Extracorporeal liver ablation using sonography-guided high-intensity focused ultrasound.
OBJECTIVE
High-intensity focused ultrasound (HIFU) is the only radiation beam that can remotely destroy deep-seated tissue targets without causing damage to the intervening tissues. This study evaluates the ability of sonography-guided HIFU to extracorporeally induce liver ablation in a rabbit model.


METHODS
Under sonographic guidance, the HIFU beam was transcutaneously focused at the target tissue in the liver through a subcostal approach. A computer controlled the HIFU exposure and transducer movement to destroy a preselected tissue volume. Simultaneous sonography monitored the tissue response. Ten insonated rabbits were killed from days 0 to 10, and the liver and intervening tissues were examined histologically.


RESULTS
A sharply demarcated sonolesion of coagulation necrosis was produced in the liver in 9 of 10 animals. No damage was found in the intervening tissues (n = 6) when adequate acoustic coupling and proper beam path was applied.


CONCLUSIONS
Sonography-guided HIFU might be a potential new modality for extracorporeal inducement of liver cancer ablation without resorting to laparatomy.
Yang
R
R
Department of Surgery, Indiana University School of Medicine, Indianapolis.
Sanghvi
N T
NT
Rescorla
F J
FJ
Galliani
C A
CA
Fry
F J
FJ
Griffith
S L
SL
Grosfeld
J L
JL
D000818:Animals; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D011817:Rabbits; D014465:Ultrasonics; D014463:Ultrasonography