HIGH INTENSITY FOCUSED ULTRASOUND FOR CANCER MANAGEMENT

Rationale: Surgical resection remains the mainstay for conventional treatment of cancers/tumours. Normally, a margin area surrounding the cancer is removed to minimize relapse. However, due to the need for large access wounds for excising deep-seated abnormalities, traditional open surgery is associated with several operative and post-operative complications resulting into high morbidity and mortality rates. Many patients are not good candidates for resection. Minimally Invasive Surgery (MIS), though introduced in the earlier part of the 20th century, started to gain wide clinical acceptance during the 1980s. In MIS, also known as key-hole surgery, the affected area is laparoscopically or, endoscopically resected under visual guidance. In these applications, specialized tools and devices that are used can be inserted through constrained access holes while the surgeon views the operative filed through the video images reproduced at the surgeon’s console. Hand-eye coordination using indirect means (2D imaging) presents a challenge to the clinical users for precise visual and tactile feedback and thus involves a steep learning curve. Minimally invasive procedures offer several advantages over open, conventional surgery, notably shorter length of stay, decreased analgesic requirements, shorter recovery time, decreased post-operative complications, and in some cases a lower morbidity rate as well. Surgery, either in an open or key-hole mode, is usually followed by adjuvant and non-invasive procedures, such as radiotherapy and chemotherapy, particularly when the neoplastic growth is stage-II and beyond.

 

HIFU is emerging as a potential non-invasive modality for thermally induced ablation of deep-seated abnormalities because of its unique ability in non-invasively targeting deep seated tissue volumes. Focused ultrasound surgery prevents the risk of ionization as prevalent in other non-invasive modalities such as LASER, microwave and X-ray – based ablations. Ultrasound waves are mechanical waves that can propagate through biological tissues and can be brought to a tight focus. The physical mechanisms responsible for therapeutic effects of ultrasound are both thermal and mechanical stresses. Tissue ablation due to HIFU is primarily affected by conversion of mechanical energy of an ultrasound wave into heat energy at its focal point. A temperature range of 60-80°C is achieved and the thermal effect could lead to immediate coagulative necrosis within the focal zone (an irreversible damage due to protein denaturation, protein synthesis inhibition, chemical bond disintegration in DNA /RNA molecules and other associated mechanisms). The temperature elevation produced in the focal region of the targeted beam produces immediate cytotoxity with a very sharp boundary between dead and live cells at its contour; the damaged region is called a lesion.

 

Current/Available Projects:

 

  • Tool-Tissue interactions during minimally-invasive and non-invasive surgery;

  • Spatio-temporal dynamics – tissue thermodynamics and bio-tribology;

  • Parametric studies and characterization of bio-effects in non-invasive therapy and surgery;

  • Non-invasive diagnostics and therapy using intelligent robotic techniques;

  • Other Applications: Non-invasive and adjuvant applications to stroke patients, bone and joints (solid cancers, bone-fracture), enhanced drug delivery (BBB), Alzheimer's and Parkinson’s disease.

 

 

 

 

Our relevant publications:

 

  • Abhilash RH and Sunita Chauhan, Empirical modeling of renal motion for dosage compensation and targeting during robotic FUS, Computers in Biology and Medicine, 2013. S0010-4825(12)00187-4. 

 

  • Abhilash RH and Sunita Chauhan, Respiration Induced Movement Correlation for Synchronous Non-Invasive Renal Cancer Surgery, Transactions on Ultrasonics, Ferroelectrics, and Frequency Control -  TUFFC-vol. 59, no. 7, July 2012.

 

  • Farzaneh Ahmadi, Ian McLoughlin, Sunita Chauhan, Gail ter Haar, Bio-effects and safety of low intensity, low frequency ultrasonic exposure, Progress in Biophysics and Molecular Biology, 2012 Apr;108(3):119-38.

 

  • Abhilash RH and S Chauhan,  A study of the respiration induced kidney movement and dynamic target localization using imaging ultrasound Proc. of UIA 2011, June 22-25th, Glasgow UK.

 

  • Sunita Chauhan and Gerald Seet, Monitoring and Surgical Planning during Minimally Invasive HIFU based Robotic Neurosurgery - in Proc. of Computer Assisted Radiology and Surgery, CARS June 23 - 26, 2011, Berlin, Germany, (Joint Congress of CAR / ISCAS / CMI / CAD / EuroPACS / CURAC).

 

  • Abhilash RH, Sunita Chauhan and Sree Vaishnavi, A Study on the Inaccuracy Induced by Movement of the Kidney during Non-invasive Surgery, presented at the NTU-Waseda Joint Seminar in Biological Science & Biomedical EngIneering - 30th November 2009.  

 

  • Sunita Chauhan, Modalities and devices for Thermal Ablation, Chapter 15 in Recent Advances in Diagnostic and Therapeutic Ultrasound Imaging, ArtechHouse Press, 2008.

 

  • S. Chauhan, H. Amir, G. Chen, A. Hacker, M.S. Michel, K.U. Koehrmann, Intra-operative Feedback and Dynamic Compensation for Image-guided Robotic Focal Ultrasound Surgery, Jr. Computer Aided Surgery, Volume 13, Number 6, pp 353-368, 2008. 

 

  • Meng Tong Tan, Qiong Zhang, Sunita Chauhan and Jiabin Huang, Analysis of the Phased Array Transducers for Surgical Applications, Proceedings of the 6th Intl’ Conference on Information, Communications and Singal Processing, ICICS, 10-13 Dec 2007, Singapore. 

 

  • S. Chauhan, H.Amir, G.Chen, On-line interpretation and dynamic compensation for focal ultrasound based image-guided robotic surgery, International Journal of Computer Assisted Radiology and Surgery, Volume 2, Supplement 1, pp. 191-203(13), 2007.

 

  • Jiabin Huang, Sunita Chauhan, Tan Meng Tong, Performance of HIFU Phased Array System in Multi-layer Heterogeneous Brain Tissue Structure, Proceedings of the ACCAS, Dec. 2007, Singapore. 

 

  • Chang Min Chu, Meng Tong Tan, Sunita Chauhan and Ann Liang Lim, High Intensity Ultrasound Phased Array for Surgical Applications, Proceedings of the ICBPE, 11-14 Dec. 2006, Singapore.

 

  • Chang Min Chu, Meng Tong Tan, Sunita Chauhan and Ann Liang Lim, High Intensity Ultrasound Phased Array for Surgical Applications, NTU-SGH Graduate Student Symposium, 8 Dec. 2006, Singapore.

 

  • Axel Häcker, Tina Peters, Maurice Stephan Michel, Ralf Hildenbrand, Peter Alken, Ernst Marlinghaus, Kai Uwe Köhrmann, Sunita Chauhan, Multiple Hifu-Probes For Kidney Tissue Ablation, Journal of EndoUrology, Volume 19, Number 8, 1036-1040, 2005.

 

  • Sunita Chauhan, A multi-probe, multi-route system for automated control of HIFU beam, Proceedings of the Intl’ Symposium on Therapeutic Ultrasound, ISTU 05, Harvard Medical School, Boston, USA, Oct. 27-29, 2005.

 

  • Sunita Chauhan, M. S. Michel, P. Alken, K. U. Köhrmann, A. Haecker, High-intensity-focused-ultrasound (HIFU) induced homeostasis and tissue ablation, Proceedings of the BiOS’03, Photonics West, SPIE, 25-31, Jan 2003, 4954-25, San Jose, USA.

 

  • Haecker, M. Michel, W. Back, J. Gaa, E.H Marlinghaus, A. Steidler, S. Chauhan, P. Alken, K. U. Koehrmann, Clinical follow up for noninvasive tissue ablation of the kidney by high-intensity focused ultrasound (HIFU); Proceedings of the BiOS’03, Photonics West, SPIE, 25-31, Jan 2003, 4954-24, San Jose, USA.

 

  • Sunita Chauhan, Tseng Ruey Wenn, Axel Haecker, Kai Uwe Kohrmann, An Empirical Study of HIFU Induced Hemostasis for Tissue Ablation, Proceedings of the ICBME’02, Dec.02, Singapore.

 

  • Haecker, M.S. Michel, P. Alken, K.U. Köhrmann, S. Chauhan, Multiple focused probes for High intensity focused ultrasound: An experimental investigation, Proceedings of the 20th World Congress on Endourology and Shockwave, 19- 22 Sept 2002, Genoa, Italy.

 

  • Haecker, M.S. Michel, P. Alken, K.U. Köhrmann, S. Chauhan, A model for hemostasis caused by High Intensity Focused Ultrasound (HIFU) for tissue ablation, Proceedings of the 20th World Congress on Endourology and Shockwave, 19- 22 Sept 2002, Genoa, Italy.

 

  • Haecker, M.S. Michel, W. Back, J. Gaa, E.H. Marlinghaus, A. Steidler, S. Chauhan, P. Alken, K.U. Köhrmann, 2-Year follow-up for extra corporal non-invasive tissue ablation of the kidney by High intensity focused ultrasound, Proceedings of the 20th World Congress on Endourology and Shockwave, 19- 22 Sept 2002, Genoa, Italy.

 

  • Sunita Chauhan, MJS Lowe, B L Davies, A multiple focused probe approach for HIFU based Surgery, journal of Ultrasonics, UK 2001, Vol.39, pp33-44. 

 

  • Sunita Chauhan, Field Modelling for Multiple Focused Ultrasound Transducers Proceedings of the M2VIP, 8th IEEE International Conference on Mechatronics and Machine Vision in Practice, Hong Kong 27-29th Aug. 2001.

 

  • Sunita Chauhan, Sampath Kumar, Wan Sing Ng, Kai Uwe Kohrmann, An Empirical Investigation into Focused Ultrasound Surgery (FUS) using Multiple Focused Probes, Proceedings of the Biomedical Asia 2001 Symposium, 19-21 September 2001.

 

Last Updated : January 2019

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