Histotripsy: How Ultrasound Destroys Liver Tumors

Behind me is a machine that

destroys tumors using sound waves.

I'm here at the hospital that's done

the most of this type of procedure to talk to

the doctor that's done the most of

this type of procedure to show you a demo

and exactly how this thing liquefies tumors before your

very eyes. Let's get into

it. Histotripsy is a type of cancer treatment

that

uses targeted ultrasound waves to

destroy tumors in a non-invasive

way. And this Edison system made by Histosonics

is the only

commercially available histotripsy machine

for humans on the market right now.

The patient would be laying on the table.

This device, which is called the water bath,

would be sitting on top of the

patient, and we would position this over the tumor

to get the patient prepared for

the treatment.

The water bath used in histotripsy

serves the same purpose as the gel

used during ultrasound imaging, preventing air pockets,

which would diffuse the

ultrasound waves and compromise the procedure.

The water being used is regular tap water that's run through a

special

filter to remove any air bubbles.

We're in an operating room, but this is

actually not a sterile procedure, so

there's no incisions or cuts or anything made on this.

The most invasive portion will be getting an, an IV so that you can get sedation.

Generally give patients anesthesia as

well, so they're completely asleep so they

don't move once the therapy starts.

The way these concentrated ultrasound

waves actually destroy tumor cells

is by rapidly expanding and contracting the gases naturally inside

them.

This is a mechanical destruction of the tissue rather than a thermal or a

radiation-based. So it's more similar to surgery in

that sense, where it's

mechanical. So it really liquefies this.

This treatment is instant,

so as soon as the histotripsy

is delivered, the tissue

is destroyed. It's not something we have to wait for,

um, down the road.

Dr. Burns showed us some before and after images of patients who had

undergone

histotripsy and how the liver tissue healed after the procedure.

Right now, histotripsy is primarily

focused on destroying liver

tumors, but

there's potential for this technology to be applied to tumors in other areas of the

body as well.

And so this patient had histotripsy delivered to this tumor.

This was her only tumor at the time.

Four months later, we have an MRI

showing that basically

that entire lesion is

resolved. We can see very, very small amount of a little defect here,

but just

comparing the size from the day of, from the treatment all the way down to

four

months later, you can see that basically the, you know, n-

liver has basically

repaired this entire area and reabsorbed all of this.

Trial to treat primary kidney tumors has just closed.

So we're awaiting those results. Hopefully,

that will be available commercially,

you know, in the next year or so.

And there's a trial to treat pancreatic

tumors

that's underway in Barcelona, in Spain, and that'll be probably coming to the US,

uh, in 2026. And so histotripsy and Histosonics is really a

technology platform. This is a new technology.

This is gonna expand to every organ in the body.

Looking at future trials,

probably gonna come to prostate to treat

BPH, enlarged

prostate, potentially prostate

cancer. Can think maybe uterine fibroids.

Smaller devices may be able to treat breast tumors, thyroid nodules,

even think about brain tumors. This is gonna expand across the entire body,

cancerous and non-cancerous, uh, conditions.

Air-filled organs like lungs, stomach,

and intestines still propose a

challenge due to the fact that ultrasound waves dissipate in air.

Dr.

Burns says a histotripsy

procedure can take about one to three hours,

depending on

how many tumors are being targeted.

Most patients with histotripsy go

home a couple hours after the procedure.

It's fairly common to have some pain

or discomfort where the treatment goes in.

For smaller treatments, some patients have no symptoms at all.

After the procedure, patients

can have some systemic

inflammatory symptoms.

That generally starts the day afterwards.

That's fever, a flu-like illness, just,

just a general malaise feeling.

That's very normal. That's the body reacting.

This doesn't replace all surgeries, but it, there may be patients that could

benefit from this rather than proceeding to a surgery, which obviously will have

more complications, may require hospital stays.

And this procedure can also be repeated many times.

So as long as the patient's liver function is normal,

we can go after multiple

tumors, either in the same session or over multiple procedures kinda spread

out

over weeks or months.

Histotripsy got FDA approval

back in October of 2023 and is

expanding availability as more machines are produced.

There's probably at least a center near you, if

not in your state, at least near.

It's available. It's gonna go be in the UK,

other areas in Asia.

So this is gonna expand globally as time comes.

They just have to build enough units.