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Narendra T. Sanghvi - One of the best experts on this subject based on the ideXlab platform.

  • High Intensity Focused Ultrasound Renal Tissue Ablation: A Laparoscopic Porcine Model
    The Journal of urology, 2008
    Co-Authors: Marcelo A. Orvieto, Narendra T. Sanghvi, Kevin C. Zorn, Mark B. Lyon, Stephen R. Tolhurst, David E. Rapp, Ralf Seip, Arieh L. Shalhav
    Abstract:

    Purpose: High intensity Focused Ultrasound for renal lesions is still experimental. In a porcine model we evaluated the safety and efficacy of a newly designed laparoscopic high intensity Focused Ultrasound probe and software that allows real-time Ultrasound guidance during renal tissue ablation.Materials and Methods: A Sonatherm® 600 high intensity Focused Ultrasound system with a newly designed laparoscopic high intensity Focused Ultrasound probe was used through a standard Endopath® 18 mm port. A total of 16 lesions were created in 15 kidneys in a total of 8 animals and randomized into 2 groups, including acute with sacrifice 4 days postoperatively and subacute with sacrifice 14 days postoperatively. Lesion size and location varied for each surgical procedure to simulate various treatment scenarios.Results: Mean ± SD planned ablation volume was 7.1 ± 5.1 cc and mean treatment time was 7.2 ± 06.88 minutes. For all lesions an injury volume was observed with a central zone of complete necrosis and no viab...

  • Laparoscopic Partial Kidney Ablation With High Intensity Focused Ultrasound
    The Journal of urology, 2003
    Co-Authors: Ryan F. Paterson, Eric Barret, Tibério M. Siqueira, Thomas A. Gardner, Jahan Tavakkoli, Victor V. Rao, Narendra T. Sanghvi, Liang Cheng, Arieh L. Shalhav
    Abstract:

    Purpose: High intensity Focused Ultrasound has been performed for transrectal and extracorporeal thermal ablation of tissues. We developed and tested a laparoscopic probe that allows real-time Ultrasound imaging during partial renal ablation using high intensity Focused Ultrasound.Methods: A Sonablate 200 (Focus Surgery, Indianapolis, Indiana) high intensity Focused Ultrasound system with a modified 18 mm. laparoscopic probe was used in all experiments. In 13 Yucatan mini-pigs a 5Fr ureteral catheter was inserted into the renal pelvis and 10 cc air were instilled into the collecting system. The kidney was laparoscopically dissected, the high intensity Focused Ultrasound probe was inserted through a 33 mm. laparoscopic port and the targeted renal pole was treated.Results: Renal lesions were created in 12 of 13 treated kidneys under real-time Ultrasound visualization. Median operative time was 180 minutes, average high intensity Focused Ultrasound activation time was 18.3 minutes and lesion size was 23 × 17...

  • High-Intensity Focused Ultrasound.
    Gastrointestinal endoscopy clinics of North America, 1994
    Co-Authors: Narendra T. Sanghvi, Robert H. Hawes
    Abstract:

    High-Intensity Focused Ultrasound (HIFU) is a technology that permits the use of Ultrasound waves used for imaging and then focuses them as one would use a magnifying glass to focus sunlight. The Ultrasound energy is absorbed by tissue and converted to heat and can be used to ablate tissue. This article summarizes the technology, mechanism of action, technique, and early clinical results of HIFU, then concludes with some potential future applications of this technology.

  • High-Intensity Focused Ultrasound in the treatment of prostatic tissue
    Urology, 1994
    Co-Authors: Richard Bihrle, Narendra T. Sanghvi, Richard S. Foster, F.j. Fry, John P. Donohue
    Abstract:

    Abstract Objective . Beginning in 1987, High-Intensity Focused Ultrasound was investigated in the canine model to determine the feasibility of destroying prostate tissue. After demonstrating the ability to ablate prostate tissue reliably in a canine model, a 15-patient pilot clinical study was undertaken at Indiana University in the fall of 1992. This pilot study was undertaken to assess the safety in the human clinical situation, as well as to give some early efficacy results. Methods . The early canine feasibility studies were conducted via a suprapubic extracorporeal approach using two separate transducers, one for imaging and the other for therapy. Subsequent to this, a transrectal probe, which had the dual capability of both imaging and therapy, was developed and used to treat canine prostates in a formal, "good laboratory practice" study to determine the safety of this technology prior to beginning treatment of human benign prostatic hypertrophy. Results . The formal canine studies demonstrated that prostatic tissue could be reliably ablated in the therapy zone. The dosimetry and duty cycle required to ablate canine prostatic tissue effectively was also determined in this study. The study also demonstrated that the prostatic tissue could be ablated without injury to the intervening rectal tissue or periprostatic tissue. The human pilot study has also demonstrated safety of High-Intensity Focused Ultrasound, as well as early efficacy. conclusions . These early clinical results are encouraging, but assessment of efficacy will require a randomized study comparing High-Intensity Focused Ultrasound to sham and to transurethral prostatectomy. This multicenter trial is currently planned.

  • High-Intensity Focused Ultrasound in the treatment of prostatic disease
    European Urology, 1993
    Co-Authors: Richard S. Foster, Narendra T. Sanghvi, Richard Bihrle, F.j. Fry, John P. Donohue
    Abstract:

    Beginning in 1987, High-Intensity Focused Ultrasound was investigated experimentally in a canine model to determine whether or not prostate tissue could be destroyed with good aiming and control. Subsequently a transrectal probe was developed and used to treat canine prostates in a formal study to determine whether or not this technology could be used to treat human benign prostatic hypertrophy. Next, after FDA approval, 15 patients were treated at Indiana University in the fall of 1992. Both canine and human studies have shown that High-Intensity Focused Ultrasound administered via a transrectal probe is capable of creating prostate lesions without injury to intervening and surrounding tissue.

M Marberger - One of the best experts on this subject based on the ideXlab platform.

  • Tissue Ablation in Benign Prostatic Hyperplasia with High Intensity Focused Ultrasound
    The Journal of Urology, 1994
    Co-Authors: S Madersbacher, Martin Susani, C Kratzik, M Marberger
    Abstract:

    AbstractIn a phase I clinical trial the morphological impact and safety of high intensity Focused Ultrasound administered transrectally for tissue ablation in prostates from 22 patients undergoing subsequent prostatectomy were evaluated. Location and size of the tissue lesions correlated well with the predefined target area and revealed sharply delineated coagulative necrosis in all cases. Intervening tissues, such as the rectal wall and posterior prostate capsule, were invariably intact. In a subsequent phase II clinical trial the effectiveness of transrectal high intensity Focused Ultrasound as a novel minimally invasive treatment modality for 50 patients with symptomatic benign prostatic hyperplasia was determined. The maximum urinary flow rate (ml. per second) increased from 8.9 ± 4.1 to 12.7 ± 6.4 at 3 months in 44 patients, 12.4 ± 5.6 at 6 months in 33 and 13.1 ± 6.5 at 12 months in 20. During the same period the post-void residual volume (ml.) decreased from 131 ± 120 to 48 ± 41, 59 ± 42 and 35 ± 3...

  • Tissue ablation in benign prostatic hyperplasia with high intensity Focused Ultrasound.
    The Journal of urology, 1994
    Co-Authors: S Madersbacher, Martin Susani, C Kratzik, M Marberger
    Abstract:

    In a phase I clinical trial the morphological impact and safety of high intensity Focused Ultrasound administered transrectally for tissue ablation in prostates from 22 patients undergoing subsequent prostatectomy were evaluated. Location and size of the tissue lesions correlated well with the predefined target area and revealed sharply delineated coagulative necrosis in all cases. Intervening tissues, such as the rectal wall and posterior prostate capsule, were invariably intact. In a subsequent phase II clinical trial the effectiveness of transrectal high intensity Focused Ultrasound as a novel minimally invasive treatment modality for 50 patients with symptomatic benign prostatic hyperplasia was determined. The maximum urinary flow rate (ml. per second) increased from 8.9 +/- 4.1 to 12.7 +/- 6.4 at 3 months in 44 patients, 12.4 +/- 5.6 at 6 months in 33 and 13.1 +/- 6.5 at 12 months in 20. During the same period the post-void residual volume (ml) decreased from 131 +/- 120 to 48 +/- 41, 59 +/- 42 and 35 +/- 30, respectively, and the American Urological Association symptom score (points) decreased from 24.5 +/- 4.7 to 13.3 +/- 4.4, 13.4 +/- 4.7 and 10.8 +/- 2.5, respectively. These data demonstrate that transrectal high intensity Focused Ultrasound is capable of inducing coagulative necrosis in the human prostate via a transrectal approach while preserving intervening and adjacent tissue. A 47% (+4.2 ml. per second) improvement in uroflowmetry and a 53% (-13.7 points) decrease in the American Urological Association symptom score 1 year after treatment clearly prove that transrectal high intensity Focused Ultrasound is a novel and safe minimally invasive treatment option for benign prostatic hyperplasia.

Vincent Y.t. Cheung - One of the best experts on this subject based on the ideXlab platform.

  • High-Intensity Focused Ultrasound therapy.
    Best practice & research. Clinical obstetrics & gynaecology, 2017
    Co-Authors: Vincent Y.t. Cheung
    Abstract:

    High-Intensity Focused Ultrasound therapy has received increasing interest in the management of benign uterine tumors. Either magnetic resonance or Ultrasound imaging has been used to target and monitor the ablation process. This article provides an overview of the background, clinical use, treatment outcomes, and safety of High-Intensity Focused Ultrasound in the treatment of uterine fibroids and adenomyosis, including a summary of clinical trials comparing magnetic resonance- or Ultrasound-guided High-Intensity Focused Ultrasound with other minimally invasive or surgical interventions. The potential of this treatment modality as an alternative uterus-sparing option for women with fibroids and adenomyosis is discussed.

  • Current status of High-Intensity Focused Ultrasound for the management of uterine adenomyosis
    Ultrasonography (Seoul Korea), 2017
    Co-Authors: Vincent Y.t. Cheung
    Abstract:

    While High-Intensity Focused Ultrasound has been used for some time in the management of uterine fibroids, its effectiveness and safety in managing adenomyosis is less well established. A literature review was performed of all eligible reports using this modality as a treatment for adenomyosis. Relevant publications were obtained from the PubMed electronic database from inception through March 2016. Eleven articles, including information from 1,150 treatments and follow-up data from 990 patients, were reviewed. High-Intensity Focused Ultrasound appears to be effective and safe in the management of symptomatic adenomyosis, and can be considered as an alternative uterine-sparing option for women with this condition.

  • Sonographically Guided High-Intensity Focused Ultrasound for the Management of Uterine Fibroids
    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2013
    Co-Authors: Vincent Y.t. Cheung
    Abstract:

    High-Intensity Focused Ultrasound therapy has received increasing interest in the management of solid malignancies and benign tumors. Magnetic resonance imaging has always been used to define the target for controlling and monitoring the ablation. Recently, sonographically guided High-Intensity Focused Ultrasound has been introduced to monitor the ablation process. This article provides an overview of the background, clinical use, and treatment outcomes of sonographically guided High-Intensity Focused Ultrasound in the treatment of uterine fibroids.

Michael O. Koch - One of the best experts on this subject based on the ideXlab platform.

  • High-Intensity Focused Ultrasound
    Prostate Cancer, 2016
    Co-Authors: M. Francesca Monn, Chandra K. Flack, Michael O. Koch
    Abstract:

    High-Intensity Focused Ultrasound (HIFU) is a method of thermal ablation that is gaining popularity as an acceptable alternative to radical therapy in patients with localized prostate cancer (PCa). Through converging high-energy Ultrasound waves, HIFU causes precise coagulative necrosis such that it avoids harm to outside structures and limits the morbidity (primarily urinary incontinence and erectile dysfunction) that occurs with radical prostatectomy and external-beam radiation therapy. Despite being originally pioneered as a method for primary whole-gland ablation in men who may otherwise not be candidates for radical therapy, it is now being tested as a means of focal therapy, particularly when combined with novel MR-imaging techniques, or as salvage therapy following surgical or radiation failure. Its primary advantage remains that it is a repeatable therapy, making it a versatile option either in isolation or as an adjunct to more traditional approaches.

  • Prostate Cancer Therapy with High-Intensity Focused Ultrasound
    Clinical genitourinary cancer, 2005
    Co-Authors: Thomas A. Gardner, Michael O. Koch
    Abstract:

    High-Intensity Focused Ultrasound (HIFU) has been used to ablate benign and malignant prostate tissue for several decades. This review summarizes the technology and available clinical trials to date. Continued technological advances combined with well-designed clinical trials could allow HIFU to become part of the arsenal against prostate cancer.

S Madersbacher - One of the best experts on this subject based on the ideXlab platform.

  • Tissue Ablation in Benign Prostatic Hyperplasia with High Intensity Focused Ultrasound
    The Journal of Urology, 1994
    Co-Authors: S Madersbacher, Martin Susani, C Kratzik, M Marberger
    Abstract:

    AbstractIn a phase I clinical trial the morphological impact and safety of high intensity Focused Ultrasound administered transrectally for tissue ablation in prostates from 22 patients undergoing subsequent prostatectomy were evaluated. Location and size of the tissue lesions correlated well with the predefined target area and revealed sharply delineated coagulative necrosis in all cases. Intervening tissues, such as the rectal wall and posterior prostate capsule, were invariably intact. In a subsequent phase II clinical trial the effectiveness of transrectal high intensity Focused Ultrasound as a novel minimally invasive treatment modality for 50 patients with symptomatic benign prostatic hyperplasia was determined. The maximum urinary flow rate (ml. per second) increased from 8.9 ± 4.1 to 12.7 ± 6.4 at 3 months in 44 patients, 12.4 ± 5.6 at 6 months in 33 and 13.1 ± 6.5 at 12 months in 20. During the same period the post-void residual volume (ml.) decreased from 131 ± 120 to 48 ± 41, 59 ± 42 and 35 ± 3...

  • Tissue ablation in benign prostatic hyperplasia with high intensity Focused Ultrasound.
    The Journal of urology, 1994
    Co-Authors: S Madersbacher, Martin Susani, C Kratzik, M Marberger
    Abstract:

    In a phase I clinical trial the morphological impact and safety of high intensity Focused Ultrasound administered transrectally for tissue ablation in prostates from 22 patients undergoing subsequent prostatectomy were evaluated. Location and size of the tissue lesions correlated well with the predefined target area and revealed sharply delineated coagulative necrosis in all cases. Intervening tissues, such as the rectal wall and posterior prostate capsule, were invariably intact. In a subsequent phase II clinical trial the effectiveness of transrectal high intensity Focused Ultrasound as a novel minimally invasive treatment modality for 50 patients with symptomatic benign prostatic hyperplasia was determined. The maximum urinary flow rate (ml. per second) increased from 8.9 +/- 4.1 to 12.7 +/- 6.4 at 3 months in 44 patients, 12.4 +/- 5.6 at 6 months in 33 and 13.1 +/- 6.5 at 12 months in 20. During the same period the post-void residual volume (ml) decreased from 131 +/- 120 to 48 +/- 41, 59 +/- 42 and 35 +/- 30, respectively, and the American Urological Association symptom score (points) decreased from 24.5 +/- 4.7 to 13.3 +/- 4.4, 13.4 +/- 4.7 and 10.8 +/- 2.5, respectively. These data demonstrate that transrectal high intensity Focused Ultrasound is capable of inducing coagulative necrosis in the human prostate via a transrectal approach while preserving intervening and adjacent tissue. A 47% (+4.2 ml. per second) improvement in uroflowmetry and a 53% (-13.7 points) decrease in the American Urological Association symptom score 1 year after treatment clearly prove that transrectal high intensity Focused Ultrasound is a novel and safe minimally invasive treatment option for benign prostatic hyperplasia.