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J Ther Ultrasound. 2013 Aug 1;1:13. doi: 10.1186/2050-5736-1-13. eCollection 2013.

The road to clinical use of high-intensity focused ultrasound for liver cancer: technical and clinical consensus.

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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.
Radiological Sciences Laboratory, Stanford University School of Medicine, Palo Alto, CA, USA.
Imaging Division, University Medical Center Utrecht, Amsterdam, The Netherlands.
Division of Radiotherapy and Imaging, The Institute of Cancer Research, Royal Marsden Hospital, Sutton, Surrey, UK.
Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Philips Healthcare, Boston, MA, USA.
Ultrasound Innovations Applications, Siemens Healthcare, Issaquah, WA, USA.
InSightec Ltd, 5 Nahum Heth Street, Haifa, Israel.
Chongqing Haifu Medical Technology Co., Ltd, Chongqing, China.
Focused Ultrasound Foundation, Charlottesville, VA, USA.
University of Rome, La Sapienza, Rome, Italy.
Digestive Disease Center, University of Washington, Seattle, WA, USA.
Institute of Ultrasonic Engineering in Medicine, Chongqing Medical University, Chongqing, China.
Clinical Center for Tumor Therapy, Second Affiliated Hospital of Chongqing University of Medical Sciences, Chongqing, China.
Institute for Medical Science and Technology, University of Dundee, Dundee, Scotland, UK.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Medicine, Imperial College, South Kensington Campus, Exhibition Rd, London SW7 2AZ, UK ; Saint Mary's Hospital, Praed St, W2 1NY, London, UK.


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.


Focused ultrasound; High-intensity ultrasound; Liver cancer; Non-invasive surgery; Ultrasound

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