This new, cutting-edge treatment uses sound waves to treat tumors in the liver.
What is histotripsy?
Histotripsy is a noninvasive medical procedure that uses high-intensity sound waves to destroy liver tumors — including primary liver cancer and liver metastases from other cancer types. Any patient with liver tumors might be a candidate for histotripsy.
Unlike other liver treatment methods, histotripsy does not require incisions, needles or probes, or use ionizing radiation. The procedure uses ultrasound imaging to locate the targeted tissue and monitor the treatment in real time, while directing pulses of focused and intense ultrasound waves to treat the tumor.
Roswell Park uses the Edison® Histotripsy System, made possible through donations to the Roswell Park Alliance Foundation.
How histotripsy works
Histotripsy involves placing a treatment head, which emits the sound waves, inside a soft, flexible membrane containing specially treated water. This membrane is then positioned on your abdomen and directed at the liver tumor.
The sound waves cause tiny gas bubbles in the tumor tissue to rapidly expand and collapse, creating a bubble cloud on the tissue. This bubble cloud generates strong pressure and strain on the targeted tissue. This action literally breaks apart the tumor cells and liquifies them. The remaining harmless cell “debris” is absorbed by the body.
What are the benefits of histotripsy?
- Treats difficult to reach tumors and lesions. Histotripsy offers an alternative option for tumors in challenging locations.
- Non-invasive. The procedure does not require any incisions, needles, or other insertions through the skin which can help reduce the risk of infection, bleeding, long recovery times and other complications.
- Single treatment. Most tumors can be effectively destroyed in a single treatment session. Depending on your clinical condition and treatment plan, multiple treatment sessions may be necessary.
- Can be repeated as needed. Histotripsy can be used as a chronic therapy instead of, or in conjunction with, ongoing chemotherapy.
What to expect from histotripsy?
The histotripsy procedure is performed under general anesthesia and can often be completed in as little as one treatment. The full procedure generally takes 1-3 hours; your treatment will depend on the size the size and location of your tumors.
Step 1: Consultation
You will meet your doctor who will answer your questions and discuss your eligibility for this procedure. If you are eligible, you will have an outpatient ultrasound screening evaluation of your liver before the actual histotripsy treatment.
This evaluation is done to make sure that your liver tumor(s) can be accurately targeted and safely treated with histotripsy. If this evaluation confirms that your tumor(s) can be treated with histotripsy, you will be scheduled for treatment.
Step 2: Preparation
Your doctor may require you to follow some dietary restrictions before the planned histotripsy. Be sure to follow all instructions before your planned date.
Step 3: Procedure
You will be guided into a room with a histotripsy system. Your doctor may perform an ultrasound for additional confirmation of your tumor location. General anesthesia will be administered, and your doctor will place a histotripsy treatment head over the targeted tumor.
During the procedure, the treatment head delivers sound waves to the targeted area while your doctor uses ultrasound imaging to monitor the treatment.
Step 4: Recovery
After the treatment, you may experience some pain, depending on the treatment area. Many patients can return home the same day or day after the procedure and usually resume their normal activities quickly.
Frequently asked questions
Most procedures will be performed on an outpatient basis, allowing you to return home the same or following day.
Whether or not you’ll need a hospital stay will depend on several factors, including whether you have any pain and how you feel overall. Your doctor will decide based on your individual situation.
One month after treatment, you will have a contrast enhanced CT or MRI scan to evaluate the treated tumor(s).
Yes. Currently, there are no conflicts with other treatments. Histotripsy has been used before, after or in combination with other procedures. The decision to incorporate histotripsy and the potential impact on future clinical decisions should be discussed with your physician.
Currently, we are using general anesthesia to perform the procedure. Histotripsy is a highly precise treatment; general anesthesia is primarily used to control patient movement during the procedure rather than to manage the pain.
Medicare should cover the procedure if it is reasonable and necessary. However, it will be necessary to have your selected histotripsy provider verify coverage with private insurance.
As a new treatment option, treatment coverage and payment are still being established with the different insurance companies.
The histotripsy procedure is typically performed under general anesthesia so you should not experience pain during the procedure.
You may feel some pain after treatment depending on the area treated, but there are no incision wounds, and many patients can return to normal activities quickly. The most common adverse effects were abdominal pain and fever.
Histotripsy has been studied in laboratories for over 20 years with clinical trials beginning in 2018 and FDA approval was granted in 2023. Several studies, including The #HOPE4LIVER trials, demonstrated successful use of histotripsy in patients with primary and metastatic tumors in the liver in the United States and European Union. In this research, 96% of lesions were successfully treated. https://pubs.rsna.org/doi/10.1148/radiol.233051