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MRI-guided High Intensity Focused Ultrasound (MRI-HIFU) is a promising methodfor the non-invasive ablation of pathological tissue in many organs, includingmobile organs such as liver and kidney. The possibility to locally depositthermal energy in a non-invasive way opens a path towards new therapeuticstrategies with improved reliability and reduced associated trauma, leading toimproved efficacy, reduced hospitalization and costs. Liver and kidney tumorsrepresent a major health problem because not all patients are suitable forcurative treatment with surgery. Currently, radio-frequency is the most usedmethod for percutaneous ablation. The development of a completely non-invasivemethod based on MR guided high intensity focused ultrasound (HIFU) treatmentsis of particular interest due to the associated reduced burden for the patient,treatment related patient morbidity and complication rate. The objective ofMR-guidance is hereby to control heat deposition with HIFU within the targetedpathological area, despite the physiological motion of these organs, in orderto provide an effective treatment with a reduced duration and an increasedlevel of patient safety. Regarding this, several technological challenges haveto be addressed: Firstly, the anatomical location of both organs within thethoracic cage requires inter-costal ablation strategies, which preserve thetherapeutic efficiency, but prevent undesired tissue damage to the ribs and theintercostal muscle. Secondly, both therapy guidance and energy deposition haveto be rendered compatible with the continuous physiological motion of theabdomen.

MRI-guided HIFU Methods for the Ablation of Liver and Renal Cancers