title: Mechanical high-intensity focused ultrasound destruction of soft tissue: working mechanisms and physiologic effects.
abstract: The best known method of high-intensity focused ultrasound is thermal ablation, but interest in non-thermal, mechanical destruction is increasing. The advantages of mechanical ablation are that thermal protein denaturation remains limited and less damage is created to the surrounding tissue by thermal diffusion. The two main techniques for mechanical fragmentation of tissue are histotripsy and boiling histotripsy. These techniques can be used for complete liquefaction of tumor tissue into submicron fragments, after which the fragmented tissue can be easily removed by natural (immunologic) responses. Interestingly it seems that there is a correlation between the degree of destruction and tissue specific characteristics based on the treatment settings used. In this review article, the technical aspects of these two techniques are described, and an overview of the in vivo pathologic and immunologic responses is provided.
authors: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: martijn.hoogenboom@radboudumc.nl.
authors: Martijn
authors: M
authors: Hoogenboom
authors: Department of Tumor Immunology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Dylan
authors: D
authors: Eikelenboom
authors: Department of Tumor Immunology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Martijn H
authors: MH
authors: den Brok
authors: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Arend
authors: A
authors: Heerschap
authors: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
authors: Jurgen J
authors: JJ
authors: Fütterer
authors: Department of Tumor Immunology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Gosse J
authors: GJ
authors: Adema
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D012983:Soft Tissue Neoplasms / Q000628:therapy*
keywords: Boiling histotripsy; High-intensity focused ultrasound; Histotripsy; Immune response; Mechanical high-intensity focused ultrasound