Optimising patient specific treatment plans for ultrasound ablative therapies in the abdomen (OptimUS)

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Surgical and ablative technologies are the most effective local therapies for solid malignancies. The significant side effects associated with surgical interventions have led to an ongoing quest for safer, more efficient, and better tolerated alternatives. In recent years, there has been a notable shift away from open surgery towards less invasive procedures such as laparoscopic and robotic surgery, and from there to other methods for in situ tumour destruction, often involving energy based destruction. These include embolisation, radiofrequency, microwave and laser ablation, cryoablation and HIFU. HIFU is a procedure which uses high-amplitude ultrasound to thermally ablate a localised region of tissue. For abdominal applications, the ultrasound is typically generated by a focused transducer located extracorporealy. As the ultrasound propagates through tissue and at high acoustic intensities, absorption of the energy can induce targeted tissue necrosis within a well-defined volume without damaging the overlying tissue.The aim of OptimUS is to develop a novel mathematical and treatment planning framework for tumours of the abdomen which are to be ablated using HIFU. This new framework will be purpose built for a CE marked commercially available MR-guided & monitored HIFU system, which includes a multi-element transducer. It will make use of high-performance computing capabilities which will deliver optimal treatment plans both accurately and fast. This framework will greatly extend and reinforce the role of HIFU as a completely non-invasive ablative modality, and radically improve the treatment of kidney, pancreas and liver tumours, of uterine fibroids and renal sympathetic denervation (RSD).World-leading investigators and partners have been assembled to collaborate on this project, from University College London, University of Cambridge, the Institute of Cancer Research UK and Oxford HIFU Unit. All bring unique yet complementary expertise in the fields of mathematics, engineering, physics, oncology and computing to solve a series of complex challenges, which will lead to a significant increase in the quality of life and life expectancy of patients. In addition, the development of HIFU treatment planning methods will lead to more cost-effective cancer treatment protocols, saving the NHS time, resources and money.