19th Internarional Symposium of ISTU 5th European Symposium of EUFUS Barcelona 2019 | 13th - 15th June ABSTRACT BOOK ORGANIZING COMMITEE Scientific Organizing Committee Robin Cleveland, Co-Chair Vera Khokhlova, Co-Chair Local Organizing Committee Joan Vidal-Jové, Chair EUFUS Organizing Committee Andreas Melzer, Co-Chair Wladyslaw Gedroyc Alessandro Napoli Matthias Matzko Lisa Landgraf ISTU Joo Ha Hwang, President Kim Butts Pauly, Secretary General Jean-François Aubry Gail ter Haar Thursday, June 13th 2019 Friday, June 14th 2019 Saturday, June 15th 2019 Education: Getting Medical Education: Neurological Disease Education: Immunology Devices to Market Raúl Martínez Elizabeth Repasky Nicolas Guillen Education: Hyperthermia Welcome Education: Bioeffects of US Technologies Joo Ha Hwang, Joan Vidal-Jové, Diane Dalecki Holger Gruell Andreas Melzer Fry / Lizzi / Pioneer Award Session Horizon / Jolesz Lectures Organ Panel: Brain Invited speakers: Invited speakers: Chairs: Chrit Moonen Invited speakers: Chairs: Jin Woo Chang Chairs: Lawrence Crum Kevin Haworth Morry Blumenfeld Alessandro Napoli Cesare Gagliardo Wladyslaw Gedroyc Jean-François Aubry W. Apoutou N’Djin Neal F. Kassell Wladyslaw Gedroyc Roland Beisteiner Marine Sánchez Joo Ha Hwang Leonid Gavrilov Henning Lohse-Busch Physics and Modelling Drug Delivery Organ Panel: Uterus Invited speakers: Chairs: Invited speakers: Chairs: Invited speakers: Chairs: Jean-François Aubry Bradley Treeby Karun Sharma Holger Grull Suzanne LeBlang Matthias Matzko Robert Staruch Aki Pulkkinen Juan Tu Michael Gray Jaron Rabinovici Nikolaos Bailis Break Break Break Hardware Immunotherapy Organ Panel: Prostate and Kidney Invited speakers: Chairs: Gil Dubernard Amanda Beserra Invited speakers: Chairs: Invited speakers: Chairs: Adam Maxwell Cyril Lafon Elizabeth Repasky Natasha Sheybani Jens Rassweiler Andreas Melzer Chandan Guha Tatiana Khokhlova Mark Emberton George Schade Industry Pitch Lunch & Posters session Lunch & Posters session Lunch break Monitoring and feedback Therapy ultrasound plus Invited speakers: Chairs: Invited speakers: Chairs: Industry Pitch Presentations Henrik Odeen Elodie Cao Sarah Brüningk Gail ter Haar Sunao Shoji Shin-ichiro Umemura Edwin Heijman Lisa Landgraf Nonthermal mechanisms Neuromodulation Organ Panel: Musculoskeletal Invited speakers: Chairs: Invited speakers: Chairs: Invited speakers: Chairs: Francisco Aparisi Markus Duex Tatiana Khokhlova Ki Joo Pahk Elisa Konofagou Lennart Verhagen Pejman Ghanouni Alessandro Napoli Zhen Xu Oleg Sapozhnikov Jan Kubanek Wynn Legon Francesco Arrigoni Alberto Bazzocchi Break Break Break Drug delivery design/engineering Brain – preclinical Organ Panel: Liver and Pancreas Invited speakers: Chairs: Invited speakers: Chairs: Invited speakers: Chairs: John Callan Dario Carugo Richard Price Elisa Konofagou Joo Ha Hwang Joan Vidal-Jové Michel Versluis Eleanor Stride Nathan McDannold Muna Aryal Xavier Serres Milka Marinova Debate – Micron-sized contrast agents Other clinical HIFU applications have a great future in clinical HIFU ISTU General Assembly Invited speakers: Chairs: Andreas Melzer Constantin Coussios Gail ter Haar Joan Vidal-Jové Mike Averkiou Joo Ha Hwang USgHIFU Meeting: Clinical Application EUFUS General Assembly Closing (sponsored session) Joo Ha Hwang, Joan Vidal-Jové, Welcome Reception Gala Dinner Andreas Melzer MRgFUS FOR THE TREATMENT OF NEUROLOGICAL DISORDERS: A CLINICAL UPDATE Raul Martinez Fernandez, Centro Integral en Neurociencias A.C. (HM CINAC), Madrid e-mail: [email protected] Since the first studies using MRgFUS for the treatment of essential tremor came out in 2013, its applications for neurological diseases have progressively increased. Today, MRgFUS thalamotomy is a FDA-approved treatment for both essential and parkinsonian tremors and some evidence suggests that it can also be useful for tremors of other origins. Furthermore, ablation of other targets such as the subthalamic nucleus and the internal globus pallidus has preliminary shown to safely provide benefit on all Parkinson’s disease motor features and complications. MRgFUS has also been applied, with initial but promising results, in dystonia or obsessive-compulsive disorder, and has started to experimentally be considered in other neurological conditions like refractory epilepsy or stroke. While the main objective of the mentioned applications is the symptomatic relief, the ability of FUS to transiently and focally open the Blood-Brain Barrier through a physical mechanism, have paved the way to impact on the neurodegenerative process and achieve a disease modifying effect. Accordingly, experimental trials for Parkinson’s disease, Alzheimer dementia and amyotrophic lateral sclerosis are ongoing. This talk will present an overview of the current evidence with focused ultrasound in Neurology, with special attention in movement disorders, the most investigated field so far. AWARDS SESSION FRY / LIZZI / PIONEER FRY AWARD, INVITED TALK: Towards an increased clinical impact of focused ultrasound ‐ Chrit Moonen LIZZI AWARD, INVITED TALKS: Exploding droplets and singing bubbles in therapeutic ultrasound ‐ Kevin Haworth A healthy future for focal conformal therapeutic ultrasound ‐ W. Apoutou N’Djin PIONEER AWARD: Presentation of the ISTU/EUFUS Pioneer Award winner, Leonid Gavrilov TOWARDS AN INCREASED CLINICAL IMPACT OF FOCUSED ULTRASOUND Chrit Moonen Imaging Division, University Medical Center, The Netherlands E-mail [email protected] HIFU is a disruptive, minimally invasive, therapeutic technology in medicine, and its history follows the nature cycle from the inventive stage, technical developments, preclinical and clinical applications. Following early promise by the Fry brothers, the advent of image guidance and many technical refinements, clinical applications started with prostate cancer, and have since broadened considerably to other tumors, and include not only tissue ablation but also drug delivery and immune system stimulation. The current status and progress is well described by the FUSFoundation annual reports. Although HIFU fits well in current strategies of personalized and precision medicine, of patient Quality-of-Life, clinical adoption of HIFU is slow, and adequate reimbursement is often lacking. Here, the hurdles for further progress are analyzed. A comparison is made between HIFU and recent developments in RadioTherapy. Clinical workflow for HIFU and RadioTherapy are similar, and image guidance has become a major issue for both therapeutic technologies. The importance of moving beyond feasibility studies of HIFU towards randomized, multi-site, clinical trials is highlighted. Financial issues play an important role since the business model for companies working in HIFU is very different from that in Pharma, and Radio Therapy, and it is hard to find financial support for such Phase 3 trials. For hospitals, HIFU equipment is an additional investment, not replacing other modalities. Sufficient patient numbers have to be treated to guarantee a return on investment. In addition, since HIFU is a disruptive technology, FDA approval based on 510k clearance, is not possible and hence, regulatory issues are more difficult for HIFU than for RadioTherapy. Nevertheless, recent highlights in the treatment of essential tremor, its increasing share in prostate cancer therapy and in uterine fibroid treatment, show that it is possible to increase the clinical impact of HIFU. As patient awareness of HIFU is increasing, HIFU is finding its way into the clinic. EXPLODING DROPLETS AND SINGING BUBBLES IN THERAPEUTIC ULTRASOUND K. J. Haworth1,2 1 Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA 2 Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA e-mail: [email protected] Though widely used clinically for diagnostic imaging, microbubbles also provide a rich opportunity for inducing bioeffects, both intended and unintended. Phase-change agents that take advantage of acoustic droplet vaporization are particularly interesting for therapeutic applications due to their in situ ultrasound-mediated production of microbubbles. The first half of this presentation will provide a review of these applications (with a focus on the author’s humble contributions to the field), including a new subfield of localized dissolved gas scavenging. In addition to the direct mediation of therapies, the microbubbles can also be used to improve both therapeutic insonation focusing and image-guidance. Using microbubble scattering and emissions for guiding therapy will be reviewed in the second half of this presentation. In particular, passive cavitation imaging will be reviewed, including methods, applications, limitations, and future directions. A HEALTHY FUTURE FOR FOCAL CONFORMAL THERAPEUTIC ULTRASOUND W.A. N’Djin1 1 LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France e-mail: [email protected] Therapeutic ultrasound is in constant evolution. Focal/conformal strategies are now often sought after to improve the patient care, but their development remains challenging and requires bringing together new solutions. In open surgery, we proposed an unconventional toroidal focusing strategy for USgHIFU therapy of liver metastases. This solution allowed optimizing the energy distribution, to generate and juxtapose manually large ablations, little affected by vascularization and organ motions. A clinical study ran in France validated the concept of complementary tool