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Noninvasive high-intensity focused ultrasound treatment of twin-twin transfusion syndrome: A preliminary in vivo study.

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Date
2016-07
ICR Author
Rivens, Ian
Civale, John
Ter Haar, Gail
Author
Shaw, CJ
Civale, J
Botting, KJ
Niu, Y
Ter Haar, G
Rivens, I
Giussani, DA
Lees, CC
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Type
Journal Article
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Abstract
We investigated the efficacy, maternofetal responses, and safety of using high-intensity focused ultrasound (HIFU) for noninvasive occlusion of placental vasculature compared to sham treatment in anesthetized pregnant sheep. This technique for noninvasive occlusion of placental vasculature may be translatable to the treatment of conditions arising from abnormal placental vasculature, such as twin-twin transfusion syndrome (TTTS). Eleven pregnant sheep were instrumented with maternal and fetal arterial catheters and time-transit flow probes to monitor cardiovascular, acid-base, and metabolic status, and then exposed to HIFU (n = 5) or sham (n = 6) ablation of placental vasculature through the exposed uterine surface. Placental vascular flow was occluded in 28 of 30 targets, and histological examination confirmed occlusion in 24 of 30 targets. In both HIFU and sham exposures, uterine contact reduced maternal uterine artery flow, but delivery of oxygen and glucose to the fetal brain remained normal. HIFU can consistently occlude in vivo placental vessels and ablate blood flow in a pregnant sheep model. Cardiovascular and metabolic fetal responses suggest that the technique is safe in the short term and potentially translatable to human pregnancy.
URI
https://repository.icr.ac.uk/handle/internal/1041
DOI
https://doi.org/10.1126/scitranslmed.aaf2135
Collections
  • Radiotherapy and Imaging
Subject
Brain
Fetus
Animals
Sheep
Fetofetal Transfusion
Oxygen
Glucose
Pregnancy
Female
High-Intensity Focused Ultrasound Ablation
Research team
Imaging for Radiotherapy Adaptation
Therapeutic Ultrasound
Language
eng
Date accepted
2016-06-13
License start date
2016-07
Citation
Science translational medicine, 2016, 8 (347), pp. 347ra95 - ?

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