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THERAPY HIFU (HAYFU) of patients with renal tumors

CRITERIA FOR THERAPY HIFU of patients with renal tumors

indications:

  • Renal cell carcinoma in a patient with a solitary kidney
  • Tumors on both kidneys
  • An alternative method in patients with contraindications to resection (radical nephrectomy or partial-) hypovascular with renal cell carcinoma:
  • In hypervascular renal cell carcinoma - before HAYFU ablation is required are performing TAE (transarterialna embolization).
Radical HIFU therapy is possible in the I-st and II-nd stage; In the III-rd and IV-instar apply palliative HIFU treatment

Contraindications:

  • Thrombosis of renal vein and inferior vena cava
  • IUD (intrauterine device)
  • Histologically verified cystic hypernephroma.
  • Multilokularen cystic nephroma.
  • Angiomiolipoma.
  • Hematoma in tumor mass.
  • Concretions and calcifications in pielona and urethra, which lie within the acoustic path.
  • Impaired kidney function (higher levels of creatinine).
  • Thrombocytes
  • Prothrombin time
  • Leukocytes (WBC) norm

Abstract

High-intensity focused ultrasound (HIFU) provides a potential noninvasive alternative to conventional therapies. We report our preliminary experience from clinical trials designed to evaluate the safety and feasibility of a novel, extracorporeal HIFU device for the treatment of liver and kidney tumours in a Western population. The extracorporeal, ultrasound-guided Model-JC Tumor Therapy System (HAIFU™ Technology Company, China) has been used to treat 30 patients according to four trial protocols. Patients with hepatic or renal tumours underwent a single therapeutic HIFU session under general anaesthesia. Magnetic resonance imaging 12 days after treatment provided assessment of response. The patients were subdivided into those followed up with further imaging alone or those undergoing surgical resection of their tumours, which enabled both radiological and histological assessment. HIFU exposure resulted in discrete zones of ablation in 25 of 27 evaluable patients (93%). Ablation of liver tumours was achieved more consistently than for kidney tumours (100 vs 67%, assessed radiologically). The adverse event profile was favourable when compared to more invasive techniques. HIFU treatment of liver and kidney tumours in a Western population is both safe and feasible. These findings have significant implications for future noninvasive image-guided tumour ablation.