HIFU: Introduction, principles, and advantages

High-Intensity Focused Ultrasound (HIFU) is a cutting-edge medical technology that has been gaining traction in the field of non-invasive therapy for various diseases, particularly in oncology, cosmetic medicine, and urology. This innovative technique uses ultrasonic waves to target and destroy diseased tissue with precision, without harming the surrounding healthy tissue. The principle, development, applications, advantages, notable manufacturers, cost, and post-treatment care of HIFU illustrate the significant impact of this technology in modern medicine.

HIFU:Introduction, principles, and advantages
HIFU:Introduction, principles, and advantages

Introduction to HIFU Technology

High-Intensity Focused Ultrasound (HIFU) is a therapeutic procedure that employs ultrasound waves to heat and destroy specific tissues within the body. Unlike traditional surgical methods, HIFU is non-invasive, meaning it does not require incisions or penetration through the skin. This aspect alone significantly reduces the risk of infection and complications, making it a preferred option for patients and physicians alike.

Technical Principle

The core principle behind HIFU technology lies in its use of ultrasound waves, which are focused at a specific point within the body. At the focal point, these waves generate intense heat, typically reaching temperatures of 65-85°C, causing thermal ablation of the targeted tissue. The precision of focusing the ultrasound waves means that only the diseased tissue is affected, preserving the surrounding healthy tissue intact.

Development History

HIFU technology has evolved significantly since its inception. Initially explored in the 1940s for tumor treatment, it wasn’t until the 1990s that HIFU began to be widely recognized and utilized in clinical settings, thanks to advancements in ultrasound imaging and technology. Over the years, the equipment has become more sophisticated, with improvements in accuracy, safety, and treatment efficacy.

Suitable Diseases for Treatment

HIFU has been successfully used in treating a variety of conditions. In oncology, it’s applied in the treatment of cancers such as prostate, liver, kidney, and breast cancer. In cosmetic medicine, HIFU is used for skin tightening and lifting. Additionally, it has shown effectiveness in treating uterine fibroids, a common benign tumor in women, and certain cases of benign prostatic hyperplasia (BPH) in men.

Advantages of HIFU

The benefits of HIFU are manifold. Primarily, its non-invasive nature means patients experience less pain, fewer complications, and a quicker recovery time compared to traditional surgery. The precision of the treatment allows for targeted therapy, minimizing damage to surrounding tissues. Additionally, HIFU treatments can often be performed on an outpatient basis, reducing the need for hospital stays.

American Equipment Manufacturers

Several notable American companies specialize in the development and manufacturing of HIFU equipment. Among them, SonaCare Medical and EDAP TMS are leaders in the market, offering state-of-the-art devices for prostate and kidney cancer treatments, respectively. These manufacturers are at the forefront of HIFU technology, constantly innovating and improving their offerings.

Treatment Cost

The cost of HIFU treatment varies depending on the condition being treated, the equipment used, and the geographic location of the treatment center. In the United States, the cost can range from 15,000-25,000 for prostate cancer treatment. While this may seem high, it is important to consider the overall cost savings from a quicker recovery and lower risk of complications compared to traditional surgery.

Post-Treatment Care

After HIFU treatment, patients may experience mild discomfort, swelling, or redness in the treated area, but these symptoms typically subside within a few days. Patients are advised to rest and avoid strenuous activities for a short period. Follow-up appointments are crucial to monitor the treatment’s success and manage any potential side effects.

Conclusion

High-Intensity Focused Ultrasound (HIFU) represents a significant advancement in non-invasive medical treatments, offering a safer, less painful alternative to traditional surgery. Its precision, effectiveness, and rapid recovery times make it an increasingly popular choice for treating a wide range of conditions. As technology continues to evolve, the potential applications and benefits of HIFU are likely to expand, further solidifying its role in modern medicine.

A case of HIFU treatment for uterine fibroids:

Mrs. Li, 42 years old, visited her local hospital due to unbearable dizziness and fatigue. A routine blood test revealed that her hemoglobin level was only 70g/L. A color ultrasound indicated a fibroid on the posterior wall of her uterus, approximately 6cm in diameter, pressing against the endometrium. After a detailed inquiry by the doctor, Mrs. Li disclosed that she had been experiencing heavy menstrual flow with large blood clots for the past two years. She assumed it was normal as she was approaching menopause and did not pay much attention to it until the dizziness became intolerable, prompting her visit to the hospital.

The uterine fibroid pressing against the endometrium led to a significant increase in menstrual flow, resulting in moderate anemia, which definitely required surgery. After a thorough medical history review, it was found that Mrs. Li had suffered a cerebral infarction three years prior, with imaging showing severe stenosis of the right middle cerebral artery, moderate to severe stenosis of the right anterior cerebral artery, and multiple severe stenoses of the bilateral posterior cerebral arteries. Given the high anesthesia risk assessed by the anesthesiology department, she was transferred to our hospital.

Upon admission, a multidisciplinary consultation involving the departments of gynecology, neurology, and anesthesiology and perioperative medicine was conducted. Considering Mrs. Li’s severe cerebral vascular stenosis, obesity, and previous cerebral infarction, the risk of another stroke post-general anesthesia was deemed very high, hence general anesthesia for surgery was not recommended. The anesthesiologists deliberated whether spinal anesthesia could be an option for the surgery. At 42, Mrs. Li was still young, and the color ultrasound showed only one fibroid, making minimally invasive laparoscopic surgery the preferred choice. However, laparoscopic surgery would require general anesthesia. How could the fibroid be treated with minimal trauma while avoiding the risks of anesthesia?

The gynecology department conducted a pelvic MRI assessment for Mrs. Li. After thorough review of the images, Professor Yuan suggested trying high-intensity focused ultrasound (HIFU) ablation treatment. This method could inactivate uterine fibroid cells without the need for surgery or anesthesia, allowing the fibroid to gradually shrink and relieve the pressure on the endometrium, thereby improving the menstrual flow and correcting the anemia. After discussing with Professor Yuan, Mrs. Li and her family agreed to the treatment. The subsequent treatment was very satisfactory. After two sessions of high-intensity focused ultrasound ablation, contrast-enhanced ultrasound assessment showed that the entire fibroid had no blood supply, achieving a 100% ablation rate.

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