ELECTRONIC BEAM STEERING USED WITH ATOROIDAL HIFU TRANSDUCER SUBSTANTIALLY INCREASES THE COAGULATED VOLUME JEREMYVINCENOT,DAVIDMELODELIMA,FRANCOISECHAVRIER,ALEXANDREVIGNOT,ANTHONYKOCOT,

lated volume. When all the elements are working in phase for 40 s, a volume of 6–8 cm 3 can be ablated. However, the mechanical juxtaposition of single lesions is still necessary for treating one tumor with a diameter of 2 cm. The objective of this study was to combine this toroidal transducer geometry with electronic beam steering to ablate tumors with adequate normal tissue margins and without any mechanical displacement of the high-intensity focused ultrasound device. In vitro tests demonstrated that the coagulated volume obtained from 130 s of total exposure has an average diameter of 41.4 ± 4.0 mm and an average length of 53.3 ± 6.1 mm. This single lesion can be used to treat various size of metastasis, located at depths in the liver ranging 5–45 mm. (E-mail: Jeremy. Vincenot@inserm.fr) 2013 World Federation for Ultrasound in Medicine & Biology.

[1]  F. Lammert,et al.  Parenchyma-preserving hepatic resection for colorectal liver metastases , 2012, Langenbeck's Archives of Surgery.

[2]  J. Chapelon,et al.  Assisted hepatic resection using a toroidal HIFU device: an in vivo comparative study in pig. , 2011, Medical physics.

[3]  S. Meijer,et al.  The impact of intraoperative ultrasonography on the surgical treatment of patients with colorectal liver metastases , 2010, Surgical Endoscopy.

[4]  J. Chapelon,et al.  Thermal ablation produced using a surgical toroidal high-intensity focused ultrasound device is independent from hepatic inflow occlusion , 2009, Physics in medicine and biology.

[5]  Hui Zhu,et al.  High intensity focused ultrasound (HIFU) therapy for local treatment of hepatocellular carcinoma: role of partial rib resection. , 2009, European journal of radiology.

[6]  Ahmedin Jemal,et al.  International Trends in Colorectal Cancer Incidence Rates , 2009, Cancer Epidemiology Biomarkers & Prevention.

[7]  Parmentier Hubert,et al.  High-Intensity Focused Ultrasound Ablation for the Treatment of Colorectal Liver Metastases During an Open Procedure: Study on the Pig , 2009 .

[8]  Bernard Rachet,et al.  Cancer survival in five continents: a worldwide population-based study (CONCORD). , 2008, The Lancet. Oncology.

[9]  Dominique Cathignol,et al.  Treatment of esophageal tumors using high intensity intraluminal ultrasound: first clinical results , 2008, Journal of Translational Medicine.

[10]  Chris J Diederich,et al.  Transurethral ultrasound applicators with dynamic multi-sector control for prostate thermal therapy: in vivo evaluation under MR guidance. , 2008, Medical physics.

[11]  J. Chapelon,et al.  Toric HIFU Transducer for Large Thermal Ablation , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[12]  Wen-Zhi Chen,et al.  “Wide local ablation” of localized breast cancer using high intensity focused ultrasound , 2007, Journal of surgical oncology.

[13]  D. Morris,et al.  Recurrence and Survival Outcomes after Hepatic Resection with or without Cryotherapy for Liver Metastases from Colorectal Carcinoma , 2007, Annals of surgical oncology.

[14]  Laura Curiel,et al.  Control of prostate cancer by transrectal HIFU in 227 patients. , 2007, European urology.

[15]  Constantin Coussios,et al.  High intensity focused ultrasound: Physical principles and devices , 2007, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[16]  G Montaldo,et al.  Compensating for bone interfaces and respiratory motion in high-intensity focused ultrasound , 2007, International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group.

[17]  E. Dixon,et al.  Current role of radiofrequency ablation for the treatment of colorectal liver metastases , 2006, The British journal of surgery.

[18]  E. Sigurdson,et al.  Liver-directed therapies for patients with primary liver cancer and hepatic metastases , 2006, Current treatment options in oncology.

[19]  C D Claussen,et al.  Magnetic resonance imaging for hepatic radiofrequency ablation. , 2006, European journal of radiology.

[20]  Z. Hamady,et al.  Resection margin in patients undergoing hepatectomy for colorectal liver metastasis: a critical appraisal of the 1cm rule. , 2006, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[21]  R.T. Held,et al.  Annular phased-array high-intensity focused ultrasound device for image-guided therapy of uterine fibroids , 2006, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[22]  Toyoaki Uchida,et al.  Treatment of localized prostate cancer using high‐intensity focused ultrasound , 2006, BJU international.

[23]  F V Gleeson,et al.  The safety and feasibility of extracorporeal high-intensity focused ultrasound (HIFU) for the treatment of liver and kidney tumours in a Western population , 2005, British Journal of Cancer.

[24]  Hui Zhong,et al.  Focused beam control for ultrasound surgery with spherical-section phased array: sound field calculation and genetic optimization algorithm. , 2005, IEEE transactions on ultrasonics, ferroelectrics, and frequency control.

[25]  Guy Marchal,et al.  Local Recurrence After Hepatic Radiofrequency Coagulation: Multivariate Meta-Analysis and Review of Contributing Factors , 2005, Annals of surgery.

[26]  Kullervo Hynynen,et al.  MR imaging-controlled focused ultrasound ablation: a noninvasive image-guided surgery. , 2005, Magnetic resonance imaging clinics of North America.

[27]  Evelyne M. Loyer,et al.  Effect of Surgical Margin Status on Survival and Site of Recurrence After Hepatic Resection for Colorectal Metastases , 2005, Annals of surgery.

[28]  Wen-Zhi Chen,et al.  Advanced hepatocellular carcinoma: treatment with high-intensity focused ultrasound ablation combined with transcatheter arterial embolization. , 2005, Radiology.

[29]  D. Cathignol,et al.  Cancer treatment by ultrasound: Increasing the depth of necrosis , 2004 .

[30]  Kenneth Hess,et al.  Recurrence and Outcomes Following Hepatic Resection, Radiofrequency Ablation, and Combined Resection/Ablation for Colorectal Liver Metastases , 2004, Annals of surgery.

[31]  Luigi Solbiati,et al.  Guidance and monitoring of radiofrequency liver tumor ablation with contrast-enhanced ultrasound. , 2004, European journal of radiology.

[32]  Alban Denys,et al.  Total and segmental liver volume variations: implications for liver surgery. , 2004, Surgery.

[33]  L H Blumgart,et al.  Segment-oriented approach to liver resection. , 2004, The Surgical clinics of North America.

[34]  Takashi Azuma,et al.  Effect of split-focus approach on producing larger coagulation in swine liver. , 2003, Ultrasound in medicine & biology.

[35]  K Hynynen,et al.  MRI-guided gas bubble enhanced ultrasound heating in in vivo rabbit thigh. , 2003, Physics in medicine and biology.

[36]  M. Rivoire,et al.  Combination of neoadjuvant chemotherapy with cryotherapy and surgical resection for the treatment of unresectable liver metastases from colorectal carcinoma , 2002, Cancer.

[37]  F. Chavrier,et al.  1.5-D high intensity focused ultrasound array for non-invasive prostate cancer surgery , 2002, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[38]  Roland Materne,et al.  Body surface area and body weight predict total liver volume in Western adults , 2002, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[39]  D E Dupuy,et al.  Image-guided radiofrequency tumor ablation: challenges and opportunities--part I. , 2001, Journal of vascular and interventional radiology : JVIR.

[40]  W. Jarnagin,et al.  Recent advances in hepatic resection. , 2000, Seminars in surgical oncology.

[41]  J. Chapelon,et al.  Modeling of high-intensity focused ultrasound-induced lesions in the presence of cavitation bubbles , 2000, The Journal of the Acoustical Society of America.

[42]  D. Morris,et al.  Indicators of recurrence following cryotherapy for hepatic metastases from colorectal cancer , 1999, The British journal of surgery.

[43]  P. Lavin,et al.  Surgical margin in hepatic resection for colorectal metastasis: a critical and improvable determinant of outcome. , 1998, Annals of surgery.

[44]  C. Damianou,et al.  Dependence of ultrasonic attenuation and absorption in dog soft tissues on temperature and thermal dose. , 1997, The Journal of the Acoustical Society of America.

[45]  Oleg A. Sapozhnikov,et al.  Lamb waves in piezoelectric focused radiator as a reason for discrepancy between O’Neil’s formula and experiment , 1997 .

[46]  W. Dewey,et al.  Thermal dose determination in cancer therapy. , 1984, International journal of radiation oncology, biology, physics.

[47]  H. O'neil Theory of Focusing Radiators , 1949 .

[48]  H H PENNES,et al.  Temperature of skeletal muscle in cerebral hemiplegia and paralysis agitans. , 1949, Archives of neurology and psychiatry.

[49]  Michael A Choti,et al.  Expanding criteria for resectability of colorectal liver metastases. , 2008, The oncologist.

[50]  E. Abdalla,et al.  New paradigm in the management of liver-only metastases from colorectal cancer. , 2007, Gastrointestinal cancer research : GCR.

[51]  R. Lovegrove,et al.  Meta-analysis of clinical outcome after first and second liver resection for colorectal metastases. , 2007, Surgery.

[52]  F. Chavrier,et al.  Experimental evaluation of lesion prediction modelling in the presence of cavitation bubbles: Intended for high-intensity focused ultrasound prostate treatment , 2006, Medical and Biological Engineering and Computing.

[53]  T. Pawlik,et al.  Combined Resection and Radiofrequency Ablation for Advanced Hepatic Malignancies: Results in 172 Patients , 2003, Annals of Surgical Oncology.

[54]  W R Lees,et al.  Minimally invasive treatment of malignant hepatic tumors: at the threshold of a major breakthrough. , 2000, Radiographics : a review publication of the Radiological Society of North America, Inc.

[55]  Z. Tang,et al.  [Hepatic resection with removal of tumor thrombi for hepatocellular carcinoma with tumor thrombi in portal vein and curative analysis]. , 1999, Zhonghua wai ke za zhi [Chinese journal of surgery].

[56]  F. Duck Physical properties of tissue , 1990 .