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4 - Principles of high-intensity focused ultrasound

from Section II - Principles of image-guided therapies

Published online by Cambridge University Press:  05 September 2016

By
Aradhana M. Venkatesan  and
Bradford J. Wood
Edited by
Jean-Francois H. Geschwind  and
Michael C. Soulen
Aradhana M. Venkatesan
Affiliation:
Radiology and Imaging Sciences and Center for Interventional Oncology
Bradford J. Wood
Affiliation:
Department of Radiology
Jean-Francois H. Geschwind
Affiliation:
Yale University School of Medicine, Connecticut
Michael C. Soulen
Affiliation:
Department of Radiology, University of Pennsylvania Hospital, Philadelphia
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Summary

Introduction

High-intensity focused ultrasound (HIFU), also known as focused ultrasound (US), is a non-invasive image-guided therapy which has been primarily employed in the clinical realm for non-invasive thermal ablation of benign and malignant neoplasms. Real-time imaging guidance, treatment monitoring, and therapy control are achieved with either US or magnetic resonance imaging (MRI) guidance. HIFU clinical experience has been described in the treatment of leiomyomata (uterine fibroids), prostate (benign prostatic hypertrophy and cancer), breast, hepatic, renal, pancreatic, brain, and bone tumors, although for most of these tumors, relatively small numbers of treated patients have been described and widespread adoption of HIFU thermoablation remains limited. Ongoing technical challenges include the feasibility of treating large tumors within a finite treatment time, treating tumors prone to motion, and accessing targets when the acoustic window is restricted by intervening anatomy (e.g., ribs, bowel).

A range of provocative bioeffects of therapeutic US beyond thermoablation have the potential to be leveraged in the care of selected oncology patients. Hyperthermic effects can potentiate the release of thermosensitive drugs, enhance the permeability and retention (“EPR effect”) of chemotherapeutic agents or nanoparticles, sensitize tissues to radiation effects, and potentially augment therapeutic gene transfection within tumors. Mechanical effects of HIFU, including stable and inertial cavitation and radiation forces, also play roles in heat-sensitive drug and gene delivery, and the enhanced permeability of therapeutic molecules, and disruption of the blood–brain barrier (BBB). These are areas of ongoing and promising oncologic research.

This chapter will provide an overview of the principles and existing therapeutic platforms for HIFU, including US and MRI guidance, treatment planning, and monitoring capabilities. A summary of current and potential future clinical applications is also presented.

HIFU principles and bioeffects

History

HIFU is not a new technology. Its first medically applicable use was described by Lynn et al. in 1942; these authors designed a focused US system and executed preclinical testing in the brain. Subsequently, in the 1950s, the Fry brothers developed a clinical HIFU device intended to treat patients with neurological disorders like Parkinson's disease. This system employed radiography to determine target location in relation to the overlying calvarium and focused the US beam through a craniotomy.

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Interventional Oncology
Principles and Practice of Image-Guided Cancer Therapy
 , pp. 20 - 34
Publisher: Cambridge University Press
Print publication year: 2016

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References

1. Jenne, JW, Preusser, T, Gunther, M. High-intensity focused ultrasound: principles, therapy guidance, simulations and applications. Z Med Phys 2012; 22: 311–322.Google Scholar
2. Al-Bataineh, O, Jenne, J, Huber, P. Clinical and future applications of high intensity focused ultrasound. Cancer Treatment Rev 2012; 38: 346–353.Google Scholar
3. Napoli, A, Anzidei, M, Ciolina, F, et al. MR-guided high-intensity focused ultrasound: current status of an emerging technology. Cardiovasc Interv Radiol 2013; 36: 1190–1203.Google Scholar
4. Lynn, LG, Zwemer, RL, Chick, AJ, Miller, AE. A new method for the generation and use of focused ultrasound in experimental biology. J Gen Physiol 1942; 26: 179–193.Google Scholar
5. Fry, WJ, Fry, FJ. Fundamental neurological research and human neurosurgery using intense ultrasound. IRE Trans Med Electron 1960; ME-7: 166–181.Google Scholar
6. Tempany, CMC, McDannold, NJ, Hynynen, K, Jolesz, FA. Focused ultrasound surgery in oncology: overview and principles. Radiology 2011; 259: 39–56.Google Scholar
7. Meyers, R, Fry, WJ, Fry, FJ, Dreyer, LL, Schultz, DF, Noyes, RF. Early experiences with ultrasonic irradiation of the pallidofugal and nigral complexes in hyperkinetic and hypertonic disorders. J Neurosurg 1959; 16: 32–54.Google Scholar
8. Zhou, YF. High intensity focused ultrasound in clinical tumor ablation. World J Clin Oncol 2011; 10: 8–27.Google Scholar
9. Hynynen, K, Lulu, BA. Hyperthermia in cancer treatment. Invest Radiol 1990; 25: 824–834.Google Scholar
10. Al-Bataineh, O, Jenne, J, Huber, P. Clinical and future applications of high intensity focused ultrasound in cancer. Cancer Treatment Rev 2012; 38: 346–353.Google Scholar
11. McDannold, N, Tempany, CM, Fennessy, FM, et al. Uterine leiomyomas: MR imaging-based thermometry and thermal dosimetry during focused ultrasound thermal ablation. Radiology 2006; 240: 263–272.Google Scholar
12. Enholm, J, Kohler, MO, Quesson, B, Mougenot, C, Moonen, C, Sokka, S. Improved volumetric MR-HIFU ablation by robust feedback control. IEEE Trans Biomed Eng 2010; 57:103–113.Google Scholar
13. McDannold, N, King, R, Jolesz, F, Hynynen, K. Usefulness of MR imaging-derived thermometry and dosimetry in determining the threshold for tissue damage induced by thermal surgery in rabbits. Radiology 2000; 216: 517–523.Google Scholar
14. Venkatesan, AM, Partanen, A, Pulanic, TK, et al. Magnetic resonance imaging-guided volumetric ablation of symptomatic leiomyomata: correlation of imaging with histology. J Vasc Interv Radiol 2012; 23: 786–794.Google Scholar
15. Fjield, T, Sorrentino, V, Cline, H, Hynynen, K. Design and experimental verification of thin acoustic lenses for the coagulation of large tissue volumes. Phys Med Biol 1997; 42: 2341–2354.Google Scholar
16. Fan, X, Hynynen, K. Control of the necrosed tissue volume during noninvasive ultrasound surgery using a 16-element phased array. Med Phys 1995; 22: 297–306.Google Scholar
17. Daum, D, Hynynen, K. Thermal dose optimization via temporal switching in ultrasound surgery. IEEE Trans Ultrason Ferroelectr Freq Control 1998; 45: 208–215.Google Scholar
18. Liu, HL, Lin, WL, Chen, YY. A fast and conformal heating scheme for producing large thermal lesions using a 2D ultrasound phased array. Int J Hyperthermia 2007; 23: 69–82.Google Scholar
19. Kohler, MO, Mougenot, C, Quesson, B, et al. Volumetric HIFU ablation under 3D guidance of rapid MR thermometry. Med Phys 2009; 36: 3521–3525.Google Scholar
20. Moonen, CT, Madio, DP, Zwart, JA de, et al. MRI-guided focused ultrasound as a potential tool for control of gene therapy. Eur Radiol 1997; 7: 1165.Google Scholar
21. O'Neill, BE, Li, KC. Augmentation of targeted delivery with pulsed high intensity focused ultrasound. Int J Hyperthermia 2008; 24: 506–520.Google Scholar
22. Deckers, R, Quesson, B, Arsaut, J, Eimer, S, Couillaud, F, Moonen, CT. Image-guided, noninvasive, spatiotemporal control of gene expression. Proc Natl Acad Sci USA 2009; 106: 1175–1180.Google Scholar
23. Needham, D, Anyarambhatia, G, Kong, G, Dewhirst, MW. A new temperature-sensitive liposome for use with mild hyperthermia: characterization and testing in a human xenografts model. Cancer Res 2009; 60: 1197–1201.Google Scholar
24. Schroeder, A, Kost, J, Barenholz, Y. Ultrasound, liposomes, and drug delivery: principles for using ultrasound to control the release of drugs from liposomes. Chem Phys Lipids 2009; 162: 1–16.Google Scholar
25. Dromi, S, Frenkel, V, Luk, A, et al. Pulsed-high intensity focused ultrasound and temperature-sensitive liposomes for enhanced targeted drug delivery and antitumor effect. Clin Cancer Res 2007; 13: 2722–2727.Google Scholar
26. Jolesz, FA, McDannold, N. Current status and future potential of MRI-guided focused ultrasound surgery. J Magn Reson Imaging 2008; 27: 391–399.Google Scholar
27. Hynynen, K, Clement, G. Clinical applications of focused ultrasound-the brain. Int J Hyperthermia 2007; 23: 193–202.Google Scholar
28. Sapareto, SA, Dewey, WC. Thermal dose determination in cancer therapy. Int J Radiat Oncol Biol Phys 1984; 10: 787–800.Google Scholar
29. Dewey, WC. Arrhenius relationships from the molecule and cell to the clinic. Int J Hyperthermia 1994; 10: 457–483.Google Scholar
30. Diederich, CJ. Thermal ablation and high-temperature thermal therapy: overview of technology and clinical implementation. Int J Hyperthermia 2005; 21: 745–753.Google Scholar
31. Malietzis, G, Monzon, L, Hand, J, et al. High-intensity focused ultrasound: advances in technology and experimental trials support enhanced utility of focused ultrasound surgery in oncology. Br J Radiol 2013; 86: 2013044.Google Scholar
32. Leighton, TG. The Acoustic Bubble. London: Academic Press, 1994; pp. 531–551.
33. Vykhodtseva, N, McDannold, N, Hynynen, K. Induction of apoptosis in vivo in the rabbit brain with focused ultrasound and Optison. Ultrasound Med Biol 2006; 32: 1923–1929.Google Scholar
34. Mason, TJ. A sound investment. Chem Ind 1998; 21: 878–882.Google Scholar
35. Zarnitsyn, VG, Prausnitz, MR. Physical parameters influencing optimization of ultrasound-mediated DNA transfection. Ultrasound Med Biol 2004; 30: 527–538.Google Scholar
36. Gruzman, H, McNamara, A, Nguyen, D, Prausnitz, M. Bioeffects caused by changes in acoustic cavitation bubble density and cell concentration: a unified explanation based on cell-to-bubble ratio and blast radius. Ultrasound Med Biol 2003; 29: 1211–1222.Google Scholar
37. Schlicher, RK, Radhakrishna, H, Tolentino, TP, Apkarian, RP, Zarnitsyn, V, Prausnitz, MR. Mechanism of intracellular delivery by acoustic cavitation. Ultrasound Med Biol 2006; 32: 915–924.Google Scholar
38. Vykhodtseva, NI, Hynynen, K, Damianou, C. Histologic effects of high intensity pulsed ultrasound exposure with subharmonic emission in rabbit brain in vivo. Ultrasound Med Biol 1995; 21: 969–979.Google Scholar
39. Hynynen, K, Chung, AH, Colucci, V, Jolesz, FA. Potential adverse effects of high-intensity focused ultrasound exposure on blood vessels in vivo. Ultrasound Med Biol 1996; 22: 193–201.Google Scholar
40. Hynynen, K, Colucci, V, Chung, A, Jolesz, F. Noninvasive arterial occlusion using MRI guided focused ultrasound. Ultrasound Med Biol 1996; 22: 1071–1077.Google Scholar
41. Siegel, RJ, Cumberland, DC, Myler, RK, DonMichael, TA. Percutaneous ultrasonic angioplasty: initial clinical experience. Lancet 1989; 2: 772–774.Google Scholar
42. Rosenschein, U, Bernstein, JJ, DiSegni, E, Kaplinsky, E, Bernheim, J, Rozenzsajn, LA. Experimental ultrasonic angioplasty: disruption of atherosclerotic plaques and thrombi in vitro and arterial recanalization in vivo. J Am Coll Cardiol 1990; 15: 711–717.Google Scholar
43. Kim, HJ, Greenleaf, JF, Kinnick, RR, Bronk, JT, Bolander, ME. Ultrasound-mediated transfection of mammalian cells. Hum Gene Ther 1996; 7: 1339–1346 Google Scholar
44. Bednarski, MD, Lee, JW, Callstrom, MR, Li, KC. In vivo target-specific delivery of macromolecular agents with MR-guided focused ultrasound. Radiology 1997; 204: 263–268.Google Scholar
45. Therapeutic Ultrasound Group. Non-invasive ultrasonic tissue fractionation for treatment of benign disease and cancer-histotripsy. Biomedical Engineering Department, University of Michigan. http://www.histotripsy.umich.edu/ (accessed August 11, 2014).
46. Smith, NB, Hynynen, K. The feasibility of using focused ultrasound for transmyocardial revascularization. Ultrasound Med Biol 1998; 24: 1045–1054.Google Scholar
47. Xu, Z, Ludomirsky, A, Eun, LY, et al. Controlled ultrasound tissue erosion. IEEE Trans Ultrason Ferroelectr Freq Control 2004; 51: 726–736.Google Scholar
48. Parsons, JE, Cain, CA, Abrams, GD, Fowlkes, JB. Pulsed cavitational ultrasound therapy for controlled tissue homogenization. Ultrasound Med Biol 2006; 32: 115–129.Google Scholar
49. Pitt, WG, Husseini, GA, Staples, BJ. Ultrasonic drug delivery – a general review. Expert Opin Drug Deliv 2004; 1: 37–56.Google Scholar
50. Hynynen, KH. Fundamental principles of therapeutic ultrasound. In: Jolesz, FA, Hynynen, KH, eds. MRI Guided Focused Ultrasound Surgery. New York: Informa Healthcare, 2008; pp. 5–18.
51. Martin, CJ, Pratt, BM, Watmough, DJ. Observations of ultrasound induced effects in the fish Xiphophorous maculatus . Ultrasound Med Biol 1983; 9: 177–183.Google Scholar
52. Frenkel, V, Oberoi, J, Stone, MJ, et al. Pulsed high-intensity focused ultrasound enhances thrombolysis in an in vitro model. Radiology 2006; 239: 86–93.Google Scholar
53. Wu, F. Extracorporeal high intensity focused ultrasound in the treatment of patients with solid malignancy. Minim Invasive Ther Allied Technol 2006; 15: 26–35.Google Scholar
54. Seip, R, VanBaren, P, Cain, CA, Ebbini, ES. Noninvasive real-time multipoint temperature control for ultrasound phased array treatments. IEEE Trans Ultrason Ferroelectr Freq Control 1996; 43: 1063–1073.Google Scholar
55. Curiel, L, Chopra, R, Hynynen, K. In vivo monitoring of focused ultrasound surgery using local harmonic motion. Ultrasound Med Biol 2009; 35: 65–78.Google Scholar
56. Orsi, F, Zhang, L, Arnone, P, et al. High intensity focused ultrasound ablation: effective and safe therapy for solid tumors in difficult locations. Am J Roentgenol 2010; 195: W245–W252.Google Scholar
57. Rieke, V, Pauly, KB. MR thermometry. J Magn Reson Imaging 2008; 27: 376–390.Google Scholar
58. Higuchi, N, Bleier, AR, Jolesz, FA, Colucci, VM, Morris, JH. Magnetic resonance imaging of the acute effects of interstitial neodymium:YAG laser irradiation on tissues. Invest Radiol 1992; 27: 814–821.Google Scholar
59. Bleier, AR, Jolesz, FA, Cohen, MS, et al. Real-time magnetic resonance imaging of laser heat deposition in tissue. Magn Reson Med 1991; 21: 132–137.Google Scholar
60. Ishihara, Y, Calderon, A, Watanabe, H, et al. A precise and fast temperature mapping using water proton chemical shift. Magn Reson Med 1995; 34: 814–823.Google Scholar
61. Pauly, KB. Overview of PRF thermometry. http://rsl.stanford.edu/kim/index.html (accessed August 10, 2014).
62. Peters, RD, Hinks, RS, Henkelman, RM. Ex vivo tissue-type independence in proton resonance frequency shift MR thermometry. Magn Reson Med 1998; 40: 454–459.Google Scholar
63. Kuroda, K, Chung, AH, Hynynen, K, Jolesz, FA. Calibration of water proton chemical shift with temperature for noninvasive temperature imaging during focused ultrasound surgery. J Magn Reson Imaging 1998; 8: 175–181.Google Scholar
64. Makin, IR, Mast, TD, Faidi, W, Runk, MM, Barthe, PG, Slayton, MH. Miniaturized ultrasound arrays for interstitial ablation and imaging. Ultrasound Med Biol 2005; 31: 1539–1550.Google Scholar
65. Focused Ultrasound Foundation. Manufacturers. 2014. http://www.fusfoundation.org/the-technology/manufacturers (accessed August 29, 2014).
66. Gardner, TA, Koch, MO. Prostate cancer therapy with high-intensity focused ultrasound. Clin Genitourin Cancer 2005; 4: 187–192.Google Scholar
67. Sonacare Medical. Sonablate 500 high intensity focused ultrasound. 2014. http://sonacaremedical.com/sonablate-500-high-intensity-focused-ultrasound (accessed August 11, 2014).
68. Shehata, A. Treatment with high intensity focused ultrasound: secrets revealed. Eur J Radiol 2012; 81: 534–541.Google Scholar
69. Furusawa, H, Namba, K, Nakahara, H, et al. The evolving non-surgical ablation of breast cancer: MR guided focused ultrasound (MRgFUS). Breast Cancer 2007; 14: 55–58.Google Scholar
70. Fukunishi, H, Funaki, K, Sawada, K, et al. Early results of magnetic resonance-guided focused ultrasound surgery of adenomyosis: analysis of 20 cases. J Minim Invasive Gynecol 2008; 15: 571–579.Google Scholar
71. InSightec. Transcranial magnetic resonance-guided focused ultrasound surgery: current applications and progress for noninvasive neurosurgery. 2010. http://www.insightec.com/contentManagment/uploadedFiles/fileGallery/brainwhitepapersep2.pdf (accessed August 11, 2014).
72. Elias, WJ, Huss, D, Voss, T, et al. A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med 2013; 369: 640–648.Google Scholar
73. Wu, F, Wang, ZB, Zhu, H, et al. Feasibility of US-guided high-intensity focused ultrasound treatment in patients with advanced pancreatic cancer: initial experience. Radiology 2005; 236: 1034–1040.Google Scholar
74. Illing, RO, Kennedy, JE, Wu, F, et al. The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumors in a western population. Br J Cancer 2005; 93: 890–895.Google Scholar
75. Wu, F, Wang, ZB, Chen, WZ, Bai, J, Zhu, H, Qiao, TY. Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy. J Urol 2003; 170: 2237–2240.Google Scholar
76. Thüroff, S, Chaussy, C, Vallancien, G, et al. High-intensity focused ultrasound and localized prostate cancer: efficacy results from the European multicentric study. J Endourol 2003; 17: 673–677.Google Scholar
77. Blana, A, Murat, FJ, Walter, B, et al. First analysis of the long-term results with transrectal HIFU in patients with localised prostate cancer. Eur Urol 2008; 53: 1194–1201.Google Scholar
78. Misraï, V, Rouprêt, M, Chartier-Kastler, E, et al. Oncologic control provided by HIFU therapy as single treatment in men with clinically localized prostate cancer. World J Urol 2008; 26: 481–485.Google Scholar
79. Uchida, T, Ohkusa, H, Yamashita, H, et al. Five years experience of transrectal high intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer. Int J Urol 2006; 13: 228–233.Google Scholar
80. Warmuth, M, Johansson, T, Mad, P. Systematic review of the efficacy and safety of high-intensity focussed ultrasound for the primary and salvage treatment of prostate cancer. Eur Urol 2010; 58: 803–815.Google Scholar
81. EDAP TMS. EDAP updates on FDA advisory committee meeting on Ablatherm-HIFU for the treatment of prostate cancer. 2014. http://investor.edap-tms.com/releasedetail.cfm?ReleaseID=863185#top (accessed August 26, 2014).
82. Partanen, A, Yerram, NK, Trivedi, H, et al. Magnetic resonance imaging (MRI)-guided transurethral ultrasound therapy of the prostate: a preclinical study with radiological and pathological correlation using customized MRI-based moulds. BJU Int 2013; 508–516.Google Scholar
83. Siddiqui, K, Chopra, R, Vedula, S, et al. MRI-guided transurethral ultrasound therapy of the prostate gland using real-time thermal mapping: initial studies. Urology 2010; 76: 1506–1511.Google Scholar
84. Chopra, R, Colquhoun, A, Burtnyk, M, et al. MR imaging-controlled transurethral ultrasound therapy for conformal treatment of prostate tissue: initial feasibility in humans. Radiology 2012; 265: 303–313.Google Scholar
85. Payne, A, Merrill, R, Minalga, E, et al. Design and characterization of a laterally mounted phased-array transducer breast-specific MRgHIFU device with integrated 11-channel receiver array. Med Phys 2012; 39: 1552–1560.Google Scholar
86. Mougenot, C, Tillander, M, Koskela, J, Kohler, MO, Moonen, C, Ries, M. High intensity focused ultrasound with large aperture transducers: a MRI based focal point correction for tissue heterogeneity. Med Phys 2012; 39: 1936–1945.Google Scholar
87. Gianfelice, D, Khiat, A, Boulanger, Y, Amara, M, Belblidia, A. Feasibility of magnetic resonance imaging-guided focused ultrasound surgery as an adjunct to tamoxifen therapy in high-risk surgical patients with breast carcinoma. J Vasc Interv Radiol 2003; 14: 1275–1282.Google Scholar
88. Wu, F, Wang, ZB, Zhu, H, et al. Extracorporeal high intensity focused ultrasound treatment for patients with breast cancer. Breast Cancer Res Treat 2005; 92: 51–60.Google Scholar
89. Wu, F, Wang, ZB, Cao, YD, et al. “Wide local ablation” of localized breast cancer using high intensity focused ultrasound. J Surg Oncol 2007; 96: 130–136.Google Scholar
90. Fukuda, H, Ito, R, Ohto, M, et al. Treatment of small hepatocellular carcinomas with US-guided high intensity focused ultrasound. Ultrasound Med Biol 2011; 37: 1222–1229.Google Scholar
91. Sibille, A, Prat, F, Chapelon, JY, et al. Extracorporeal ablation of liver tissue by high-intensity focused ultrasound. Oncology 1993; 50: 375–379.Google Scholar
92. Fischer, K, Gedroyc, W, Jolesz, FA. Focused ultrasound as a local therapy for liver cancer. Cancer J 2010; 16: 118–124.Google Scholar
93. Quesson, B, Merle, M, Köhler, MO, et al. A method for MRI guidance of intercostal high intensity focused ultrasound ablation in the liver. Med Phys 2010; 37: 2533–2540.Google Scholar
94. Jung, SE, Cho, SH, Jang, JH, Han, JY. High-intensity focused ultrasound ablation in hepatic and pancreatic cancer: complications. Abdom Imaging 2011; 36: 185–195.Google Scholar
95. Ng, KK, Poon, RT, Chan, SC, et al. High-intensity focused ultrasound for hepatocellular carcinoma: a single-center experience. Ann Surg 2011; 253: 981–987.Google Scholar
96. Wu, F, Wang, ZB, Chen, WZ, et al. Advanced hepatocellular carcinoma: treatment with high-intensity focused ultrasound ablation combined with transcatheter arterial embolization. Radiology 2005; 235: 659–667.Google Scholar
97. Chen, W, Zhu, H, Zhang, L, et al. Primary bone malignancy: effective treatment with high-intensity focused ultrasound ablation. Radiology 2010; 255: 967–978.Google Scholar
98. Liberman, B, Gianfelice, D, Inbar, Y, et al. Pain palliation in patients with bone metastases using MR-guided focused ultrasound surgery: a multicenter study. Ann Surg Oncol 2009; 16: 140–146.Google Scholar
99. Hurwitz, MD, Ghanouni, P, Kanaev, SV, et al. Magnetic resonance-guided focused ultrasound for patients with painful bone metastases: phase III trial results. J Natl Cancer Inst 2014; 106: 1–9.Google Scholar
100. Borasi, G, Melzer, A, Russo, G, et al. Cancer therapy combining high-intensity focused ultrasound and megavoltage radiation. Int J Radiat Oncol Biol Phys 2014; 89: 926–927.Google Scholar
101. Salgaonkar, VA, Prakash, P, Rieke, V, et al. Model based feasibility assessment and evaluation of prostate hyperthermia with a commercial MR-guided endorectal HIFU ablation array. Med Phys 2014; 41: 033301.Google Scholar
102. Phenix, CP, Togtema, M, Pichardo, S, Zehbe, I, Curiel, L. High intensity focused ultrasound technology, its scope and applications in therapy and drug delivery. J Pharm Sci 2014; 17: 136–153.Google Scholar
103. Hancock, HA, Smith, LH, Cuesta, J, et al. Investigations into pulsed high-intensity focused ultrasound-enhanced delivery: preliminary evidence for a novel mechanism. Ultrasound Med Biol. 2009; 35: 1722–1736.CrossRefGoogle Scholar
104. Ranjan, A, Jacobs, GC, Woods, DL, et al. Image-guided drug delivery with magnetic resonance guided high intensity focused ultrasound and temperature sensitive liposomes in a rabbit Vx2 tumor model. J Control Release 2012; 158: 487–494.Google Scholar
105. Gasselhuber, A, Dreher, MR, Partanen, A, et al. Targeted drug delivery by high intensity focused ultrasound mediated hyperthermia combined with temperature-sensitive liposomes: computational modelling and preliminary in vivo validation. Int J Hyperthermia 2012; 28: 337–348.Google Scholar
106. Treat, LH, McDannold, N, Vykhodtseva, N, Zhang, Y, Tam, K, Hynynen, K. Targeted delivery of doxorubicin to the rat brain at therapeutic levels using MRI-guided focused ultrasound. Int J Cancer 2007; 121: 901–907.Google Scholar
107. Sheikov, N, McDannold, N, Vykhodtseva, N, Jolesz, F, Hynynen, K. Cellular mechanisms of the blood–brain barrier opening induced by ultrasound in presence of microbubbles. Ultrasound Med Biol 2004; 30: 979–989.Google Scholar
108. Hynynen, K, McDannold, N, Vykhodtseva, N, Jolesz, FA. Noninvasive MR imaging-guided focal opening of the blood–brain barrier in rabbits. Radiology 2001; 220: 640–646.Google Scholar
109. Kinoshita, M, McDannold, N, Jolesz, FA, Hynynen, K. Targeted delivery of antibodies through the blood–brain barrier by MRI-guided focused ultrasound. Biochem Biophys Res Commun 2006; 340: 1085–1090.Google Scholar
110. Marquet, F, Tung, YS, Teichert, T, Ferrera, VP, Konofagou, EE. Noninvasive, transient and selective blood–brain barrier opening in non-human primates in vivo. PLoS ONE 2011; 6: e22598.Google Scholar
111. Aryal, M, Vykhodtseva, N, Zhang, YZ, Park, J, McDannold, N. Multiple treatments with liposomal doxorubicin and ultrasound-induced disruption of blood–tumor and blood–brain barriers improve outcomes in a rat glioma model. J Control Release 2013; 169: 103–111.Google Scholar
112. Alonso, A, Reinz, E, Leuchs, B, et al. Focal delivery of AAV2/1-transgenes into the rat brain by localized ultrasound-induced BBB opening. Mol Ther Nucleic Acids 2013; 2: e73.Google Scholar
113. Park, EJ, Zhang, YZ, Vykhodtseva, N, McDannold, N. Ultrasound-mediated blood–brain/blood–tumor barrier disruption improves outcomes with trastuzamab in a breast cancer brain metastasis model. J Control Release 2012; 163: 277–284.Google Scholar
114. Kinoshita, M, McDannold, N, Jolesz, FA, Hynynen, K. Noninvasive localized delivery of Herceptin to the mouse brain by MRI-guided focused ultrasound-induced blood–brain barrier disruption. Proc Natl Acad Sci USA 2006; 103: 11719–11723.Google Scholar

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