Liver Tumor Article

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Very interesting

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Yes, I just heard about this technique the other day. Sounds like cool technology. Any of our @HealthExperts want to offer a quick explanation and the instances in which this could be best used (and where it is is maybe not as useful)?

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Wow this is close to a miracle. 96% success rate. Painless and quick.

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Is even this possible?

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Just to provide a bit more context, this is not a miracle cure for all liver cancers. It is likely that they have picked particular patients where this technique is most appropriate. Looking around, it seems like they have to be relatively small, easy to see on ultrasound, not many metastases, and it’s in a good spot for pointing the high intensity shockwaves into. I’m also not sure what they define as success in this study (it’s behind a paywall).

Again, happy for any @HealthExperts to provide further information.

TT

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Histotripsy is intended to reduce the tumor size for liver cancers, called ‘loco-regional therapy’, just like the intended use for microwave ablation or radio-frequency ablation. There is not enough data to support its use as a curative treatment for liver cancer, like what resection or liver transplant can achieve. In the HOPE4Liver trial https://pubs.rsna.org/doi/full/10.1148/radiol.233051 ‘Success’ was defined by procedural success of complete tumor coverage upon imaging at 36 hours. Note that the study did not look at clinical outcomes such as survival and time to progression.

Histotripsy works by using focused ultrasound wave to produce controlled acoustic cavitation (= holes or empty spaces) that mechanically destroys and liquifies targeted liver tissue without heating. The advantage is that it can be used for liver masses that could not be treated by radiofrequency ablation due to the proximity to major liver structures e.g., an artery or gallbladder. The masses cannot be too big - the trial inclusion set the upper limit of 3cm, and up to 3 lesions could be treated at each session. The individual would need reasonably preserved liver function to receive this treatment. As the procedure needs to be done under general anaesthesia, the general health status is also a key consideration.

Hope this helps!

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Thanks Loey! Just an introduction for the community, Loey is a super-star gastroenterologist based in Hong Kong, who has been part of carrying out many clinical trials of Hep B therapies - Department of Medicine

We are super lucky to have her contributions to this site!

TT

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Thanks Thomas for the kind introduction! This is a brilliant platform. I am happy to contribute to the best of my knowledge.

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Hello Dr. Loey, my name is Fu Ming, and I am in Shanghai. I have sent you an email, the main idea of which is: “I believe a similar platform is needed on the mainland too.” I hope you can see the email. Thank you very much!

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Hi @FUMING,

Thanks for your representation of China and making sure the needs of all communities are met. We’re finalising the implementation of a plug-in that should facilitate the automatic translation of all of the posts to your default language. This should help bridge some of these aspects, please stay tuned!

Cheers,

Thomas

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Wow, this is amazing!

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