Associate Professor University of Virginia, United States
Learning Objectives: Educate learners on effective pre-procedural evaluation and workup for hepatic solid tumor histotripsy.
Background: The treatment of primary and secondary liver tumors requires a multimodal interdisciplinary approach with interventional-oncology innovating locoregional therapy options. Histotripsy is a novel technology approved in the fall of 2023 for focal treatments in the liver. As a new technology, there is limited literature on the protocols and procedures beyond the manufacturer’s recommendations for performing histotripsy. The device has limitations due to target size, patient anatomy, penetration of ultrasound waves, interference of bones and gas, and sensitivity of tumor targeting with patient breaths. Failure to account for these variables can reduce technical success and increase patient complications. We discuss our pre-procedural protocols implementing histotripsy ablation to improve the safety and efficacy of the technique.
Clinical Findings/Procedure Details: This educational exhibit will: (1) review the basic principles and mechanism behind histotripsy, (2) discuss the technical advantages and limitations of histotripsy in the liver. (3) Provide patient screening and selection criteria (4) Review important pre-procedural cross sectional imaging considerations (5) Understand the essential integration of patient positioning and ultrasound acquisition (6) Summarize guidance and tips for to achieve technical success.
Conclusion and/or Teaching Points: After reviewing this exhibit, the viewer will gain a deeper understanding of the benefits and limitations of histotripsy for patients, how to select patients appropriately, and tips for pre-procedural imaging and evaluation to help improve operator performance and technical success. The viewer will learn helpful tips for performing histotripsy in the liver.
.jpg "Warren A. Campbell, IV, MD, PhD photo")