First of its kind in South India GE IQ PET/CT at MIOT HospitalsMIOT Hospitals
The GE IQ PET/CT at MIOT International (1st of its kind in South India) offers Superior Image Quality and Intelligent Quantitation enabling the Physician to discover and diagnose cancer confidently. Now, we can detect even minute abnormalities and offer accurate diagnoses and monitoring to our patients.
(December 2, 2021) The Bench to Bedside Series: Preclinical Cancer Research w...Scintica Instrumentation
Overview:
The goal of this webinar will be to provide a high-level overview of the various stages of preclinical cancer research and discuss the role that innovative instrumentation can play in moving science forward.
To better understand how to treat and control cancer, researchers start by investigating the basics – the cells, molecules, and genes that make up the human body. This type of study, which is often referred to as basic or discovery research, aims to understand the underlying mechanisms contributing to cancer growth and spread. This knowledge is an essential starting point for developing future diagnostic tests and treatment strategies.
After finding an innovative idea that works in cells, researchers need to take their studies to the next level by employing animal models that have similar biology to humans. Animal models have helped scientists make some of the most important cancer discoveries over the years. Furthermore, preclinical imaging technologies allow researchers to perform longitudinal animal studies that are noninvasive leaving the underlying biology intact so that one can track changes throughout the entire disease process.
It was previously thought that the journey from bench to bedside was unidirectional, starting with discovery research and moving towards clinical trials. However, in the last decade, it has become crucial for basic scientists and clinicians to work together towards finding innovative solutions that will positively impact patient care.
After attending this webinar, we hope you will have a better understanding of the preclinical workflow needed to push an idea from bench to bedside as well as some of the key equipment that is needed along the way.
This webinar series will be hosted by Drs. Katie Parkins and Tyler Lalonde, both of which have extensive experience in translational research areas including oncology, neuroscience, molecular imaging, and drug development.
In this webinar we will discuss the following topics:
• Introduction To Cancer Research
• What does “Bench to Bedside” mean?
• In vitro characterization
• Rapid throughput screening
• Quantitative tools
• Moving towards translation
Field of oncology has evolved since many decades! This presentation will demonstrate how oncology had evolved. Special focus is on current radiation oncology and surgical oncology practices along with principles of oncology.
First of its kind in South India GE IQ PET/CT at MIOT HospitalsMIOT Hospitals
The GE IQ PET/CT at MIOT International (1st of its kind in South India) offers Superior Image Quality and Intelligent Quantitation enabling the Physician to discover and diagnose cancer confidently. Now, we can detect even minute abnormalities and offer accurate diagnoses and monitoring to our patients.
(December 2, 2021) The Bench to Bedside Series: Preclinical Cancer Research w...Scintica Instrumentation
Overview:
The goal of this webinar will be to provide a high-level overview of the various stages of preclinical cancer research and discuss the role that innovative instrumentation can play in moving science forward.
To better understand how to treat and control cancer, researchers start by investigating the basics – the cells, molecules, and genes that make up the human body. This type of study, which is often referred to as basic or discovery research, aims to understand the underlying mechanisms contributing to cancer growth and spread. This knowledge is an essential starting point for developing future diagnostic tests and treatment strategies.
After finding an innovative idea that works in cells, researchers need to take their studies to the next level by employing animal models that have similar biology to humans. Animal models have helped scientists make some of the most important cancer discoveries over the years. Furthermore, preclinical imaging technologies allow researchers to perform longitudinal animal studies that are noninvasive leaving the underlying biology intact so that one can track changes throughout the entire disease process.
It was previously thought that the journey from bench to bedside was unidirectional, starting with discovery research and moving towards clinical trials. However, in the last decade, it has become crucial for basic scientists and clinicians to work together towards finding innovative solutions that will positively impact patient care.
After attending this webinar, we hope you will have a better understanding of the preclinical workflow needed to push an idea from bench to bedside as well as some of the key equipment that is needed along the way.
This webinar series will be hosted by Drs. Katie Parkins and Tyler Lalonde, both of which have extensive experience in translational research areas including oncology, neuroscience, molecular imaging, and drug development.
In this webinar we will discuss the following topics:
• Introduction To Cancer Research
• What does “Bench to Bedside” mean?
• In vitro characterization
• Rapid throughput screening
• Quantitative tools
• Moving towards translation
Field of oncology has evolved since many decades! This presentation will demonstrate how oncology had evolved. Special focus is on current radiation oncology and surgical oncology practices along with principles of oncology.
Divorce Mediator Specialists Playa del Reypeace talks
Peace Talks Mediation Services have Expert Divorce Mediator Specialists Team Who Provide Parenting Plan, Divorce Mediation, premarital mediation, Estate Planning and more.
Formal peace talks must be accompanied by public peace communication. While the confidentiality of peace negotiation must be respected, people's confidence on of the peace process must also be won. this presentation shares some insights on how to get the larger public incolved in the peace process, especially in the context of Mindanao, Philippines.
President Rodrigo Roa Duterte will handle many issues that will have an impact on the resources industry as he embark on his six years of governance. A few of these important issues include the proposed shift to a federal form of government, peace and order, the role of the mineral industry in economic development, renewable energy vis a vis coal-fired power plants, and the West Philippine Sea dispute with China.
The asquith group case study some statisticsasalarsson
21% of young people in Australia do not complete secondary school. (Deloitte Access Economics, 2012) In Victoria an estimated 10,000 school-age people disengage early from education every year.
Young people who do not finish school are far more likely to be unemployed into their 20s and beyond than their contemporaries.
In 2011, about 35 per cent of 20-24 year old Victorians whose highest level of school attainment was Year 11 or below were either unemployed or had withdrawn entirely from the workforce or study.
the purpose of this
invention is to provide a biological housing system capable of undergoing highly controlled ultrasonic stimulations, capable of guaranteeing, at
the same time, practicality and simplicity of use, low cost and complete sterility of the biological samples tested
Application Brief: Tumor Microenvironment Imaging with Photoacoustic TechnologyFUJIFILM VisualSonics Inc.
Photoacoustics (PA) combines optical contrast with the high spatial resolution and deep tissue penetration offered by ultrasound. Such applications are especially beneficial for monitoring tumor development, measuring blood concentration changes within it, and quantifying networks of vasculature formation and carcinoma growth over time.
Application Brief: Tumor Microenvironment Imaging with Photoacoustic TechnologyFUJIFILM VisualSonics Inc.
Combining photoacoustic technology with high-resolution ultrasound projections offered by the Vevo 2100 system provides tremendous benefits for cancer screening. Researchers can now benefit from the combined high-resolution ultrasound and optical contrast ability of the Vevo® LAZR photoacoustic imaging system to achieve clear, deep, images in 2D and 3D for optimal in vivo visualization and quantification of internal anatomy, tumor tissue, and hemodynamics.
Ligation-assisted endoscopic enucleation for the diagnosis and resection of s...Enrique Moreno Gonzalez
Ligation-assisted endoscopic enucleation (EE-L) was developed for the pathological
diagnosis and resection of small gastrointestinal tumors originating from the muscularis
propria. The technique combines endoscopic band ligation and endoscopic enucleation. The aim of this study was to evaluate the efficacy and safety of EE-L in the diagnosis and
resection of gastrointestinal tumors originating from the muscularis propria.
Tumor angiogenesis is currently one of the key focal points in biomedical research. It is based upon the hypothesis laid out by Judah Folkman in 1971 that neovasculature is needed to support the growth and metastasis of tumors, and thus anti-angiogenic treatment might be an effective way to cure cancer. Genentech’s anti-VEGF-A drug Avastin a great demonstration of this concept, generating more than $2.7 billion of sales in 2008.
Role of HIFU Therapy in Treatment of Benign Prostate Hyperplasia Sonablate® 5...YogeshIJTSRD
The health and quality of life of elderly men is directly dependent on non neoplastic diseases, among which benign prostatic hyperplasia BPH is of particular importance. Currently, various methods of minimally invasive surgical treatment of BPH are flourishing. Among the methods that can rightfully be considered the gold standards of surgical treatment of BPH transurethral resection of the prostate, laser enucleation of the prostate , a special place is occupied by borderline techniques that work at the junction of conservative and surgical treatment of BPH. Such techniques include HIFU High Intensity Focused Ultrasound or transrectal ablation with high intensity focused ultrasound, which allows directed ultrasound to destroy deep tissue without damaging nearby healthy areas. In the focusing area, the intensity of ultrasound reaches a very significant level, which is sufficient for a local increase in the tissue temperature in the focusing area up to 70 100 ° C. This leads to tissue necrosis of prostatic hyperplasia, and then, after rejection of the necrotic ablated areas, to improvement. Lower urinary tract symptoms associated with BPH. Shodmonova Z. R | Yusupov Dj. F | Gafarov R. R | Batirov B. A "Role of HIFU Therapy in Treatment of Benign Prostate Hyperplasia (Sonablate®-500 Equipment)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Special Issue | Innovative Development of Modern Research , April 2021, URL: https://www.ijtsrd.com/papers/ijtsrd41125.pdf Paper URL : https://www.ijtsrd.com/medicine/other/41125/role-of-hifu-therapy-in-treatment-of-benign-prostate-hyperplasia-sonablate®500-equipment/shodmonova-z-r
Mechanical signals inhibit growth of a grafted tumor in vivo proof of conceptRemy BROSSEL
We apply the principles of physical oncology (or mechanobiology) in vivo to show the effect of a “constraint field” on tumor growth.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0152885
A comparative study on the clinical and functional outcome of limb salvage su...NAAR Journal
The aim of this study was to analyze the survival, recurrence, complications as well as the quality of life (QOL) in tibial osteosarcoma (OSA) patients managed by limb salvage surgery (LSS), either by a prosthesis, resection or graft or by amputation. 106 tibial osteosarcoma patients were enrolled where 39 had custom-designed endoprosthetic arthroplasty (LSS1), 36 underwent resection and bone graft (LSS2) while only 31 underwent amputation. A Comparison was done based on post-operative survival rates, postoperative recurrence, and complications. The impact of the patient’s QOL was also evaluated.
What Is Smart Fusion?
Smart Fusion presents volume-to-volume fusion of two different imaging modalities, using previ- ously acquired images with real-time ultrasound. CT is the most commonly used modality for ultra- sound fusion with the other option being MRI.
Read our tips for using Smart Fusion effectively in this white paper.
Find out more about our solutions in ultrasound at http://www.toshiba-medical.eu/eu/product-solutions/diagnostic-ultrasound/
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...
21 years of reasearch on hifu on breast
1. Proceedings of 20
th
International Congress on Acoustics, ICA 2010
23-27 August 2010, Sydney, Australia
ICA 2010 1
A brief review of development of high intensity focused
ultrasound (HIFU) in Chongqing Medical University of
the past 21 years
Faqi Li(1), Zhibiao Wang(1), Wenzhi Chen(2), Chengzhi Li(1),
Lian Zhang(2), Feng Wu(1), Junru Wu(3)
(1) Sate Key Laboratory of Medical Ultrasound Engineering, Institute of Ultrasound Engineering in Medicine,
Department of Biomedical Engeering, Chongqing Medical University, Chongqing 400016, China
(2) The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
(3) Department of Physics, University of Vermont, Burlington VT 05405, USA
PACS: 43.35.Wa, 43.80.Gx, 43.80.Vj
ABSTRACT
Basic research and clinical applications of HIFU to treat many life-threatening diseases such as uterine fibroids,
osteosarcoma, liver cancer, breast cancer, and many others have attracted broad interests in global medical communi-
ties (Nat Rev Cancer. 2005; 5(4): 321-327; Nature Reviews Drug Discovery. 2005; 4:255-260). HIFU has been
considered as one of the most important developing technologies of modern medicine (Nature News. February 17,
2004). Since 1988, researchers and medical doctors in Chongqing Medical University, China have been performing
fundamental research, animal experiments, and clinical trials on HIFU technology. This presentation will serve a
brief review of this development of the past 21 years. Due to the multi-disciplinary nature of this technology, this talk
will focused on the inter-linkage of the three aspects: engineering, biology and clinical protocol. Examples of clinical
treatments of liver, bone and breast cancers will be introduced; our treatment record shows that patients have
survived longer than ten year after treatments. In addition, we also will report on applications of HIFU in the treat-
ment of gynecological non-neoplastic diseases such as nonneoplastic epithelial disorders of vulva, chronic cervicitis
and HPV infections.
In the last 20 years, High Intensity Focused Ultrasound
(HIFU) has been widely recognized as a non-invasive yet
effective extracorporeal method for treating tumors. This
“non-invasive surgery” presents great potential applications
in medical science. The principle of this technology is focus-
ing ultrasoundic energy inside a human body and forming a
local high-intensity region, the in situ target tissue absorbs
the sound energy and transform it into thermal energy which
can induce a rapid rise of tissue temperature to ≥ 65ºC within
1 second, causing protein denaturation and resulting in irre-
versible coagulative necrosis, while the surrounding normal
tissue remains intact.
Since 1998, professionals at Chongqing Medical Uni-
versity have been applying this HIFU technology for the
treatment of bone, breast, liver and kidney cancers success-
fully. This article focuses on the researches conducted by
Chongqing Medical University in the field of HIFU.
1. How to induce a single coagulative necrosis
within deep tissue non-invasively
The principle of HIFU treatment is based on focusing ultra-
sound energy into a target tissue and inducing a single coagu-
lative necrosis. In terms of technology, focusing of ultra-
sound has been already achieved in water and the distribution
of focal sound field can be detected and verified by using
hydrophones. However, due to heterogeneity of biological
tissue, the variations of ultrasonic attenuation and speed of
sound in layers of tissue have serious effects on focusing.
Additionally, acoustic caviation and boiling occurring in
tissues induced by high intensity ultrasound can also affect
ultrasound propagation. The combination of all these factors
makes use of the uniform and isotropic medium model as a
toolto evaluate the focusing effects of focused ultrasound in
biological tissues invalid.
Through a large quantity of experimental studies using
in vitro and in vivo tissues, Wang et al [1, 2] proposed the
concept of Biological Focal Region (BFR) Which corre-
2. 23-27 August 2010, Sydney, Australia Proceedings of 20th International Congress on Acoustics, ICA 2010
2 ICA 2010
sponds to the acoustic focal region (AFR) in vivo. The en-
ergy deposition from a single HIFU exposure of biological
tissue induces a region of coagulative necrotic tissue which is
called HIFU BFR. In general, it is a complex concept and a
function of the size and shape of AFR, ultrasound intensity
(I), ultrasound exposure time (t), depth of focus (D), tissue
structure (TS), and tissue function (Tf) [3] . This can be rep-
resented by the following formula:
BFR = f (AFR, I, t, D, Ts, Tf). (1)
2. How to achieve a complete coagulative necro-
sis of a tumor tissue
Relative to a tumor with a large volume, the cogulative ne-
crotic tissue induced from single HIFU exposure is too small.
In order to completely “remove” a large tumor, a “surgical
procedure” must be followed. The extracorporeal transducer
must follow a certain combination of movements in order to
completely ablate the entire tumor (same as normal surgery).
A complete “surgery” in this case usually includes tissue
ablation of dots, lines, slices and volume; i. e., many single
coaguative necrotic dots making a line, several lines forming
a slice and a few slices making a block etc. The procedure
starts from deep tissue and moves up to superficial tissue
with a set spacing between each line to form a slice of ne-
crotic tissues, combining multiple slices of necrotic tissue to
form a block of necrotic tissue. The key is the formation of
line necrosis, which is based on the size and location of indi-
vidual necrotic lesions (Figure 1).
Source: (Z.B. Wang, 1998)
Figure 1.Mehod of ablating a tissue volumn through dot to
line lesion, slice lesion and volume lesion
Experiments done in bovine liver have shown that fol-
lowing the procedure line necrosis, slice necrosis and volume
necrosis can be generated. Closer examination by slicing
open the treated liver shows clear boundaries between the
complete cogulative necrotic tissue and normal tissue (Figure
2). This “surgery procedure” can avoid “lesion-lesion interac-
tion” (damage-damage interference effect). The movement of
the extracorporeal transducer which forms multiple coagula-
tive necrotic points within the target lesion, instead of in-
creasing the size of necrotic tissue at single point, is the ma-
jor difference between HIFU technology, microwave and
radiofrequency method.
3. Image-guided HIFU treatment
Clinical HIFU treatment of tumors must be conducted under
precise image monitoring. At present, two methods of moni-
toring are achieved by using real-time ultrasound imaging
and Magnetic Resonance Imaging (MRI). Regardless of
which means of monitoring is utilized, they must be able to
guide, locate, monitor changes in target lesion and evaluate
the therapeutic efficacy. In clinical applications, it is impor-
tant to monitor changes at target region and how this would
relate to pathological changes as well as how the therapeutic
efficacy can be evaluated from these changes. Research has
shown that, immediately post-HIFU exposure, real-time ul-
trasound monitoring on the target region show hyperecho,
which diminished in its intensity and range with time [4].
Compared with pre-HIFU exposure, the strength of this echo
Source: (Faqi Li, 2003)
Figure 2.HIFU induced dot, line, slice,
and volume lesion in tissue respectively
A. BFR (coagulative necrosis generated by
a single ultrasound exposure)
B1 B2
B. line lesion (B1.multiple pulses, B2.linear scanning)
C. slice lesion D.volume lesion
3. 23-27 August 2010, Sydney, Australia Proceedings of 20th International Congress on Acoustics, ICA 2010
ICA 2010 3
can be calculated using computer software which analysis
gray-scale value (Figure 3).
This gray scale value is the result of HIFU exposure in-
duced cavitation and bubble formation which causes rapid
temperature rise in tissues and the structural changes in co-
agulative necrotic tissues. When the grayscale value reaches
a certain value, it represents coagulative necrosis. The largest
cross-section of the scope of hyperecho is the same as the
cross-section of the coagulative necrotic tissue (Figure 4).
During HIFU treatment, real-time evaluation of grayscale
value determines whether coagulative necrosis has occurred.
If the grayscale value of the target lesion has not reached
certain value, it is necessary to treat this lesion again, until
the grayscale value reached that of coagulative necrosis.
Therefore, it is possible to utilize real-time ultrasound to
guide, locate, monitor and give real-time evaluation of treat-
ment efficacy in HIFU tumor therapy.
4. HIFU Treatment system
After 10 years of basic research, the first ultrasound guided
focused ultrasound tumor therapy system (JC-model Focused
Ultrasound Tumor Therapy System) was developed in 1998.
This system consisted of high frequency power generator,
mechanical motion systems, integrated transducer with ultra-
sound probe, control console and water treatment system.
This system was awarded the SFDA Certification in 1999
and the CE Certification in 2005. Based on this system,
JC200-model was developed, as well as CZF-model which
specialized in the treatment of white lesions of vulva and
chronic cervicitis. As of 2005, a collaboration with Siemens
to develop MRI-guided focused ultrasound tumor therapy
system (JM-model Focused Ultrasound Tumor Therapy Sys-
tem), which is undergoing clinical trials.
5. Clinical applications of HIFU
Since 1997, the HIFU therapy system developed by
Chongqing Medical University has been used in more than
10 countries worldwide for the treatment of liver cancer,
breast cancer, malignant bone cancer, soft tissue sarcoma,
kidney cancer, pancreatic cancer and uterine fibroids. The
safety and efficacy of this treatment is evident in more than
10,000 cases [5]. The clinical feedback of the HIFU thera-
peutic system from these countries is all positive. They all
agree that HIFU is a novel, safe and effective non-invasive
treatment technology. RO Illing [6-8] has used JC-model
Focused Ultrasound Tumor Therapy System to treat 30
Western patients with liver or kidney cancer and stated that
HIFU treatment on these Western patients is safe and feasible.
Zhang et al [9] have used the JM-model Focused Ultrasound
Tumor Therapy System to treat 23 patients with uterine fi-
broids. Their studies showed that MR images obtained at 3
month follow-up from 12 patients indicated shrinkage of
treated fibroid volume by 31.4%.
In 2009, on the first Non-Invasive Ultrasound Treatment
Summit, results of 10 year follow-up of HIFU treated liver
cancer, bone cancer and breast cancer patients were presented
[10].
In addition, focused ultrasound is also used to success-
fully treat gynecological diseases such as white lesion of
vulva and chronic cervicitis of more than 10,000 cases, show-
ing both safety and efficacy. Li et al [11] used HIFU to treat
76 cases of white lesions of vulva and vulvar dystrophies.
After 2 years follow-up, 49 patients were successfully treated
and 23 patients had improved symptoms. Jinyun Chen [12]
compared ultrasound therapy and laser therapy for sympto-
matic cervical ecotopy, showing ultrasound therapy with a
better outcome and little damage to the normal tissue.
CONCLUSION
High Intensity Focused Ultrasound is recognized as an effec-
tive non-invasive treatment in the 21st
Century. Chongqing
Medical University has always insisted on integrating basic
Source: (Faqi Li, 2007)
Figure 3.Gray scale at the focus before and
after HIFU treatment
Source: (Faqi Li, 2007)
Figure 4.Shape and size of coagulative necrotic tissue is
comparable to the scope of hyperecho in figure 3.
4. 23-27 August 2010, Sydney, Australia Proceedings of 20th International Congress on Acoustics, ICA 2010
4 ICA 2010
research, engineering technology and clinical trials as a new
way to develop a medical modality. HIFU provides physi-
cians with a truly non-invasive treatment and its application
is not limited to only treatment of cancer. It can also be used
to treat benign and other diseases and symptoms such as pal-
liative relief of chronic pain caused by malignant cancer as
well as inducing surgical coagulation. Recent technological
advances show that HIFU will play a pivotal role in future
surgical applications.
ACKNOWLEDGEMENTS
This work was funded by National Nature and Science Foun-
dation of China (Grant 30830040, 30970827)
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