Journal of Gastrointestinal Oncology, Год журнала: 2024, Номер 15(6), С. 2739 - 2742
Опубликована: Дек. 1, 2024
Journal of Gastrointestinal Surgery, Год журнала: 2025, Номер unknown, С. 102000 - 102000
Опубликована: Фев. 1, 2025
Histotripsy is a novel, non-invasive, non-ionizing, non-thermal approach using focused ultrasound waves to treat liver tumors. The technology received FDA De Novo grant in late 2023. We aim provide the first reporting of post-trial, real-world clinical safety data. Safety outcomes within 30 days histotripsy were collected since clearance (12/22/2023 - 7/25/2024). All centers who have performed invited participate. Complications requiring treatment graded Clavien-Dindo and Comprehensive Index (CCI). In total, 295 patients 510 tumors at 18 centers. Treated tumor types included colorectal metastases (n=140), neuroendocrine (n=46), hepatocellular carcinoma (n=31), pancreas (n=30), breast (n=26). most common number treated per procedure 1 (n=170), 2 (n=69), 3 (n=37). Tumors all 8 segments. data was available for 230 from 9 A total 12 out experienced complications any grade (5.2%). Most (n=9, 75%) minor (< Grade II). Median mean CCI 0 (IQR 0-0) points (95%CI 0-0.75). three major (>Clavien-Dindo II, 1.3%) death disease progression. these had undergone with palliative intent known advanced intra- extrahepatic disease. This report on therapeutic use well tolerated few overall rare serious indicating profile which compares favorably other liver-directed surgical therapies Long-term follow-up including oncologic are being collected.
Язык: Английский
Процитировано
2
Artificial Intelligence Surgery, Год журнала: 2025, Номер 5(1), С. 65 - 72
Опубликована: Фев. 5, 2025
This editorial announces the need for a consensus conference on definitions of surgical nomenclature, which is evolving due to introduction non-human (hardware, software) devices and applications, including robotics. A recently created entity, Artificial Intelligence Organization Next Generation Surgeons (AIONS), comprised primarily AIS board members, has proposed updated following terms: surgery, endoluminal percutaneous robots, robotic-assisted surgery (RAS), remote artificial intelligence (AIS), robotic surgomics, non-invasive surgery. These will be discussed during Consensus Conference Definitions Intelligence, Surgery, Surgomics Robotics, scheduled February 12, 2025.
Язык: Английский
Процитировано
0
Ultrasound in Medicine & Biology, Год журнала: 2025, Номер unknown
Опубликована: Фев. 1, 2025
Histotripsy is a non-invasive acoustic ablation technique that leverages cavitation to impart mechanical damage viscoelastic medium, such as tissue. Although histotripsy bubbles and lesions can be imaged with variety of modalities, reliable methods predict tissue disruption across different tissue-types remain determined. Several ex-vivo bovine tissues were ablated by intrinsic threshold over range pulse-per-location doses. Acoustic Cavitation Emission (ACE) signals captured following every other therapeutic pulse using transmit-receive capable arrays. Final bubble lifespan, lifespan-slope, percent-reduction calculated correlated against histologic necrosis score (0-5: 0=0% necrosis, 5=>95% necrosis) residual structure (0-4: 0=none present, 4=intact) evaluate the ability features from ACE-signals histotripsy-induced damage. Further, optimal ACE-feature thresholds determined for binary evaluation whether equal or greater than 4 had been reached. Measured lifespans increased lifespan-slopes decreased pulses per location (ppl) eventually plateaued in all types, similar trends those previously observed phantoms. Necrosis increasing dose. Bubble lifespan-slope well score. Thresholds able brain, liver, kidney high sensitivity/specificity (>80%). The 5 expected correspond near-complete/complete histological evaluation. Features measured ACE-signals, particularly percent reduction, used large-volume treatments ex vivo kidney, brain good accuracy. Tissue heterogeneities impact corresponding thus predication
Язык: Английский
Процитировано
0
Frontiers in Surgery, Год журнала: 2025, Номер 12
Опубликована: Март 6, 2025
Hepatocellular carcinoma (HCC) is increasing in prevalence globally, and cure remains limited with non-operative treatment. Surgical intervention, through resection or transplantation, offers a potential for select patients. However, many patients present advanced unresectable disease, recurrence rates remain high. Recent advances systemic therapies, particularly immune checkpoint inhibitors, have demonstrated promise treating HCC as adjuvant therapy. Evidence from trials highlights the synergistic of combined liver-directed therapies. These findings ignited growing interest neoadjuvant therapy across various scenarios: (1) bridging strategy while awaiting (2) downstaging disease to enable (3) converting resectable state, (4) treatment operable cases. Early-stage reported promising outcomes. To realize HCC, thoughtfully designed, adequately powered, multi-center clinical are essential.
Язык: Английский
Процитировано
0
Cancers, Год журнала: 2025, Номер 17(6), С. 915 - 915
Опубликована: Март 7, 2025
Background/Objective: Hepatocellular carcinoma (HCC) is an aggressive disease that known to be resistant conventional chemotherapy and radiotherapy. While surgical resection transarterial therapy can improve overall survival, the biological aspects of HCC contribute complexity its management limit effectiveness current treatment options. The purpose this scoping review identify limitations currently available therapies for explore emerging role histotripsy could play in addressing these limitations, with intent informing direction future research clinical management. Methods: PRISMA checklist reviews was followed structure review, a systematic search conducted following online databases: PubMed/MEDLINE (National Library Medicine), Embase (Elsevier), Scopus (Elsevier). Results: evidence supports offers several key advantages address strategies HCC. Clinical trials have highlighted ability technology destroy solid tumors induce remission minimal side effects. In addition, preclinical studies point potent immunostimulatory effects histotripsy, including induction abscopal This poses significant promise treating tumor metastasis as well improving regimens by combining immunotherapy. Future should aim overcome enhance outcomes patients. examines existing treatments HCC, emphasizing promising potential immunotherapy target metastatic advanced stages disease.
Язык: Английский
Процитировано
0
Cancers, Год журнала: 2025, Номер 17(7), С. 1100 - 1100
Опубликована: Март 25, 2025
Liver malignancies, both primary and metastatic tumors, are a major cause of cancer-related mortality. Colorectal cancer alone results in liver metastases nearly 50% patients, with approximately 85% presenting unresectable disease. Similarly, hepatocellular carcinoma intrahepatic cholangiocarcinoma frequently present at advanced stages, limiting curative options. Systemic therapies provide modest survival benefits, underscoring the need for alternative treatments. Locoregional approaches, such as thermal ablation chemoembolization, while effective, have notable limitations, including invasiveness, peri-procedural risks, requirement to interrupt systemic Histotripsy is novel, non-invasive method that uses focused ultrasound-induced cavitation enable precise tumor without heat or radiation. Our institution utilizes multidisciplinary board approach evaluate patients histotripsy, particularly cases involving disease, complex surgical candidacy, palliative intent related disease control symptom management, bridging therapy transplantation. Early results, preclinical data THERESA #HOPE4LIVER trials, highlight its efficacy treating tumors minimal complications. This review outlines institutional protocols covering pre- post-procedural along ethical considerations current treatment paradigms. As patient-centered approach, histotripsy offers novel option favorable safety profile compatibility therapies.
Язык: Английский
Процитировано
0
BMJ Case Reports, Год журнала: 2025, Номер 18(4), С. e264212 - e264212
Опубликована: Апрель 1, 2025
Pancreatic cancer is a malignancy with poor prognosis and overall response to systemic therapy. Moreover, patients locally advanced or unresectable tumours have historically worse outcomes compared those earlier stages of disease. We report case female patient in the fourth decade pancreatic adenocarcinoma, who received 12 cycles modified FOLFIRINOX (mFOLFIRINOX: fluorouracil/leucovorin/irinotecan/oxaliplatin) chemotherapy, followed by pancreaticoduodenectomy, resulting near complete pathological after definitive surgical treatment. Given lack indication for adjuvant therapy, she considered remission. The demonstrates that potentially curative resection can be viable sought-after treatment option and/or metastatic cancer, as it not readily available many due disease’s aggressive nature presence stage at diagnosis. It holds meaningful implications clinical practice promotes considerations future advancements strategies.
Язык: Английский
Процитировано
0
CardioVascular and Interventional Radiology, Год журнала: 2025, Номер unknown
Опубликована: Апрель 28, 2025
Abstract Purpose The purpose of this prospective, multi-centre, single-arm feasibility trial is to evaluate the technical success and safety profile HistoSonics System for treatment primary solid renal tumours using histotripsy. Methods/design CAIN will enrol up 20 patients with a non-metastatic tumour ≤ 3 cm treated Histotripsy non-thermal non-ionizing mechanical process tissue destruction resulting from targeted delivery focused ultrasound pulses. endpoints are freedom index procedure related major complications. Technical defined as complete coverage determined 36 h post-index by contrast-enhanced magnetic resonance imaging (MRI) or computerized tomography (CT). An complication Clavien-Dindo Classification Grade higher 30 days after last histotripsy procedure. Treated have follow-up visit performed at 14 days, 90 180 post-procedure. Trial Registration : Clinicaltrials.gov identifier NCT05432232 & NIHR CRN CPMS 53429. Graphical
Язык: Английский
Процитировано
0
Biomedicines, Год журнала: 2024, Номер 12(10), С. 2226 - 2226
Опубликована: Сен. 30, 2024
Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death worldwide with an average five-year survival rate in US 19.6%. With advent HBV and HCV treatment prevention, along rising rates obesity, nonalcoholic fatty liver disease (NAFLD) metabolic syndrome are set to overtake infectious causes as HCC. While surgical resection transplantation can be curative when amenable, commonly unresectable on presentation, other approaches mainstay therapy. In these patients, locoregional therapies have evolved a vital tool both palliation for advanced bridge transplantation. this review, we will exploring primary HCC patients NAFLD, including transarterial chemoembolization (TACE), bland embolization (TAE), radioembolization (TARE), percutaneous ablation.
Язык: Английский
Процитировано
1
Radiology, Год журнала: 2024, Номер 313(3)
Опубликована: Дек. 1, 2024
Язык: Английский
Процитировано
1