title: Management of respiratory motion in extracorporeal high-intensity focused ultrasound treatment in upper abdominal organs: current status and perspectives.
abstract: Extracorporeal high-intensity focused ultrasound (HIFU) is a minimally invasive therapy considered with increased interest for the ablation of small tumors in deeply located organs while sparing surrounding critical tissues. A multitude of preclinical and clinical studies have showed the feasibility of the method; however, concurrently they showed several obstacles, among which the management of respiratory motion of abdominal organs is at the forefront. The aim of this review is to describe the different methods that have been proposed for managing respiratory motion and to identify their advantages and weaknesses. First, we specify the characteristics of respiratory motion for the liver, kidneys, and pancreas and the problems it causes during HIFU planning, treatment, and monitoring. Second, we make an inventory of the preclinical and clinical approaches used to overcome the problem of organ motion. Third, we analyze their respective benefits and drawbacks to identify the remaining physical, technological, and clinical challenges. We thereby consider the outlook of motion compensation techniques and those that would be the most suitable for clinical use, particularly under magnetic resonance thermometry monitoring.
authors.affiliation: Service de Radiologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France. arnaud.muller@chu-lyon.fr.|CREATIS-LRMN, CNRS UMR 5220-INSERM U630, 69621, Villeurbanne Cedex, France. arnaud.muller@chu-lyon.fr.
authors.forename: A
authors.initials: A
authors.lastname: Muller
authors.affiliation: Department of Radiology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Petrusca
authors.affiliation: Department of Radiology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: V
authors.initials: V
authors.lastname: Auboiroux
authors.affiliation: Service de Radiologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.
authors.forename: P J
authors.initials: PJ
authors.lastname: Valette
authors.affiliation: Department of Radiology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.|INSERM, ADR 05 Rhône Alpes, Lyon, France.
authors.forename: R
authors.initials: R
authors.lastname: Salomir
authors.affiliation: Service de Radiologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.|CREATIS-LRMN, CNRS UMR 5220-INSERM U630, 69621, Villeurbanne Cedex, France.|Laboratoire d'Anatomie de Rockefeller, University Claude Bernard Lyon 1, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Cotton
mesh_terms: D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000601:surgery*; D008099:Liver / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D009068:Movement; D010179:Pancreas / Q000601:surgery*; D012119:Respiration; D062125:Thermometry / Q000379:methods