Histotripsy is a relatively new therapeutic ultrasound technology to mechanically liquefy tissue into subcellular debris using high-amplitude focused ultrasound pulses. In contrast to conventional high-intensity focused ultrasound thermal therapy, histotripsy has specific clinical advantages: the capacity for real-time monitoring using ultrasound imaging, diminished heat sink effects resulting in lesions with sharp margins, effective removal of the treated tissue, a tissue-selective feature to preserve crucial structures, and immunostimulation. The technology is being evaluated in small and large animal models for treating cancer, thrombosis, hematomas, abscesses, and biofilms; enhancing tumor-specific immune response; and neurological applications. Histotripsy has been recently approved by the US Food and Drug Administration to treat liver tumors, with clinical trials undertaken for benign prostatic hyperplasia and renal tumors. This review outlines the physical principles of various types of histotripsy; presents major parameters of the technology and corresponding hardware and software, imaging methods, and bioeffects; and discusses the most promising preclinical and clinical applications.Expected final online publication date for the Annual Review of Biomedical Engineering, Volume 26 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

中文翻译：

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组织解剖学：超声机械组织消融的一种方法

组织解剖学是一种相对较新的超声治疗技术，利用高振幅聚焦超声脉冲将组织机械液化成亚细胞碎片。与传统的高强度聚焦超声热疗相比，组织解剖具有特定的临床优势：使用超声成像进行实时监测的能力，减少热沉效应导致病变边缘尖锐，有效去除治疗组织，组织-保留关键结构的选择性特征和免疫刺激。该技术正在小型和大型动物模型中进行评估，用于治疗癌症、血栓、血肿、脓肿和生物膜；增强肿瘤特异性免疫反应；和神经学应用。美国食品和药物管理局最近批准组织解剖学用于治疗肝脏肿瘤，并针对良性前列腺增生和肾肿瘤进行了临床试验。这篇综述概述了各种类型组织解剖学的物理原理；介绍了该技术的主要参数以及相应的硬件和软件、成像方法和生物效应；并讨论了最有前途的临床前和临床应用。《生物医学工程年度评论》第 26 卷的预计最终在线发布日期为 2024 年 5 月。请参阅 http://www.annualreviews.org/page/journal/pubdates 了解修订后的估计。