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Destroying Tumors with Sound Histotripsy Demo & Explainer · THE DAILY BRIEF

• 0:00
  Speaker 1: Behind me is a machine that destroys tumors using sound waves.
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  Speaker 1: I'm here at the hospital that's done the most of
• 0:05
  Speaker 1: this type of procedure. To talk to the doctor that's
• 0:07
  Speaker 1: done the most of this type of procedure, to show
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  Speaker 1: you a demo and exactly how this thing liquefies tumors
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  Speaker 1: before your very eyes.
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  Speaker 2: Let's get into it.
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  Speaker 1: Histotripsy is a type of cancer treatment that uses targeted
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  Speaker 1: ultrasound waves to destroy tumors in a non invasive way.
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  Speaker 1: And this Edison system, made by Histosonics is the only
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  Speaker 1: commercially available histotripsy machine for humans on the market.
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  Speaker 3: Right now, the patient would be laying on the table.
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  Speaker 3: This device, which is called the water bath, would be
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  Speaker 3: sitting on top of the patient and we would position
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  Speaker 3: this over the tumor to get the patient prepared for
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  Speaker 3: the treatment.
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  Speaker 1: The water bath used in histotripsy serves the same purpose
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  Speaker 1: as the gel used during ultrasound imaging, preventing air pockets
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  Speaker 1: which would diffuse the ultrasound waves and compromise the procedure.
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  Speaker 1: The water being used is regular tapwater that's run through
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  Speaker 1: a special filter to remove any air bubbles.
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  Speaker 2: We're in an operating room.
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  Speaker 3: But this is actually not a sterile procedure, so there's
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  Speaker 3: no incisions or or anything made on this. The most
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  Speaker 3: invasive portion will be getting an IV so that you
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  Speaker 3: can get a sedation. Generally give patients anesthesia as well,
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  Speaker 3: so they're completely asleep so they don't move once the
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  Speaker 3: therapy starts.
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  Speaker 1: Doctor Burns, who at the time of this recording has
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  Speaker 1: done more of these procedures than any other doctor, showed
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  Speaker 1: us how he begins by finding the tumor on the patient.
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  Speaker 3: We can turn all of these different knobs to make
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  Speaker 3: the size, so it's calibrated to every tumor, and so
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  Speaker 3: we can make these big, we can make these small.
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  Speaker 3: We have to figure out how much power we need
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  Speaker 3: to deliver. That's different for each patient, each tumor, and
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  Speaker 3: so we have to do some calibration steps and then
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  Speaker 3: we would start the treatment.
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  Speaker 1: Doctors can watch the histotripsy live via ultrasound imaging to
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  Speaker 1: make sure everything is going as it should.
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  Speaker 3: Think about this kind of like a satellite dish, so
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  Speaker 3: it has multiple different arrays of ultrasound emitting basically spread
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  Speaker 3: throughout this. They're going to columnate down to a very
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  Speaker 3: small little point and only at that focal point is
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  Speaker 3: where the histo tripsy is going to happen, so there's
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  Speaker 3: nothing damaging the body wall in between.
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  Speaker 1: The way these concentrated ultrasound waves actually destroy tumor cells
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  Speaker 1: is by rapidly expanding and contracting the gases naturally inside them.
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  Speaker 3: This is a mechanical destruction of the tissue rather than
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  Speaker 3: a thermal or radiation based so it's more similar to
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  Speaker 3: surgery in that sense, where it's mechanical, so it really
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  Speaker 3: liquefies this This treatment is instant, so as soon as
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  Speaker 3: the histo tripsy is delivered, the tissue is destroyed.
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  Speaker 2: It's not something we have to wait for down the road.
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  Speaker 1: Doctor Burns showed me an example of what the procedure
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  Speaker 1: is like on screen from the doctor's perspective. This is
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  Speaker 1: for demonstration purposes only, since obviously there was not a
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  Speaker 1: patient in the operating room at the time.
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  Speaker 3: And so we're just pretending there's a tumor in here,
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  Speaker 3: and so this is kind of what our workflow would
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  Speaker 3: be for this treatment.
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  Speaker 1: The doctor begins by setting planning points, which allow the
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  Speaker 1: machine to map out the shape of the tumor that
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  Speaker 1: is being targeted, plus a slight margin of healthy tissue
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  Speaker 1: surrounding it as well.
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  Speaker 3: Now the edison system is going to move this bubble
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  Speaker 3: cloud or through our plan treatment volume in order to
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  Speaker 3: accurately and precisely destroy this tumor. One of the benefits here,
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  Speaker 3: so you can see these lines, and so the histo
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  Speaker 3: tripsy is really confined to this.
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  Speaker 2: It doesn't have a gradient, meaning it's.
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  Speaker 3: Very start margin, so we can get very close to
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  Speaker 3: critical structures without avoiding damaging them.
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  Speaker 1: The liquefied humor gets absorbed naturally by the body's immune response,
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  Speaker 1: and some studies in animals are suggesting that histotripsy may
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  Speaker 1: have the potential to help in other unexpected ways.
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  Speaker 3: Where the life state of the tumor may contain some
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  Speaker 3: sort of antigen or protein that has been hidden from
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  Speaker 3: the immune system. So in certain patients, when that listate
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  Speaker 3: is absorbed, that may give a systemic immunologic benefit where
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  Speaker 3: your body's owned immune system could recognize the tumor.
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  Speaker 2: And that's something that's kind of promising.
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  Speaker 3: It needs a lot more research in humans, but it's
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  Speaker 3: something that we see in animal model so I think
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  Speaker 3: in the future we can figure out how to best
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  Speaker 3: harness this and maybe help turn this into a systemic
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  Speaker 3: treatment for cancer.
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  Speaker 1: Doctor Burns showed us some before and after images of
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  Speaker 1: patients who had undergone histotripsy and how the liver tissue
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  Speaker 1: healed after the procedure. Right now, histotripsy is primarily focused
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  Speaker 1: on destroying liver tumors, but there's potential for this technology
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  Speaker 1: to be applied to tumors in other areas of the
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  Speaker 1: body as well.
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  Speaker 3: And so this patient had histotripsy delivered to this tumor.
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  Speaker 3: This was her only tumor at the time. Four months later,
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  Speaker 3: we have an MRI showing that basically that entire legion
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  Speaker 3: is resolved. We can see a very very small amount
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  Speaker 3: of a little defect here, but just comparing the size
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  Speaker 3: the day from the treatment all the way down to
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  Speaker 3: four months later, you can see that basically the liver
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  Speaker 3: has basically repaired this entire area and reabsorbed. All of
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  Speaker 3: this trial to treat primary kidney tumors as just closed
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  Speaker 3: or awaiting those results. Hopefully that will be available commercially
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  Speaker 3: in the next year or so. When there's a trial
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  Speaker 3: to treat pancreatic tumors that's underway in Barcelona in Spain
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  Speaker 3: and that'll be probably.
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  Speaker 2: Coming to the US in twenty twenty six.
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  Speaker 3: And so histotripsy and histosonics is really a technology platform.
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  Speaker 3: This is a new technology. This is going to expand
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  Speaker 3: to every organ in the body. Looking at future trials,
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  Speaker 3: probably going to come to prostate to treat BPH and
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  Speaker 3: large prostate potentially prostate cancer. Can think maybe uterine fibroids.
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  Speaker 3: Smaller devices may be able to treat breast tumors, thyroid nodules,
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  Speaker 3: even think about brain tumors. This is going to expand
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  Speaker 3: across the entire body, cancerous and non cancerous conditions.
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  Speaker 1: Air filled organs like lungs, stomach, and intestines still propose
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  Speaker 1: a challenge due to the fact that ultrasound waves dissipate
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  Speaker 1: in air. Doctor Burns says a histotripsy procedure can take
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  Speaker 1: about one to three hours, depending on how many tumors
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  Speaker 1: are being targeted.
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  Speaker 3: With histor tripsy. Go home a couple hours after the procedure.
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  Speaker 3: It's fairly common to have some pain or discomfort where
• 5:05
  Speaker 3: the treatment goes in. For smaller treatment, some patients have
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  Speaker 3: no symptoms at all after the procedure. Patients can have
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  Speaker 3: some systemic inflammatory symptoms that generally starts the day afterwards.
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  Speaker 3: That's fever, a flu like illness, just the general malaise
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  Speaker 3: feeling that's very normal.
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  Speaker 2: That's the body reacting.
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  Speaker 3: This doesn't replace all surgeries, but there may be patients
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  Speaker 3: that could benefit from this rather than proceeding to a surgery,
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  Speaker 3: which obviously will have more complications, may require hospital stays.
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  Speaker 3: And this procedure can also be repeated many times, so
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  Speaker 3: as long as the patient's liver function is normal, we
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  Speaker 3: can go after multiple tumors, either in the same session
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  Speaker 3: or over multiple procedures kind of spread out over weeks.
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  Speaker 2: Or months histor trips.
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  Speaker 1: He got FDA approval back in October of twenty twenty
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  Speaker 1: three and is expanding availability as more machines are produced.
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  Speaker 3: There's probably at least a center near you, if not
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  Speaker 3: in your state, at least near it's available. It's going
• 5:48
  Speaker 3: to go be in the UK, other areas in Asia,
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  Speaker 3: so this is going to expand globally as time comes.
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  Speaker 2: They just have to build enough units.
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  Speaker 1: Let us know down in the comments about any medical
• 5:56
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• 5:59
  Speaker 1: scenet for everything that makes you say what the future