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This study investigates the safety profile for use of histotripsy, a non-invasive ultrasonic ablation method currently being developed for the treatment of liver cancer, for liver ablation in an in vivo porcine model. Histotripsy treatments were applied to the liver and hepatic veins of 22 porcine subjects, with half of the subjects receiving systemic heparinization. Vital signs (heart rate, blood pressure, temperature, electrocardiogram and SpO 2 ) were monitored throughout the procedure and for 1 h post-treatment. Blood was drawn at six points during the experiment to analyze blood gases, liver function and free hemoglobin levels. All treatments were guided and monitored by real-time ultrasound imaging. After treatment, the tissue was harvested for histological analysis. Results indicated that histotripsy generated well-defined lesions inside the liver and around the treated hepatic veins of all subjects in both treatment groups. Vital signs and blood analysis revealed that animals responded well to histotripsy, with all animals surviving the treatment. One animal in the non-heparinized group had a transient increase in pH and decreases in blood pressure, heart rate and PCO 2 during the 15-min vessel treatment, with these changes returning to baseline levels soon after the treatment. Overall, the results indicate that histotripsy can safely be performed on the liver without the need for systemic heparinization, even in regions containing large hepatic vessels, supporting its future use for the treatment of liver cancer., (Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

We have implemented an MR technique that employs a rapid gradient echo sequence, preceded by magnetization preparation pulses to provide T1- and T2-weighted tissue contrast. With this technique, which can be identified as a member of a new family of pulse sequences, generically named Magnetization Prepared RApid Gradient Echo (MP-RAGE), very short repetition times are used, allowing acquisition times of less than one second and images virtually free of motion-induced artifacts during quiet respiration. Fifteen patients with known liver lesions (metastases, hemangiomas, and cysts) were examined using T1- and T2-weighted 2-dimensional MP-RAGE sequences, and the images were compared with conventional T1- and multi-echo T2-weighted spin-echo (SE) sequences. Signal difference-to-noise ratios (SD/Ns) of the lesions were calculated for all pulse sequences using corresponding axial images and were normalized for voxel volume. The mean normalized SD/Ns of the MP-RAGE sequences were generally comparable to those for the SE sequences. In addition, there were no noticeable respiratory artifacts on the MP-RAGE images whereas these were clearly present on the T2-weighted SE images and to a lesser degree on the T1-weighted SE images. It is concluded that the MP-RAGE technique could become an important method for evaluating the liver for focal disease.