High-intensity focused ultrasound

[probiotic]

Hello everyone
is high-intensity focused ultrasound (HIFU) a rad onc procedure. Any ideas?

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[seper]

Ouch!
That thing hurts.

 

[medgator]

Nope. It's done by urologists. Also, it is not FDA-approved to be performed in this country for the management of prostate cancer, so urologists have to fly down to the carribean to do it.

 

[Sheldor]

Nope. It's done by urologists. Also, it is not FDA-approved to be performed in this country for the management of prostate cancer, so urologists have to fly down to the carribean to do it.

It's also being explored for treatment of uterine fibroids by IR, but not here in the US. It's also being explored as a tool for tumor ablation, which would be in addition to the RF ablation that IR already does.

If you're curious about more you can check out the Focused Ultrasound Surgery Foundation.

 

[Gfunk6]

The Radiation Oncology department at UVA performs MRI focused ultrasound to treat cancer and has federal funding to investigate this technology.

 

[Werg]

It's also being explored for treatment of uterine fibroids by IR, but not here in the US. It's also being explored as a tool for tumor ablation, which would be in addition to the RF ablation that IR already does.

If you're curious about more you can check out the Focused Ultrasound Surgery Foundation.

I thought HIFU was FDA cleared for uterine fibroids.

 

[Sheldor]

I thought HIFU was FDA cleared for uterine fibroids.

Not last time I was at a conference dealing with it, but admittedly that was a little while ago now. Back then the MR guided HIFU was being used in Europe but not here. Perhaps it is now approved?

Edit to add: So I looked it up and it seems that the Exablate was approved for MR guided HIFU for uterine fibroids back in 2004.

http://http://www.fda.gov/medicalde...rances/recently-approveddevices/ucm080704.htm

 

[Sheldor]

Here is some more information about HIFU:

http://http://www.fusfoundation.org/Treatment-Sites/treatment-locations

Based on what's I've seen of these machines it seems like the administration could easily fall under the scope of practice of radiation oncology. The planning software is similar, and an understanding of tumor volume and dosing is also required. It will be interesting to see where it goes over the next decade, but it sure seems to me that rad oncs should attempt to be the ones to administer it.

 

[JumpingFrenchmn]

Here is some more information about HIFU:

http://http://www.fusfoundation.org/Treatment-Sites/treatment-locations

Based on what's I've seen of these machines it seems like the administration could easily fall under the scope of practice of radiation oncology. The planning software is similar, and an understanding of tumor volume and dosing is also required. It will be interesting to see where it goes over the next decade, but it sure seems to me that rad oncs should attempt to be the ones to administer it.

Certainly sounds like "therapeutic radiology" to me

 

[Seldon1985]

Sorry to resurrect an older thread, but I was wondering how HIFU treatments were evolving in the clinical world. There were a couple of Rad Onc programs I interviewed at last year (forget which ones though) that made some mention of this modality in passing... Are Rad Onc departments yet trying to get into this line of "therapeutic radiology"?

 

[Sheldor]

http://news.sky.com/home/uk-news/article/16209988

Saw this on Google news this morning and figured it was good excuse to revive this discussion.

 

[medgator]

http://news.sky.com/home/uk-news/article/16209988

Saw this on Google news this morning and figured it was good excuse to revive this discussion.

No mention of the amount of F/U in the study, but most of the endpoints in the abstract appear to measured at 12 months. Definitely more F/U needed than that for something like localized prostate CA

http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70121-3/abstract

Findings
42 men were recruited between June 27, 2007, and June 30, 2010; one man died from an unrelated cause (pneumonia) 3 months after treatment and was excluded from analyses. After treatment, one man was admitted to hospital for acute urinary retention, and another had stricture interventions requiring hospital admission. Nine men (22%, 95% CI 11—38) had self-resolving, mild to moderate, intermittent dysuria (median duration 5·0 days [IQR 2·5—18·5]). Urinary debris occurred in 14 men (34%, 95% CI 20—51), with a median duration of 14·5 days (IQR 6·0—16·5). Urinary tract infection was noted in seven men (17%, 95% CI 7—32). Median overall International Index of Erectile Function-15 (IIEF-15) scores were similar at baseline and at 12 months (p=0·060), as were median IIEF-15 scores for intercourse satisfaction (p=0·454), sexual desire (p=0·644), and overall satisfaction (p=0·257). Significant deteriorations between baseline and 12 months were noted for IIEF-15 erectile (p=0·042) and orgasmic function (p=0·003). Of 35 men with good baseline function, 31 (89%, 95% CI 73—97) had erections sufficient for penetration 12 months after focal therapy. Median UCLA Expanded Prostate Cancer Index Composite (EPIC) urinary incontinence scores were similar at baseline as and 12 months (p=0·045). There was an improvement in lower urinary tract symptoms, assessed by International Prostate Symptom Score (IPSS), between baseline and 12 months (p=0·026), but the IPSS-quality of life score showed no difference between baseline and 12 months (p=0·655). All 38 men with no baseline urinary incontinence were leak-free and pad-free by 9 months. All 40 men pad-free at baseline were pad-free by 3 months and maintained pad-free continence at 12 months. No significant difference was reported in median Trial Outcomes Index scores between baseline and 12 months (p=0·113) but significant improvement was shown in median Functional Assessment of Cancer Therapy (FACT)-Prostate (p=0·045) and median FACT-General scores (p=0·041). No histological evidence of cancer was identified in 30 of 39 men biopsied at 6 months (77%, 95% CI 61—89); 36 (92%, 79—98) were free of clinically significant cancer. After retreatment in four men, 39 of 41 (95%, 95% CI 83—99) had no evidence of disease on multiparametric MRI at 12 months.

 

[deleted103644]

Certainly sounds like "therapeutic radiology" to me

I don't know... It sounds kind of "interventional".