Siedek Florian, Yeo Sin Yuin, Heijman Edwin, Grinstein Olga, Bratke Grischa, Heneweer Carola, Puesken Michael, Persigehl Thorsten, Maintz David, Grüll Holger
Institute of Diagnostic and Interventional Radiology, University-Hospital of Cologne, Germany.
Rofo. 2019 Jun;191(6):531-539. doi: 10.1055/a-0817-5686. Epub 2019 Jan 10.
High-intensity focused ultrasound (HIFU) allows noninvasive heating of deep-seated tissues. Guidance under magnetic resonance imaging (MR-HIFU) offers spatial targeting based on anatomical MR images as well as MR-based near-real-time temperature maps. Temperature feedback allows delivery of a well-defined thermal dose enabling new applications such as the ablation of malignant tissue.
Peer-reviewed publications on MR-HIFU were studied and are summarized in this review. Literature was restricted to applications in oncology.
Several MR-HIFU-based applications for the treatment of malignant diseases are currently part of clinical trials or translational research. Recent trials regarding the treatment of prostate cancer with MR-HIFU have already shown this to be a safe and patient-friendly method. For the treatment of breast cancer and malignancies within abdominal organs, MR-HIFU has been applied so far only in proof of concept studies.
MR-HIFU is currently being investigated for the ablative treatment of malignant tissue in a variety of oncological applications. For example, the transrectal as well as transurethral ablation of prostate cancer using MR-HIFU was shown to be a patient-friendly, safe alternative to other local treatment options with low side effects.
· MR guidance offers high soft tissue contrast for treatment planning, near-real-time temperature monitoring, and post-interventional therapy evaluation.. · Special HIFU transducers and technological solutions are available for the treatment of e. g. prostate cancer, breast cancer or abdominal malignancies..
· Siedek F, Yeo SY, Heijman E et al. MR-Guided High-Intensity Focused Ultrasound (MR-HIFU): Overview of Emerging Applications (Part 2). Fortschr Röntgenstr 2019; 191: 531 - 539.
高强度聚焦超声（HIFU）可对深部组织进行无创加热。磁共振成像引导下的HIFU（MR-HIFU）基于解剖学磁共振图像以及基于磁共振的近实时温度图提供空间靶向。温度反馈可实现明确热剂量的输送，从而实现诸如恶性组织消融等新应用。
对关于MR-HIFU的同行评审出版物进行了研究，并在本综述中进行了总结。文献仅限于肿瘤学应用。
目前，几种基于MR-HIFU的恶性疾病治疗应用正处于临床试验或转化研究阶段。近期关于用MR-HIFU治疗前列腺癌的试验已表明这是一种安全且对患者友好的方法。对于乳腺癌和腹部器官内的恶性肿瘤，到目前为止，MR-HIFU仅应用于概念验证研究。
目前正在研究MR-HIFU在各种肿瘤学应用中对恶性组织的消融治疗。例如，使用MR-HIFU经直肠以及经尿道消融前列腺癌已被证明是一种对患者友好、安全的替代其他局部治疗选择的方法，且副作用低。
·磁共振引导为治疗计划、近实时温度监测和介入后治疗评估提供了高软组织对比度。·有特殊的HIFU换能器和技术解决方案可用于治疗例如前列腺癌、乳腺癌或腹部恶性肿瘤。
· Siedek F, Yeo SY, Heijman E等。磁共振引导下的高强度聚焦超声（MR-HIFU）：新兴应用概述（第2部分）。Fortschr Röntgenstr 2019; 191: 531 - 539。
