Summary
This journal documents a noteworthy case of noninvasive tumor ablation using high-intensity focused ultrasound (HIFU) as a curative treatment for renal tumors. The study presents a detailed examination of a patient with renal cell carcinoma who underwent HIFU treatment, followed by an extended follow-up period to assess the outcomes.
HIFU treatment was administered using specialized equipment, involving ultrasound waves generated by a cylindrical piezoelectric element focused by a paraboloid reflector. The patient received HIFU treatment for three tumors in separate sessions, with the option of general anesthesia or sedation analgesia. Subsequent magnetic resonance imaging (MRI) was employed to track the progress over 6 months.
The results of this treatment were promising, with post-treatment MRI scans revealing the successful necrosis of two of the three tumors within a relatively short time frame. For 6 months, these necrotic areas exhibited a continued reduction in size. However, the tumor located in the upper kidney pole remained unaffected due to ultrasound energy being absorbed by intervening ribs. It was noted that applying high-energy levels of focused ultrasound required general anesthesia for patient comfort and safety. The absorption of high-intensity focused ultrasound in the tissue led to well-defined thermonecrotic zones.
This study is situated within a broader context of research spanning five decades, exploring the application of HIFU for various medical indications, including the brain, eyes, prostate, liver, and bladder. While HIFU has been employed experimentally for renal tumors, only a limited number of clinical studies have demonstrated effective tissue ablation.
In conclusion, this case study underscores the potential of HIFU as a noninvasive and effective treatment for renal tumors when specific conditions, including precise energy coupling, adequate ultrasound energy levels, and the use of general anesthesia, are met. This research contributes valuable insights into the evolving field of HIFU applications for medical purposes and may pave the way for more widespread use.
