title: The road to clinical use of high-intensity focused ultrasound for liver cancer: technical and clinical consensus.
abstract: Clinical use of high-intensity focused ultrasound (HIFU) under ultrasound or MR guidance as a non-invasive method for treating tumors is rapidly increasing. Tens of thousands of patients have been treated for uterine fibroid, benign prostate hyperplasia, bone metastases, or prostate cancer. Despite the methods' clinical potential, the liver is a particularly challenging organ for HIFU treatment due to the combined effect of respiratory-induced liver motion, partial blocking by the rib cage, and high perfusion/flow. Several technical and clinical solutions have been developed by various groups during the past 15 years to compensate for these problems. A review of current unmet clinical needs is given here, as well as a consensus from a panel of experts about technical and clinical requirements for upcoming pilot and pivotal studies in order to accelerate the development and adoption of focused ultrasound for the treatment of primary and secondary liver cancer.
authors.affiliation: Institut Langevin, ESPCI ParisTech, CNRS UMR 7587, INSERM U979, Université Denis Diderot, Paris VII, Paris, France ; Department of Radiation Oncology, University of Virginia, Charlottesville, VA, USA.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Aubry
authors.affiliation: Radiological Sciences Laboratory, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Kim Butts
authors.initials: KB
authors.lastname: Pauly
authors.affiliation: Imaging Division, University Medical Center Utrecht, Amsterdam, The Netherlands.
authors.forename: Chrit
authors.initials: C
authors.lastname: Moonen
authors.affiliation: Division of Radiotherapy and Imaging, The Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey, UK.
authors.forename: Gail Ter
authors.initials: GT
authors.lastname: Haar
authors.affiliation: Imaging Division, University Medical Center Utrecht, Amsterdam, The Netherlands.
authors.forename: Mario
authors.initials: M
authors.lastname: Ries
authors.affiliation: Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Rares
authors.initials: R
authors.lastname: Salomir
authors.affiliation: Philips Healthcare, Boston, MA, USA.
authors.forename: Sham
authors.initials: S
authors.lastname: Sokka
authors.affiliation: Ultrasound Innovations Applications, Siemens Healthcare, Issaquah, WA, USA.
authors.forename: Kevin Michael
authors.initials: KM
authors.lastname: Sekins
authors.affiliation: InSightec Ltd, 5 Nahum Heth Street, Haifa, Israel.
authors.forename: Yerucham
authors.initials: Y
authors.lastname: Shapira
authors.affiliation: Chongqing Haifu Medical Technology Co., Ltd, Chongqing, China.
authors.forename: Fangwei
authors.initials: F
authors.lastname: Ye
authors.affiliation: Focused Ultrasound Foundation, Charlottesville, VA, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Huff-Simonin
authors.affiliation: Focused Ultrasound Foundation, Charlottesville, VA, USA.
authors.forename: Matt
authors.initials: M
authors.lastname: Eames
authors.affiliation: Focused Ultrasound Foundation, Charlottesville, VA, USA.
authors.forename: Arik
authors.initials: A
authors.lastname: Hananel
authors.affiliation: Focused Ultrasound Foundation, Charlottesville, VA, USA.
authors.forename: Neal
authors.initials: N
authors.lastname: Kassell
authors.affiliation: University of Rome, La Sapienza, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Napoli
authors.affiliation: Digestive Disease Center, University of Washington, Seattle, WA, USA.
authors.forename: Joo Ha
authors.initials: JH
authors.lastname: Hwang
authors.affiliation: Institute of Ultrasonic Engineering in Medicine, Chongqing Medical University, Chongqing, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Wu
authors.affiliation: Clinical Center for Tumor Therapy, Second Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Institute for Medical Science and Technology, University of Dundee, Dundee, Scotland, UK.
authors.forename: Andreas
authors.initials: A
authors.lastname: Melzer
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Young-Sun
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Medicine, Imperial College, South Kensington Campus, Exhibition Rd, London SW7 2AZ, UK ; Saint Mary's Hospital, Praed St, W2 1NY, London, UK.
authors.forename: Wladyslaw M
authors.initials: WM
authors.lastname: Gedroyc
keywords: Focused ultrasound; High-intensity ultrasound; Liver cancer; Non-invasive surgery; Ultrasound