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Purpose <p>Histotripsy is a non-invasive ultrasound-based tumor ablation modality. This study aims to describe the preliminary safety and short-term imaging findings related to histotripsy of liver metastases.</p> Materials and Methods <p>All patients who underwent histotripsy for liver metastases from February 2024 to January 2025 at a single center were retrospectively reviewed. Demographic, clinical, imaging, procedural, and adverse event data were collected via chart review. Immediate post-treatment ablation zones were measured on CT and compared to pretreatment tumor size and treatment cavity size on follow-up imaging. Untreated tumors were assessed using revised RECIST criteria to evaluate for off-target effects.</p> Results <p>Histotripsy was performed on 56 metastatic liver tumors (most common: 32% colorectal, 18% breast) in 26 patients (54% female, age 59.1 ± 15.6y). All patients were discharged within 36&#xa0;h. Immediate post-procedural ablation zones (36.6 + 13.1&#xa0;mm) were larger compared to pretreatment tumors (30.5 + 18.5&#xa0;mm) (<i>p</i> = 0.0013). One-month ablation zones (31.5 + 16.7&#xa0;mm) were smaller compared to immediate post-procedural ablation zones (<i>p</i> = 0.00064). Two patients experienced off-target effects in non-treated liver tumors following histotripsy while off cytotoxic therapy. One patient experienced a Grade 3 complication of bacteremia requiring prolonged inpatient admission. No deaths occurred within 30&#xa0;days.</p> Conclusion <p>Histotripsy demonstrates a favorable safety profile for liver metastases. Observed off-target effects in untreated lesions suggest systemic immunomodulatory responses. Further investigation is warranted to elucidate patient-specific factors (e.g., tumor biology, concurrent therapies) that optimize systemic immune activation. Larger prospective studies with longitudinal immune profiling are needed to validate histotripsy’s potential dual role as a locoregional therapy and immune primer in metastatic liver disease.</p> Level of Evidence <p>Level 2b, retrospective cohort study.</p> Graphical Abstract <p></p>

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Histotripsy of Liver Metastases: Short-Term Safety and Imaging Findings

  • 期刊论文

  • 发表日期：

    2025年9月28日

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  • Tarub S. Mabud,
  • Monica Vergara,
  • Jasper Du,
  • William H. Moore,
  • Shu Liu,
  • Frederic Bertino,
  • Bedros Taslakian,
  • Christopher Wolfgang,
  • D. Brock Hewitt,
  • Mikhail Silk

摘要

Purpose

Histotripsy is a non-invasive ultrasound-based tumor ablation modality. This study aims to describe the preliminary safety and short-term imaging findings related to histotripsy of liver metastases.

Materials and Methods

All patients who underwent histotripsy for liver metastases from February 2024 to January 2025 at a single center were retrospectively reviewed. Demographic, clinical, imaging, procedural, and adverse event data were collected via chart review. Immediate post-treatment ablation zones were measured on CT and compared to pretreatment tumor size and treatment cavity size on follow-up imaging. Untreated tumors were assessed using revised RECIST criteria to evaluate for off-target effects.

Results

Histotripsy was performed on 56 metastatic liver tumors (most common: 32% colorectal, 18% breast) in 26 patients (54% female, age 59.1 ± 15.6y). All patients were discharged within 36 h. Immediate post-procedural ablation zones (36.6 + 13.1 mm) were larger compared to pretreatment tumors (30.5 + 18.5 mm) (p = 0.0013). One-month ablation zones (31.5 + 16.7 mm) were smaller compared to immediate post-procedural ablation zones (p = 0.00064). Two patients experienced off-target effects in non-treated liver tumors following histotripsy while off cytotoxic therapy. One patient experienced a Grade 3 complication of bacteremia requiring prolonged inpatient admission. No deaths occurred within 30 days.

Conclusion

Histotripsy demonstrates a favorable safety profile for liver metastases. Observed off-target effects in untreated lesions suggest systemic immunomodulatory responses. Further investigation is warranted to elucidate patient-specific factors (e.g., tumor biology, concurrent therapies) that optimize systemic immune activation. Larger prospective studies with longitudinal immune profiling are needed to validate histotripsy’s potential dual role as a locoregional therapy and immune primer in metastatic liver disease.

Level of Evidence

Level 2b, retrospective cohort study.

Graphical Abstract