disease in MR/US targeted biopsies. On the mpMRI, confined void space was evident, an indication of necrotic tissues encompassing the treated lesion, which was completely resolved at 12 months, forming a band-like scar with no evidence of recurrent tumor. The patient's urinary and sexual functions were unchanged. During the one-year follow-up, changes on the DCE sequence and in the Ktrans and ADC values assist in qualitatively and quantitatively evaluating tissue changes. The results highlight the potential of gold-nanoparticle-enabled sub-ablative laser treatment to target and control localized PCa, maintain quality of life, and preserve baseline functionality. [ABSTRACT FROM AUTHOR]