The University of Arkansas for Medical Sciences (UAMS) is now offering a noninvasive treatment option for some patients with liver tumors.
Called histotripsy, the procedure uses focused ultrasound waves to destroy tumors without surgery, radiation, or incisions.
“With this technology, our specially trained doctors can target and destroy one or more tumors in a single, noninvasive outpatient procedure with little to no pain,” said Michelle W. Krause, MD, MPH, senior vice chancellor of UAMS Health and CEO of UAMS Medical Center.
“This offers hope for patients with liver tumors — even those who are currently undergoing chemotherapy or radiation and those with tumors that are considered unresectable, meaning they cannot be safely removed through surgery,” Krause added.
During a histotripsy procedure, which takes about an hour while the patient is under general anesthesia to remain still, a machine directs high-intensity sound pulses toward one or more tumors. The alternating pressure created by the pulses creates a cloud of tiny gas-filled bubbles within the diseased tissue. As the “bubble cloud,” which is about the size of a grain of rice, moves through the tissue, it causes the targeted tumors to liquify. The liquid is then eliminated by the body over the following weeks and months.
Three physicians at UAMS have completed training in histotripsy: transplant surgeon Lyle Burdine, MD, PhD; interventional radiologist James Meek, DO; and surgical oncologist Sonia Orcutt, MD.
Orcutt said the procedure appears to strengthen the patient’s immune system. She referred to the “abscopal effect” of cancer treatment, which occurs when radiation or another type of local therapy causes tumors outside the treated area to shrink or disappear as well.
Even if only one lesion is treated, Orcutt said, the enhanced immune response may cause multiple lesions to respond without direct treatment themselves, which “has huge implications for patients with metastatic cancer that other liver-directed treatments do not have.”
“I saw this technology at a conference, and I knew right away this was something I wanted to bring to UAMS,” Meek said. “We have so many patients in Arkansas who can benefit from this treatment.”
Histotripsy had a 95.5% success rate in clinical trials, with nine out of 10 treated tumors remaining gone one year later. It received FDA approval in October 2023, following more than 20 years of development at the University of Michigan. The technology has also been used to treat patients at Johns Hopkins Medicine and the Cleveland Clinic, among other institutions across the United States.
“It’s approved for liver cancer now, but the hope is it will soon be approved for other cancers as well,” Meek said. In fact, trials are now underway to expand treatment to noninvasive renal and pancreatic tumors.