HIFU ultrasonic knife

Many people have not heard of the term "HIFU", but it is used more and more widely in life. It can be used in various surgeries, especially in liver tumors, uterine fibroids and the increasingly popular medical cosmetic surgeries. The HIFU surgical procedure uses focused ultrasound to penetrate the body. It is an advanced surgical method with a very high safety factor and deserves to be widely promoted and applied.

"HIFU knife" is also called "ultrasound focused knife", which is the translation of "high-intensity focused ultrasound tumor treatment system (High-intensity focused ultrasound)". The English abbreviation is "HIFU", which is a new technology that can kill tumors in the body without cutting the skin or puncturing. Some people also call it "non-invasive surgery." During treatment, only analgesics and sedatives are administered intravenously. During the treatment, the dosage of analgesics and sedatives is controlled so that the patient can always communicate with the doctor, reducing the risk of anesthesia-related complications and damage to adjacent organs.

Cancer patients

2. Principle

Just like sunlight can be focused through a convex lens, ultrasound can also be focused and can safely penetrate the body. The ablation principle of the HIFU knife is to use these characteristics of ultrasound to focus low-energy ultrasound into the body, focusing the knife with sufficient intensity in the "focal" area to form an instantaneous high temperature of 65℃ to 100℃. At the same time, the inherent characteristics of ultrasound - cavitation effect, mechanical effect, etc., lead to tissue coagulative necrosis and destroy the tissue in the treatment area. The necrotic tissue may gradually be absorbed or turn into scar.

3. Indications

1. Liver tumor

Benign and malignant liver tumors.

2. Pancreatic cancer

Pancreatic cancer without jaundice or after jaundice-reducing treatment.

3. Soft tissue tumors

Benign and malignant soft tissue tumors.

4. Uterine fibroids

5. Others

Retroperitoneal or abdominal or pelvic solid tumors with good ultrasound channels.

Contraindications

1. Tumors of air-containing hollow organs, such as the intestines and stomach.

2. Central nervous system tumors.

3. When there is skin ulceration or infection in the treatment area.

4. The skin in the treatment-related area has received radiotherapy of more than 45 Gy.

5. When there is significant calcification of the arterial wall in the channel of ultrasound treatment.

6. Patients with failure of important organs.

7. Patients with severe coagulation disorders.

8. Patients who cannot tolerate corresponding anesthesia.

9. Tumors that cannot be clearly displayed by the mechanical positioning imaging system.

5. Advantages

The main advantages include: no surgery, no bleeding, and no restrictions on tumor size or shape. Generally, a one-time treatment is adopted, and recovery after surgery is quick and the immune system can be activated. There is no radiation or chemical damage, and the problem of tumor insensitivity encountered in radiotherapy and chemotherapy will not occur. The treatment can be repeated, and a planned segmented treatment can be implemented. Radical treatment can be used for early-stage lesions, and palliative treatment can be used for late-stage lesions to effectively reduce the tumor burden. It can also be combined with other treatments such as radiotherapy and chemotherapy and will not conflict with other treatments. In addition, HIFU treatment for breast tumors, bone tumors, and uterine fibroids also has the advantages of preserving the original shape of the breast, preserving the limbs, and preserving the uterus.

Effect evaluation

Since it takes some time for the tumor to shrink after HIFU ablation treatment, the change in volume cannot indicate the effectiveness of the ablation. Currently, the international evaluation of the effectiveness of ablation treatment is mainly based on checking whether there is blood supply in the tumor to determine whether the tumor is still active. The ideal ablation treatment effect should be manifested as a lack of blood supply to the tumor, that is, the tumor has been completely necrotic. Currently, the commonly used clinical examination methods include: magnetic resonance imaging (MRI), enhanced CT, ultrasound angiography, etc.

complication

The complications of HIFU surgery vary depending on the surgical site. Overall, the incidence is still very low, and some complications can be avoided or alleviated through a series of preventive measures. Most of them can be recovered.

Possible complications mainly include: skin damage, secondary infection, damage to tissues and organs close to the treatment area, etc.