High-intensity focused ultrasound ablation of muscle in an anticoagulated swine model

Abstract

Introduction

Image-guided non-invasive high-intensity focused ultrasound (HIFU) has been gaining recognition in treating musculoskeletal tumors and desmoids. However, there is no consensus on the appropriate perioperative management for patients on ongoing anticoagulation who undergo HIFU ablation.

Material and methods

Image-guided HIFU treatment was performed in swine on an ongoing oral anticoagulation protocol (N = 5) in two treatment sessions seven days apart. On day one, a total of twenty locations were ablated, and on day eight, ten more muscle ablations were performed, and the animals were euthanized. Imaging, clinical examination, and histopathology were performed to investigate treated tissue for bleeding.

Results

Imaging, clinical examination, and histopathology revealed either no bleeding or, in some samples, only small scattered cavities (0.2–2 mm in diameter) filled with blood.

Conclusion

Noninvasive HIFU ablation of muscle may not require a coagulation profile within normal limits.

Keywords:

• Thermal ablation
• HIFU
• swine model
• anticoagulation
• FUS

Acknowledgements

We thank James Keller for his help with editing and preparing this manuscript.

Declaration of interest

The following authors do not have any conflict of interest to declare: Elena Kaye, Majid Maybody, Narendra Babu Gutta, Sebastien Monette. Dr. Stephen Solomon received grant funding from GE Healthcare, Johnson & Johnson, AngioDynamics and Elesta; he also received personal fees from BTG, Johnson & Johnson and Xact Robotics.

Additional information

Funding

This research project was supported by MSKCC Society grant for which the authors express grateful appreciation and in part by the NIH/NCI Cancer Center Support Grant P30 CA008748.