AdventHealth Celebration is Among First in the State to Offer Non-invasive Histotripsy Treatment for Unresectable Liver Tumors

Hepato-pancreato-biliary (HPB) surgeon Andrew Guzowski, MD, performed AdventHealth’s first liver histotripsy, a non-invasive treatment for certain patients with unresectable liver tumors. Histotripsy is a form of focused ultrasound that uses high amplitude, short pulses of sound waves to create a “bubble cloud” designed to cavitate the targeted liver tissue, mechanically destroying and liquefying the tumor at a sub-cellular level without damaging surrounding tissue.

The liver histotripsy procedure uses the Edison system, a sonic beam therapy platform created by HistoSonics, that was granted approval from the U.S. Food and Drug Administration (FDA) approval for treatment of liver tumors in October 2023. The approval was based in part on the results of the #HOPE4LIVER clinical trials held in 13 sites across the US and Europe where 44 subjects were evaluated for safety, and 44 tumors treated were evaluated for efficacy.

“Liver histotripsy is much more precise than other ablative technologies,” explains Dr. Guzowski. “While surgical resection remains the gold standard for treating malignant liver tumors, this new approach provides us with a non-invasive treatment option for some patients who are not candidates for surgery. It also allows them to avoid the morbidity and complications of current treatment modalities like radiation and thermal ablation.”

How Liver Histotripsy Works

Before the histotripsy procedure, diagnostic ultrasound is used to locate the tumor(s) and determine the size of each area to be treated. These coordinates are then programmed into the histotripsy robot so the treatment head -- the source of the ultrasound waves -- can be properly positioned. During treatment, the patient is placed under general anesthesia, and the treatment head, situated within a soft, flexible membrane filled with degassed water, is positioned over the patient’s liver. Using real-time monitoring with diagnostic ultrasound, the physician then turns on the focused treatment ultrasound, creating a “bubble cloud,” which destroys the targeted tumor tissue. Procedure time varies depending on the number of treatments delivered as multiple lesions can be treated on the same day.

“We’re thrilled to offer liver histotripsy as a new treatment option for our patients with unresectable liver tumors,” shares Dr. Guzowski. “Whenever we can destroy a tumor without incisions or damage to surrounding tissue, patients are appreciative and typically have minimal effects after treatment.”

Current Research Evaluating Use of Histotripsy for Kidney Tumors

In addition to treating liver tumors with histotripsy, AdventHealth is currently involved in the #HOPE4KIDNEY clinical trial, a multi-center study which is evaluating the safety and efficacy of histotripsy technology to treat kidney lesions. In January 2024, AdventHealth urologist Michael McDonald, MD, performed the world’s first kidney histotripsy procedure at AdventHealth Celebration as part of this study.