Advances in Focused Ultrasound for the Treatment of Brain Tumors

Rohan Rao; Anjali Patel; Kunal Hanchate; Eric Robinson; Aniela Edwards; Sanjit Shah; Dominique Higgins; Kevin J Haworth; Brandon Lucke-Wold; Daniel Pomeranz Krummel; Soma Sengupta

doi:10.3390/tomography9030090

Advances in Focused Ultrasound for the Treatment of Brain Tumors

Tomography. 2023 May 29;9(3):1094-1109. doi: 10.3390/tomography9030090.

Authors

Affiliations

¹ Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA.
² Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA.
³ Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
⁴ Department of Neurosurgery, University of North Carolina, Chapel Hill, NC 27599, USA.
⁵ Department of Internal Medicine, Division of Cardiovascular Health and Disease, University of Cincinnati, Cincinnati, OH 45267, USA.
⁶ Department of Pediatrics, University of Cincinnati, Cincinnati, OH 45229, USA.
⁷ Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45219, USA.

Abstract

Employing the full arsenal of therapeutics to treat brain tumors is limited by the relative impermeability of the blood-brain and blood-tumor barriers. In physiologic states, the blood-brain barrier serves a protective role by passively and actively excluding neurotoxic compounds; however, this functionality limits the penetrance of therapeutics into the tumor microenvironment. Focused ultrasound technology provides a method for overcoming the blood-brain and blood-tumor barriers through ultrasound frequency to transiently permeabilize or disrupt these barriers. Concomitant delivery of therapeutics has allowed for previously impermeable agents to reach the tumor microenvironment. This review details the advances in focused ultrasound in both preclinical models and clinical studies, with a focus on its safety profile. We then turn towards future directions in focused ultrasound-mediated therapies for brain tumors.

Keywords: blood–brain barrier; blood–tumor barrier; chemotherapy; glioma; immunotherapy; microbubble-enhanced focused ultrasound.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Blood-Brain Barrier / diagnostic imaging
Blood-Brain Barrier / pathology
Brain Neoplasms* / drug therapy
Brain Neoplasms* / therapy
Humans
Magnetic Resonance Imaging / methods
Tumor Microenvironment
Ultrasonography

Grants and funding

S.S. (Soma Sengupta) is supported by the Harold C. Schott Endowment, the Mischell Funds, and the Academic Research Collaborative Grant with CCHMC. K.J.H. and D.P.K. are supported by the University of Cincinnati Brain Tumor Center, Tech team. R.R. is supported by the Alpha Omega Alpha Carolyn L. Kuckein Student Research Fellowship.