Thunder Bay pioneers HIFU

Scientists at the Thunder Bay Regional Research Institute are taking the first steps toward the introduction of a new, non-invasive medical procedure for treating uterine fibroids, tumours and neurodegenerative diseases in Canada.

Used to some extent in the U.S. and in Europe, High Intensity Focused Ultrasound, or HIFU, delivers acoustic energy that heats and destroys pathogenic tissue. The $12 million research initiative is being carried out in partnership with Philips Healthcare and Sunnybrook Health Sciences Centre in Toronto, and includes the acquisition of two Philips Achieva 3T X-Series MRI scanners, which will be used to guide the high-energy acoustic waves and assess the effects of the treatment. One of the MRIs with integrated HIFU capability will be installed in Thunder Bay in January and will be used to treat uterine fibroids in clinical trials beginning in September 2009. The other unit will be located at Sunnybrook.

HIFU has been used in Europe since 1992 to treat prostate cancer and is being used in the U.S. to treat uterine fibroids, but the application of the technology is still in its infancy. It can potentially be used to also treat malignant tumours and neurodegenerative diseases such as Alzheimer's and Parkinson's, said Laura Curiel, a career scientist and medical physicist who is overseeing the research in Thunder Bay.

A non-invasive alternative to treating uterine fibroids, HIFU "can be applied in the morning and the patient can go home in the afternoon, so it eliminates a hospital stay." It's also less painful and there's less risk of blood clots and other surgery-related complications, she added.

Malignant tumours

Based on laboratory research in other jurisdictions, Curiel and her team are also optimistic about using HIFU to treat malignant tumours in the liver as well as other abdominal tumours.

The liver is of interest, explained Curiel, because "almost all cancers metastasize to the liver if not controlled." Capable of targeting tumours as small as two millimeters in diameter and one centimeter in length, HIFU, could be well suited for patients who are not candidates for surgery, she said.

Clinical trials on uterine fibroids will be limited to women who don't want to have any more children and whose only other option is a hysterectomy, but in U.S. trials conducted under similar protocols, women treated by HIFU have been able to conceive, said Curiel.

Research on using HIFU to treat neurodegernerative diseases will build on the work by Dr. Kullervo Hynynen of

Sunnybrook, who proved that HIFU is able to temporarily open the blood-brain barrier to allow for the delivery of drugs that wouldn't otherwise be able to reach the brain.

The Thunder Bay Regional Research Institute is carrying out this research on imaging guided interventions as part of its mandate to improve the quality of health care through patient-centred research focusing on molecular imaging-based diagnostic technologies for disease prevention, early detection and image-guided treatment.

The $12 million research program is being funded by a combination of grants from various levels of government and in-kind contributions from Philips Healthcare, as well as an operating grant from the Ontario Research Foundation.

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