Cleveland Clinic Uses Noninvasive Ultrasound Technology to Treat Some Liver Tumors

Global health system Cleveland Clinic has started using a recently FDA-approved ultrasound device to treat liver tumors. The non-invasive technology, called histotripsy, uses brief high-intensity ultrasound pulses that disrupt and kill the targeted tumor cells.

Choon Hyuck David Kwon, M.D., Ph.D., director of Minimally Invasive Liver Surgery at Cleveland Clinic’s Digestive Disease Institute, led a team of surgeons and nurses during the first case in which a small tumor on the left side of the patient’s liver was liquified. Following the procedure in December 2023, the patient recovered well. The patient was being treated for liver metastases from colorectal cancer.

To deliver the treatment, Dr. Kwon used an ultrasound machine connected to a mobile robotic arm, which was positioned above the patient’s abdomen to precisely target the liver tumor. The microsecond ultrasound pulses created microbubbles in the targeted tumor, which disrupted and killed the diseased cells.

“This treatment is noninvasive, which provides the patient with an easy recovery following the procedure,” said Dr. Kwon. “In addition, studies have shown that, in some cases, a histotripsy treatment may stimulate the body’s immune system to attack cancer cells.”

Researchers are looking into a phenomenon – known as abscopal effect – that has been observed in patients with cancer following radiation therapy and ablation. Following radiation therapy treatment, researchers have noticed, in some cases, an anti-tumor response that causes untreated tumors to shrink. Histotripsy may also produce an abscopal effect in some cases.

Since the first case, Dr. Kwon and his colleagues – including Federico Aucejo, M.D., and Jaekeun Kim, M.D.– have successfully used the ultrasound technology to treat more patients with liver tumors. On average, the procedure lasts up to an hour.

“More research is needed to continue to study the benefits of histotripsy, including the occurrence and frequency of the abscopal effect,” said Dr. Kwon. “I see this noninvasive treatment as a complement to our current therapies for liver tumors, including surgery and chemotherapy.”

Currently, histotripsy is only FDA-approved for tumors in the liver.

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