Magnetic-resonance-guided therapy with focused ultrasound. Noninvasive surgery for mammary carcinomas

Magnetic resonance guided focused ultrasound surgery (MRgFUS) has the poten tial to become an im porta nt therapy modality in the adjuvant, neoadjuvant or palliative cancer treatment. All ultrasound accessible regions are poss ible target areas, especially breast tumors. Ultrasound propagation is well predictable. The ultrasound energy can be fo cused to a defined spot through the intact skin, and temperatures of 60 deg reesC to 85 degreesC can be induced locally for a few seconds that instanta neously necrose biological tissues, while sparing surrounding healthy tissu e. In addition, MRI is sensitive to temperature allowing for online monitor ing of the temperature focus. In this work we demonstrate our Heidelberg experiments from basic research and animal studies towards the clinical realization of MRgFUS in breast can cer patients. The most important of these experiments involved sheep as an appropriate model for the human breast. A new therapy setup is designated t o treat human breast patients in a clinical 1.5 T MRI scanner. While the th erapies have been successful so far without any side effects, the future cl inical role of noninvasive MRgFUS has to be defined by clinical studies.