Factors Affecting Tumor Ablation during High Intensity Focused Ultrasound Treatment
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Background/Aims: High intensity focused ultrasound (HIFU)utilizes a targeted extracorporeal focused ultrasound beamto ablate neoplastic pancreatic tissue. We used an in vitromodel to examine the effects of bone, metallic stents, plasticstents, metal plates, and cyst-like lesions on HIFU treatment. Methods: HIFU was delivered to the phantom modelsimplanted with foreign bodies, and the location, shape, andsize of the ablated zones were evaluated. Results: Bone andmetallic plates reflected the ultrasound beam, shifting theablation zone from the focal zone to the prefocal area. In thephantoms containing metal stent, plastic stent, and cyst,most of the ablative energy was reflected to the prefocal areaby the surface, with the remainder penetrating through thephantom. The area of the ablated margins was significantlylarger in size and volume than the intended focal ablationzone. Conclusions: During HIFU therapy, artificial or anatomicalbarriers could affect the direction of the ultrasoundbeams, shifting the ablation zone from the focal area to aprefocal site with a larger than expected ablation zone. Thesefactors should be considered prior to HIFU treatment for pancreatictumors because they could limit ablation success, inaddition to causing complications.
Abstract
Background/Aims: High intensity focused ultrasound (HIFU)utilizes a targeted extracorporeal focused ultrasound beamto ablate neoplastic pancreatic tissue. We used an in vitromodel to examine the effects of bone, metallic stents, plasticstents, metal plates, and cyst-like lesions on HIFU treatment. Methods: HIFU was delivered to the phantom modelsimplanted with foreign bodies, and the location, shape, andsize of the ablated zones were evaluated. Results: Bone andmetallic plates reflected the ultrasound beam, shifting theablation zone from the focal zone to the prefocal area. In thephantoms containing metal stent, plastic stent, and cyst,most of the ablative energy was reflected to the prefocal areaby the surface, with the remainder penetrating through thephantom. The area of the ablated margins was significantlylarger in size and volume than the intended focal ablationzone. Conclusions: During HIFU therapy, artificial or anatomicalbarriers could affect the direction of the ultrasoundbeams, shifting the ablation zone from the focal area to aprefocal site with a larger than expected ablation zone. Thesefactors should be considered prior to HIFU treatment for pancreatictumors because they could limit ablation success, inaddition to causing complications.
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