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The Thermal Ablation with MRgFUS: From Physics to Oncological Applications.

Authors: Leporace M, Calabria FF, Siciliano R, Capalbo C, Filippiadis DK, Iezzi R

The growing interest in minimal and non-invasive therapies, especially in the field of cancer treatment, highlights a significant shift toward safer and more effective options. Ablative therapies are well-established tools in cancer treatment, with known effects including locoregional control, while their role as modulators of the systemic immune response against cancer is emerging. The HIFU developed with magnetic resonance imaging (MRI) guidance enables treatment precision, improves real-time procedural control, and ensures accurate outcome assessment. Magnetic Resonance-guided Focused Ultrasound (MRgFUS) induces deep coagulation necrosis within an elliptical focal area, effectively encompassing the entire tumor site and allowing for highly targeted radical ablation. The applications of MRgFUS in oncology are rapidly expanding, offering pain relief and curative treatment options for bone metastatic lesions. Additionally, the MRgFUS plays an effective role in targeted optional therapies for early prostate and breast cancers. Emerging research also focuses on the potential uses in treating abdominal cancers and harnessing capabilities to stimulate immune responses against tumors or to facilitate the delivery of anticancer drugs. This evolving landscape presents exciting opportunities for improving patient outcomes and advancing cancer treatment methodologies. In neuro-oncology, MRgFUS utilizes low-intensity focused ultrasound (LIFU) along with intravenous microbubbles to open the blood-brain barrier (BBB) and enhance the intra-tumoral delivery of chemotherapy drugs.

Introduction

Purpose Thermal ablation
Study Objective To briefly review the physical principles, technical aspects, and current and prospective oncologic applications of Magnetic Resonance-guided Focused Ultrasound (MRgFUS).
Disease model Cancer
MRI or image guidance method Magnetic Resonance-guided (MRI-guided)
Cargo name and characteristics Anticancer chemotherapy drugs (small-molecule chemotherapeutic agents; unspecified) intended for enhanced intratumoral delivery

Outcomes and Safety

Summary of Outcomes MRgFUS using high-intensity FUS (HIFU) produces deep coagulative necrosis enabling targeted tumor ablation and pain relief (notably for bone metastases and selected early prostate and breast cancers), while low-intensity FUS (LIFU) combined with intravenous microbubbles transiently opens the blood–brain barrier to enhance intratumoral chemotherapy delivery and may stimulate anti-tumor immune responses; successful parameter modalities reported: HIFU for ablation and LIFU + microbubbles for BBB opening/drug delivery.
Safety-related matter The provided text does not report any adverse effects or safety issues; it emphasizes MRgFUS as a safer, minimally/non-invasive and precise treatment option with improved procedural control.

Brain Region

Visualization unavailable

Ultrasound Parameters

Focal Characteristics Focal depth: None; Focal length: None; Aperture size: None

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