High-Intensity Focused Ultrasound (HIFU)

What is high-intensity focused ultrasound (HIFU)?

High-intensity focused ultrasound (HIFU) is a medical procedure that uses ultrasound waves to treat certain conditions, such as tumors. It’s a minimally invasive procedure.

Healthcare providers use regular ultrasound scans for several imaging purposes. Ultrasound uses high-frequency sound waves to create real-time pictures or video of internal organs or other soft tissues.

But HIFU doesn’t produce images. Instead, the very high-intensity and highly focused sound waves interact with targeted tissues in your body to modify or destroy them.

It’s similar to how a magnifying glass focuses sunlight on a target. In HIFU, many beams of ultrasound focus on the exact tissue area that requires treatment. The highly focused energy from the ultrasound causes the temperature of the tissue to rise, and the heat destroys (ablates) the targeted tissue area.

The ultrasound beams can pass through layers of tissue (such as your skin), leaving them unharmed, until they reach their target.

Providers often either use magnetic resonance imaging (MRI) or ultrasound imaging to guide, assess and monitor the HIFU procedure. One common type of HIFU is magnetic resonance-guided focused ultrasound (MRgFUS).

What conditions can HIFU treat?

Healthcare providers use high-intensity focused ultrasound (HIFU) to treat a variety of conditions. One common use is treating certain solid malignant (cancerous) and benign (noncancerous) tumors, including tumors in your:

• Bones.
• Brain.
• Breast.
• Connective tissues.
• Esophagus.
• Kidney.
• Liver.
• Pancreas.
• Prostate.

Providers also use HIFU to treat:

• Uterine fibroids.
• Essential tremor that can’t be managed with medication.
• Parkinson’s disease when the main symptom is tremor.
• Metastatic bone growth pain.
• Thyroid nodules.

Medical researchers are currently investigating several other conditions and issues HIFU can treat.

Why is HIFU used?

Healthcare providers use HIFU because it’s non-invasive and generally safer than other kinds of treatments.

However, providers can’t treat every type of tumor with HIFU. For example, ideal candidates for HIFU for prostate cancer are people who have early-stage, low-grade cancer that’s only in their prostate and that’s visible on an MRI or ultrasound scan. If the cancer has spread or the tumor is difficult to see with imaging tests, HIFU might not be a viable treatment option.

What happens before a HIFU procedure?

In most cases, you’ll need to undergo an imaging test, such as an MRI or ultrasound, before the HIFU procedure. This will help your healthcare provider find the exact location of the tissue they want to target.

Your provider will give you specific instructions to prepare for the HIFU procedure. Be sure to follow them.

What happens during a HIFU procedure?

How you’ll receive HIFU depends on what your healthcare provider is using it to treat. The best way to know what to expect is to talk to your healthcare team and ask questions.

In general, a HIFU procedure typically involves the following steps:

• You’ll lay on an exam table or sit in an exam chair.
• The provider may use a device to stabilize the area of the targeted tissue. For example, they may use a device to keep breast tissue still or use a head frame to keep your head still for tremor treatment.
• Depending on the situation, you may be fully conscious, lightly sedated or under general anesthesia for the procedure.
• The provider will use ultrasound or MRI imaging to find the exact location of the targeted tissue.
• They’ll center the head of the HIFU probe on (above) the tissue they’re targeting. In most cases, the probe will be above or on your skin. For prostate cancer treatment, the provider will insert the probe (about the size of your index finger) into your rectum.
• They’ll deliver a test dose to the center of the targeted tissue.
• If necessary, they’ll make adjustments to the power of the ultrasound beams based on the depth of the tissue.
• They’ll deliver bursts of ultrasonic waves to the tissue.
• They’ll use an imaging test to make sure the targeted tissue was destroyed.

Treatment with HIFU usually only requires a single session or procedure.

What are the advantages of HIFU?

Advantages of HIFU include:

• It requires no surgical incisions into your body (it’s non-invasive) and doesn’t use radiation.
• It can exactly target diseased tissue, leaving non-targeted healthy tissue unharmed.
• It’s often an outpatient procedure with a short recovery time. You can usually return to work or your usual routine within a few days.

HIFU has fewer side effects than more invasive types of tumor treatment, including:

• Chemotherapy.
• Radiation therapy.
• Open surgery.

What are the risks or complications of HIFU?

HIFU for medical treatment has a very low risk of complications. In some cases, it can cause skin burns, but this is rare.

Each use of HIFU can have different possible side effects. For example, the most common side effects of HIFU treatment for prostate cancer are urinary problems and erectile dysfunction.

If you’re concerned about side effects or complications of HIFU, talk to your healthcare provider.

What is the recovery time for HIFU?

Each person is unique, and each use of HIFU for medical treatment is different. In general, HIFU has a quicker recovery time than other, more invasive forms of treatment.

Your healthcare team will tell you what to expect and how long it’ll take you to recover after your HIFU procedure.

A note from Cleveland Clinic

High-intensity focused ultrasound (HIFU) has a wide range of applications for medical treatments. It’s minimally invasive and usually has a short recovery time. If you have any questions about HIFU or the procedure process, don’t be afraid to ask your healthcare provider. They’re available to help.