Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Background: Colorectal cancer is the third most common cancer worldwide and more than 50% of those patients will develop metastatic disease to the liver over the course of their life. Patients with cancer have complex needs and so their care cannot be addressed optimally by a single specialty, hence the multidisciplinary team approach. Hepatectomy remains the standard of care for colorectal cancer metastasis. The role of chemotherapy in the management is considerably increased being suitable for both unresectable and resectable metastases. Several mini-invasive interventional radiology procedures can serve those patients (including TACE, RFA, MWA..). HIFU is a novel technology that causes thermal ablation with no skin penetration being almost non-invasive procedure and it can be helpful in combination with the other therapeutic options in the management of colorectal cancer liver metastasis patients.Methods: Twenty patients with proven unresectable colorectal metastatic liver cancer were evaluated by multi-disciplinary team to receive high intensity focused ultrasound ablation, and correlation was made between the imaging done prior to HIFU therapy and that done within two months after HIFU therapy. The HIFU ablation was done on a dedicated JC HIFU system (Chongqing Haifu Technology, Chongqing, China) Results: 40% of the study patients achieved complete ablation while 60% achieved partial ablation using HIFU therapy. Only 5% of the study patients developed major side effects, while the rest developed only minor well-tolerable side effects. Conclusion: HIFU treatment is considered as an appreciable alternative to other local thermal ablations especially when they are patient-inconvenient. It should be done hand in hand with systemic chemotherapy. It has fewer severe complications in comparison to the other local thermal ablation modalities

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