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Focused ultrasound: The clinical possibilities beyond ablation

January 15, 2015
Jessica Foley
From the January 2015 issue of HealthCare Business News magazine
Jessica L. Foley

As our health care delivery model evolves toward optimizing population health while minimizing costs, hospitals and health care systems will need to carefully consider value-based purchasing of innovative treatment technologies, ensuring that the safety profile, patient benefit (e.g. quality of life, patient reported outcomes) and treatment volume are worth the investment.

Focused ultrasound is an early stage, non-invasive technology that is worth watching. Currently approved in the United States for a couple of indications, focused ultrasound is poised to develop into a multipurpose platform technology using several mechanisms of action to treat a range of diseases, from neurological conditions through cancers, pain and even hypertension.
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Figure 1: This chart portrays the
global status of focused ultrasound. The number
of indications in various states of
development is increasing rapidly, but
most are in the early stages of evolution.

Multipurpose platform technology
Focused ultrasound is a precise tool that can be used as a stand-alone, non-invasive and non-ionizing alternative to surgery or radiation. It can also serve as a powerful adjuvant or enhancer to other treatments, including gene therapy, chemotherapy and immunotherapy. Focused ultrasound is unique amongst other ablative modalities such as radiofrequency ablation or cryoablation in that it can also produce many other nonablative bioeffects, enabling treatment of a wide array of clinical conditions with the same therapy platform (see figure 1).

A focused ultrasound system is currently approved in the U.S.to treat symptomatic uterine fibroids and to relieve the pain of cancer that has spread to the bone. There are also two systems under review by the FDA for the treatment of early stage and salvage prostate cancer therapy. All of these applications utilize thermal ablation, where concentrated ultrasound energy is delivered to a small, precise location to heat and destroy tissue. Much like a magnifying glass focuses beams of light on a single point, focused ultrasound utilizes multiple intersecting beams of ultrasound energy concentrated on tissue deep in the body. At the point where the beams converge, the ultrasound energy is high enough to thermally kill the cells while avoiding damage to surrounding tissue.

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