Ultrasound based tissue thermal lesion non-invasive detection is of great significance in high intensity focused ultrasound (HIFU) clinical application. In this paper, we propose a sub-pixel method to quantify the ultrasound image change caused by HIFU as correlation-distance. The support vector machine (SVM) was trained by using correlation distance as samples, and the recognition effect was tested. Results showed that sub-pixel cross-correlation vector field could reflect the ablation lesions position. SVM based classification method can recognize HIFU beam lesion degree effectively.
Algorithms ; Diagnostic Imaging ; methods ; High-Intensity Focused Ultrasound Ablation ; adverse effects ; Humans ; Pattern Recognition, Automated ; methods ; Support Vector Machine

The present study was aimed to investigate the pathological changes after magnetic resonance imaging (MRI) guided high intensity focused ultrasound (MRgHIFU) therapy for ablating the liver tissue adjacent to goat portal vein. Fifty goats were involved in this study. Normal liver tissues at 0, 5, and 10 mm distance from portal vein, respectively, were ablated with MRgHIFU. Among the 50 tested subjects, 40 goats were sacrificed immediately after the operations, and the other 10 were sacrificed 7 days after the procedure for pathological examination of the targeted areas and the contiguous portal veins. Coagulation necrosis was observed in all the treated liver tissues. Collagen swelling (CS) and vessel wall fracture (VWF) emerged more frequently in the 0 mm group than that in the 5mm group: CS [0 mm group VS 5mm group = 27/40 (67.5%) VS 7/40 (17.5%), P < 0.05], VWF [0 mm group VS 5mm group = 8/40 (20%) VS 0/40 (0%), P < 0.05]. Seven days after ablation, no portal vein damages (CS and VWF) were observed under light microscope. The results indicated that MRgHIFU could be used to ablate the liver tissue adjacent to goat portal vein effectively, which may cause blood vessel damage when the focus is on the wall of blood vessels (0 mm). However, the pathological results indicated that these damages are reversible.
Animals ; Female ; Goats ; High-Intensity Focused Ultrasound Ablation ; adverse effects ; methods ; Liver ; pathology ; Magnetic Resonance Imaging ; Male ; Portal Vein ; pathology

OBJECTIVETo compare the effect of ablations with pulsed and continuous high-intensity focused ultrasound (HIFU) on the target area containing large blood vessels in isolated perfused porcine liver.

METHODSAn isolated perfused liver model was established by perfusing the isolated porcine liver with autologous blood through the portal vein and hepatic artery using an cardiopulmonary bypass machine. With B-mode ultrasound guidance, a blood vessel about 4 mm in diameter was selected, and pulsed and continuous HIFU ablation at the same dose was delivered along the blood vessel at 3 mm to the vascular wall. After the ablation, the damages of the blood vessels as the acoustic channel and the target area were inspected, and the tissues at the interface of target volume and blood vessels were sampled for pathological examination.

RESULTSNeither pulsed nor continuous HIFU caused noticeable injuries of the acoustic channel vessels, but the volume of necrotic tissues in the target area differed significantly between the two groups (P<0.05). HE staining and vessel staining did not show any injuries of the blood vessels in the pathway of ultrasound ablation in neither of the groups (P>0.05).

CONCLUSIONWhen the target area contains large blood vessels in the pathway of ultrasound ablation, pulsed HIFU can have better therapeutic efficiency to effectively induce tissue damages without affecting the blood vessels.

Animals ; Disease Models, Animal ; Extracorporeal Circulation ; Hepatic Artery ; pathology ; Hepatic Veins ; pathology ; High-Intensity Focused Ultrasound Ablation ; adverse effects ; methods ; Liver ; pathology ; Swine

OBJECTIVETo evaluate the safety and efficacy of using the JCS-01 focused ultrasound fat reduction machine for noninvasively breaking fat cells and abdomen sculpting treatment.

METHOD40 qualified subjects were enrolled in the study per the IRB-approved protocol and randomly assigned into trial and control groups. The fat reduction treatments were performed using the JCS-01 focused ultrasound fat reduction machine made by Beijing 3H Medical Technology Co., Ltd. The trial group received ultrasound energy treatment in their abdominal subcutaneous adipose tissue on the 1st and 7th days of the trial. The control group followed the similar procedure except that the ultrasound energy was turned off during treatments. Both the trial and control groups were followed-up on 1,7,14, 35 days post treatment.

RESULTSThe waist circumference measured on 14, 35 days were reduced 2.52 cm +/- 1.04 cm and 3.31 cm +/- 0.67cm in comparison with the baseline values in the trial group, reaching the protocol hypothesis of at least 1.5 cm abdominal circumference reduction, which demonstrated the treatment efficacy. The adverse events included minor and transient thermal sensation and mild pain in the treated abdomen area in the trial group. No other adverse events were observed. Clinical biochemistry assay testing showed that the subjects liver and kidney function indicators had no significant change.

CONCLUSIONIt is safe and effective to use the JCS-01 focused ultrasound fat reduction machine for abdomen fat reduction treatment.

Adult ; Body Fat Distribution ; Cosmetic Techniques ; Female ; High-Intensity Focused Ultrasound Ablation ; adverse effects ; instrumentation ; methods ; Humans ; Male ; Treatment Outcome ; Waist Circumference

D2 lymphadenectomy is currently the worldwide standard operation for locally advanced gastric cancer and D2+ is an option for some selected patients. The D2 plus lymphadenectomy includes No.8p, No.10, No.11d, No.12b, No.12p, No.13, No.14v, No.16a2 and No.16b1. Dissection of these groups of lymph nodes may cause related complications. Postoperative complications that can cause prolonged inflammation have significant impact not only on mortality but also on overall survival of patients with gastric cancer even if the tumor is resected curatively. D2 plus lymphadenectomy is recommended only in high volume medical center by experienced surgeon. The adequate exposure of the operative field, right anatomical space, use of ultrasound scalpel and operator with enough patience are proved to be pivotal to prevent the complications.
High-Intensity Focused Ultrasound Ablation ; instrumentation ; Humans ; Inflammation ; prevention & control ; Long Term Adverse Effects ; prevention & control ; Lymph Node Excision ; adverse effects ; instrumentation ; methods ; mortality ; Lymph Nodes ; Postoperative Complications ; prevention & control ; Stomach Neoplasms ; mortality ; surgery ; Surgical Instruments

PURPOSE: We evaluated the safety and effectiveness of the Magnetic Resonance-guided Focused Ultrasound (MRgFUS) with the ExAblate Conformal Bone System for the palliation of painful bone metastases. MATERIALS AND METHODS: Our Institutional Review Board approved this study, and all patients gave informed consent prior to enrollment. A total of six painful metastatic bone lesions in five patients were treated using MRgFUS with the ExAblate Conformal Bone System for pain palliation. The follow-up sessions were at 3 days, 2 weeks, 1, 2, and 3 months, and 1 year after treatment. Efficacy was evaluated by the changes in visual analog scale (VAS) scores. At 3-months and 1-year follow-ups, unenhanced computed tomography and contrast-enhanced MR imaging examinations were performed. All adverse events were assessed to evaluate treatment safety. RESULTS: All patients showed significant pain relief within 2 weeks. Two patients experienced complete pain reduction that lasted for 1 year. Two other patients showed pain relief measured as VAS scores of 2 and 4 on their last follow-up. Although the remaining patient had experienced significant pain relief in two lesions, the VAS score re-increased on his last follow-up. The size of the enhancing soft tissue mass in metastatic lesions decreased, and new bone formation was seen on follow-up images. Although adverse events were not serious, non-specific leg pain and second degree skin burn were noted. CONCLUSION: MRgFUS was demonstrated to be effective palliative treatment within 2 weeks in selected patients with painful bone metastases.
Adult ; Aged ; Bone Neoplasms/secondary/*therapy ; Contrast Media ; Female ; High-Intensity Focused Ultrasound Ablation/adverse effects/*methods ; Humans ; Magnetic Resonance Imaging, Interventional/*methods ; Magnetic Resonance Spectroscopy ; Male ; Middle Aged ; Pain ; *Pain Management ; *Palliative Care ; Prospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

PURPOSE: We evaluated the safety and effectiveness of the Magnetic Resonance-guided Focused Ultrasound (MRgFUS) with the ExAblate Conformal Bone System for the palliation of painful bone metastases. MATERIALS AND METHODS: Our Institutional Review Board approved this study, and all patients gave informed consent prior to enrollment. A total of six painful metastatic bone lesions in five patients were treated using MRgFUS with the ExAblate Conformal Bone System for pain palliation. The follow-up sessions were at 3 days, 2 weeks, 1, 2, and 3 months, and 1 year after treatment. Efficacy was evaluated by the changes in visual analog scale (VAS) scores. At 3-months and 1-year follow-ups, unenhanced computed tomography and contrast-enhanced MR imaging examinations were performed. All adverse events were assessed to evaluate treatment safety. RESULTS: All patients showed significant pain relief within 2 weeks. Two patients experienced complete pain reduction that lasted for 1 year. Two other patients showed pain relief measured as VAS scores of 2 and 4 on their last follow-up. Although the remaining patient had experienced significant pain relief in two lesions, the VAS score re-increased on his last follow-up. The size of the enhancing soft tissue mass in metastatic lesions decreased, and new bone formation was seen on follow-up images. Although adverse events were not serious, non-specific leg pain and second degree skin burn were noted. CONCLUSION: MRgFUS was demonstrated to be effective palliative treatment within 2 weeks in selected patients with painful bone metastases.
Adult ; Aged ; Bone Neoplasms/secondary/*therapy ; Contrast Media ; Female ; High-Intensity Focused Ultrasound Ablation/adverse effects/*methods ; Humans ; Magnetic Resonance Imaging, Interventional/*methods ; Magnetic Resonance Spectroscopy ; Male ; Middle Aged ; Pain ; *Pain Management ; *Palliative Care ; Prospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Incidence of gastric cancer is high in China and standard radical operation is currently the main treatment for gastric cancer. Postoperative complications, especially some special complications, can directly affect the prognosis of patients, even result in the increase of mortality. But the incidences of these special complications are low, so these complications are often misdiagnosed and delayed in treatment owing to insufficient recognition of medical staff. These special complications include (1) Peterson hernia: It is an abdominal hernia developed in the space between Roux loop and transverse colon mesentery after Roux-Y reconstruction of digestive tract. Peterson hernia is rare and can quickly result in gangrenous ileus. Because of low incidence and without specific clinical symptoms, this hernia does not attract enough attention in clinical practice, so the outcome will be very serious. Once the diagnosis is made, an emergent operation must be performed immediately. Peterson space should be closed routinely in order to avoid the development of hernia. (2) Lymphatic leakage: It is also called chyle leakage. Cisterna chylus is formed by gradual concentration of extensive lymphatic net to diaphragm angle within abdominal cavity. Lymphadenectomy during operation may easily damage lymphatic net and result in leakage. The use of ultrasonic scalpel can decrease the risk of lymphatic leakage in certain degree. If lymphatic leakage is found during operation, transfixion should be performed in time. Treatment includes total parenteral nutrition, maintenance of internal environment, supplement of protein, and observation by clamp as an attempt. (3)Duodenal stump leakage: It is one of serious complications affecting the recovery and leading to death after subtotal gastrectomy. Correct management of duodenal stump during operation is one of key points of the prevention of duodenal stump leakage. Routine purse embedding of duodenal stump is recommend during operation. The key treatment of this complication is to promt diagnosis and effective hemostasis.(4) Blood supply disorder of Roux-Y intestinal loop: Main preventive principle of this complication is to pay attention to the blood supply of vascular arch in intestinal edge. (5) Anastomotic obstruction by big purse of jejunal stump: When Roux-en-Y anastomosis is performed after distal radical operation for gastric cancer, anvil is placed in the remnant stomach and anastomat from distal jejunal stump is placed to make gastrojejunal anastomosis, and the stump is closed with big purse embedding. The embedding jejunal stump may enter gastric cavity leading to internal hernia and anastomotic obstruction. We suggest that application of interruptable and interlocking suture and fixation of stump on the gastric wall can avoid the development of this complication.
Anastomosis, Roux-en-Y ; adverse effects ; China ; Chylous Ascites ; etiology ; prevention & control ; therapy ; Duodenum ; blood supply ; surgery ; Gastrectomy ; adverse effects ; methods ; mortality ; Gastric Outlet Obstruction ; etiology ; prevention & control ; Gastric Stump ; surgery ; Hemostatic Techniques ; Hernia ; etiology ; prevention & control ; therapy ; High-Intensity Focused Ultrasound Ablation ; instrumentation ; Humans ; Jejunum ; blood supply ; surgery ; Lymph Node Excision ; adverse effects ; instrumentation ; Lymphatic System ; injuries ; Postoperative Complications ; classification ; diagnosis ; mortality ; prevention & control ; Prognosis ; Stomach ; surgery ; Stomach Neoplasms ; complications ; surgery ; Suture Techniques ; standards ; Thoracic Duct ; injuries ; Wound Closure Techniques ; standards