Image-guided non-invasive ultrasound liver ablation using histotripsy: Feasibility study in an in vivo porcine model

Hepatocellular carcinoma is one of the fastest growing cancers worldwide. Histotripsy is a non-invasive ablation method that fractionates soft tissue through the control of acoustic cavitation. In this study, we demonstrate the feasibility of using histotripsy for non-invasive liver ablation. Fourteen ~1cm³ lesions were created in the livers of eight pigs through the intact chest in vivo without using aberration correction. Complete fractionation of liver parenchyma was observed with <;500 μm sharp boundaries. In addition, two larger volumes of 18 cm³ and 60 cm³ were generated within 60 minutes. Histotripsy liver fractionation was self-limited at the boundaries of critical structures including the gallbladder and major vessels. The liver surrounding major vessels was completely fractionated while the vessels remained intact. This work demonstrates that histotripsy is capable of noninvasively fractionating liver tissue while preserving critical anatomical structures within the liver. Results suggest histotripsy has potential for the non-invasive ablation of liver tumors.