[9] In this study acoustic power used for

ablation ranged from 181 to 256 W, and HIFU exposure time varied from 30 to 202 minutes, which was dependent on the size of the targeted tumors. All patients received one HIFU session. Two patients needed artificial pleural effusion to treat tumor near the diaphragm by revealing lesions obscured by lung tissues. It was performed under the guidance of diagnostic US imaging after AUY-922 nmr general anesthesia was introduced. Then 150-300 mL saline was perfused into the pleural cavity using a thoracentesis needle. The puncture point was located at axillary line 6-7 intercostal space in the right chest wall. No patient received a second HIFU treatment in the clinical trial. Results EPZ6438 of follow-up Doppler US revealed that the tumor margin was clearly identified 2 weeks after HIFU ablation. An increase in grayscale was seen in 11 patients. No tumor blood supply was detected in any patient except no. 12. All 12 patients were followed up after HIFU ablation, color Doppler US and contrast-enhanced CT or MRI was used as the main follow-up radiological assessment in all patients. The first CT/MRI examination was performed 2 weeks after HIFU treatment while inflammatory edema disappeared completely at

the marginal area of the ablated tumor. Compared to CT/MRI images before HIFU, an obvious absence of contrast enhancement was found in the

treated tumor after HIFU, which was an indication of coagulation necrosis. In addition, a thin contrast-enhancement ring observed between the treated and untreated regions was very useful to assess whether tumor cells remained after HIFU ablation. If the residual viable tumor was demonstrated on the follow-up CT/MRI, a subsequent HIFU ablation was carried out for destruction of the remaining tumor 1-4 weeks after CT/MRI examination. Each patient was followed up every 3 months after the combined therapy. Serum biochemistry and clinical examination were also performed during follow-up. IMP dehydrogenase All data are reported as the mean ± standard deviation. Statistical analysis was performed by a statistical software package (SPSS v. 13.0). The period of follow-up was defined as the time from the completion of adjuvant chemotherapy to death or last follow-up. The Kaplan-Meier method was used to assess overall survival. P values were judged significant if they were less than 0.05. Contrast-enhanced CT/MRI and Doppler US was performed before and after HIFU ablation. The short-term effectiveness of HIFU ablation was assessed by CT/MRI and US at 2 weeks after HIFU. The disappearance of the enhancement and blood flow signal within the treated tumor was found on radiological images after HIFU as compared with before HIFU (Figs. 1, 2). This was seen as an indication of complete ablation.