Histotripsy compared to other modalities

 Histotripsy uses microsecond bursts of focused ultrasound to create tiny bubbles inside a tumor. These bubbles rapidly expand and collapse, mechanically breaking apart cancer cells into a liquefied mixture that the body clears naturally.

Unlike heat-based therapies or surgery, histotripsy is:

• Non-invasive: Delivered entirely outside the body.
   
• Non-thermal: Avoids heat-related injury to blood vessels and bile ducts.
   
• Precise: Guided in real-time with ultrasound imaging.
   
• Organ-sparing: Preserves surrounding healthy liver tissue.

•  How it works: The surgeon makes incisions to access the tumor or organ and physically removes tissue.
   
• Advantages: Direct visualization, long history of use, can treat large or complex disease.
   
• Limitations & Risks:
   
  • Major operation requiring anesthesia and hospitalization
     
  • Recovery time: weeks to months
     
  • Risks of bleeding, infection, and blood clots
     
  • Organ-specific complications (e.g., incontinence or erectile dysfunction for prostate; kidney loss for renal masses)
     
• Histotripsy advantage:
   
  • No incision, no scalpel, no hospital stay
     
  • Return to normal activities within days
     
  • Preserves surrounding structures while precisely liquefying diseased tissue

•  How it works: Uses ionizing radiation beams to damage the DNA of cancer cells, causing them to die over time.
   
• Advantages: Can treat deep or inoperable tumors, often used when surgery isn’t an option.
   
• Limitations & Risks:
   
• Requires multiple sessions (sometimes daily for weeks)
   
• Collateral damage to healthy tissues, leading to urinary, bowel, or sexual side effects
   
• Cumulative exposure may cause fatigue, fibrosis, or secondary cancers years later
   
• Tumor kill is gradual, not immediate
   
• Histotripsy advantage:
   
• One-time outpatient procedure
   
• No radiation exposure, no risk of secondary cancer
   
• Immediate tissue destruction visible on real-time ultrasound