From the Guidelines
Histotripsy is a non-invasive medical procedure that uses focused ultrasound waves to mechanically destroy targeted tissue without heat, creating microscopic bubbles that rapidly expand and collapse, physically breaking down cells with extreme precision. This technique is being developed for treating various conditions including liver tumors, kidney stones, prostate cancer, and cardiovascular diseases. The main advantages of histotripsy include its non-invasive nature, minimal damage to surrounding healthy tissue, and the ability to monitor the treatment in real-time using ultrasound imaging.
Key Points About Histotripsy
- It is a non-thermal ablation method, distinguishing it from other ultrasound-based treatments that rely on heat to destroy tissue.
- Histotripsy exploits the mechanical properties of tissue, using acoustic cavitation to tear apart cellular structures at the microscopic level.
- The procedure typically takes 30-90 minutes depending on the target area, requires no incisions, and patients often experience minimal recovery time compared to surgical alternatives.
- While the provided evidence does not directly discuss histotripsy, the concept of advanced imaging and 3D tissue reconstruction 1 highlights the importance of understanding tissue structure and function, which is crucial for the development and application of precise treatments like histotripsy.
Clinical Applications and Future Directions
Histotripsy's potential applications span multiple medical specialties, offering a promising alternative to traditional surgical methods. Its development and refinement are part of a broader trend towards less invasive, more precise medical interventions. As research continues to advance, particularly in the areas of imaging and tissue analysis 1, we can expect to see further innovations in treatments like histotripsy, enhancing patient outcomes and quality of life.
From the Research
Definition of Histotripsy
- Histotripsy is a noninvasive, non-ionizing, and non-thermal ablation technology guided by real-time imaging 2.
- It uses focused ultrasound delivered from outside the body to mechanically destroy tissue through cavitation, rendering the target into acellular debris 2, 3.
Mechanism of Action
- Histotripsy works by delivering high-intensity focused ultrasound waves to target tissue, creating cavitation bubbles within tissues that rapidly expand and collapse, thereby mechanically fractionating the tissue into acellular debris 3.
- The material in the histotripsy ablation zone is absorbed by the body within 1-2 months, leaving a minimal remnant scar 2.
Applications
- Histotripsy has been investigated for a wide range of applications in preclinical studies, including the treatment of cancer, neurological diseases, and cardiovascular diseases 2.
- It has been used to treat various types of tumors, including liver, pancreatic, renal, and prostate tumors 3, 4, 5.
- Histotripsy has also been shown to stimulate an immune response and induce abscopal effects in animal models, which may have positive implications for future cancer treatment 2, 6.
Clinical Trials
- Three human clinical trials have been undertaken using histotripsy for the treatment of benign prostatic hyperplasia, liver cancer, and calcified valve stenosis 2.
- The THERESA trial, a first-in-man study, demonstrated the technical effectiveness and safety profile of histotripsy in patients with primary and secondary liver tumors 5.
- The Hope4Liver trial demonstrated a primary efficacy of 95.5% with minimal complications (6.8%) in the treatment of hepatocellular carcinoma and liver metastases 4.