What is focused ultrasound?
Focused ultrasound, also called high-intensity focused ultrasound (HIFU), offers a nonsurgical treatment for cancerous tumors, benign growths, and movement disorders. This technique directs high-frequency sound waves to heat and destroy targeted tissue while limiting damage to surrounding healthy areas. Because HIFU treatment reaches deep targets through the skin without making an incision, recovery is usually faster than with traditional surgery.
Penn Medicine was among the first health systems to use focused ultrasound as a noninvasive treatment for prostate cancer and essential tremor. Today, we offer this advanced therapy across multiple specialties for a growing number of conditions.
How HIFU therapy works
High-intensity focused ultrasound works much like using a magnifying glass to focus sunlight. If you hold the glass over a leaf, the sun’s rays are concentrated into one tiny, hot spot that creates a hole in the leaf, while the air around it stays cool. HIFU ultrasound does the same thing with powerful sound waves focused on a small area of diseased tissue. These sound waves pass safely through the body until they meet at the target. Once focused, they create heat that destroys the abnormal cells.
To make sure every beam hits the right mark, providers use real-time imaging technologies to see the exact location of the tumor or targeted area, track temperature changes, and adjust treatment as needed.
Methods of guiding a focused ultrasound procedure
HIFU relies on real-time imaging to guide sound waves to the exact area needing treatment. Depending on your condition and the part of your body being treated, specialists use different guiding methods.
MRgFUS pairs therapeutic sound waves with magnetic resonance imaging (MRI). The MRI provides high-resolution, three-dimensional images of internal structures and monitors tissue temperature in real time. This precise thermal tracking protects delicate healthy tissue, making MRgFUS a leading incisionless treatment for conditions like essential tremor, Parkinson’s disease, and deep brain targets.
USgFUS uses standard, live ultrasound imaging to direct treatment. This method provides real-time visual monitoring of soft tissue and movement. It’s often used during an HIFU procedure for some prostate cancer treatments, where specialists can view the tissue directly through ultrasound technology.
Conditions treated with HIFU
High-intensity focused ultrasound can precisely target tissue in different parts of the body, making it a treatment option across several medical specialties. This list continues to grow as research finds new ways to use it. Your care team can tell you whether it’s an option for your specific condition.
Focused ultrasound for Parkinson’s disease and essential tremor may help reduce symptoms like tremors, stiffness, or slowed movement when medication isn’t providing enough relief. By targeting small areas in the brain, like the thalamus or pallidum, focused ultrasound uses sound waves to disrupt the abnormal brain signals behind these symptoms.
Penn Medicine’s Movement Disorders Center offers leading, research-backed treatment for these conditions. The center is also home to the only neurosurgeons offering MR-guided high-intensity focused ultrasound across Pennsylvania and New Jersey.
As a nonsurgical cancer treatment, high-intensity focused ultrasound destroys primary tumors and can relieve pain when cancer spreads:
- Prostate cancer: HIFU targets precise areas of the gland, minimizing risk to surrounding nerves and urinary function.
- Other tumors: HIFU can also treat certain kidney, liver, and pancreatic tumors, and relieve pain from cancer that has spread to the bones.
Focused ultrasound treats noncancerous conditions without invasive surgery, including:
- Uterine fibroids and adenomyosis
- Noncancerous breast lumps
- Thyroid nodules
- Chronic pain syndromes
Who is a candidate for HIFU?
Focused ultrasound may be an option if medication isn’t controlling your condition or if you’re looking for a nonsurgical treatment. Your care team will consider your overall health, medical history, and goals to determine if it’s right for you.
This therapy isn’t appropriate for everyone. Your provider will also consider factors like:
- Location: The targeted tissue must be accessible to focused ultrasound energy.
- Ability to lie still: Some procedures require you to stay in one position for several hours.
- Medical implants: Certain implants or metal objects in the body may make MRI unsafe or interfere with treatment.
- Other health conditions: Some conditions may make focused ultrasound or the imaging used to guide the procedure unsafe to use.
What to expect during HIFU treatment
Focused ultrasound is typically an outpatient procedure that takes just a few hours. You remain awake, but you may receive medication to help you stay calm and comfortable. Your experience depends on your condition and the imaging system used to guide the sound waves.
For MRgFUS, you lie on an MRI table and are moved in and out of the scanner so the team can check your response during treatment. The MRI locates the area of the body to treat. Then, HIFU waves are delivered to the targeted area, with additional MRI scans used to monitor progress.
For USgFUS, your care team uses live ultrasound imaging to locate and monitor the treatment area throughout the procedure. Depending on the treatment site, this may involve an external probe placed against your skin, similar to the ultrasound used during pregnancy, or, for prostate treatment, a probe placed in the rectum. Because ultrasound imaging works in real time, your care team can see the treatment area continuously without moving you in and out of a scanner the way MRgFUS requires.
Recovery after high-intensity focused ultrasound
One of the biggest benefits of this technology is how quickly you can get back to your normal routine. In general, many people return to normal activities within a day, though your provider may recommend short-term limits based on your treatment type. Side effects are often mild, though your care team will review what to watch for and when to call.
What results can you expect?
Your results will depend on the condition being treated, the area targeted, and the type of treatment. Some people may notice improvement soon after the procedure. For movement disorders, tremor reduction often happens while you are still on the treatment table. Others may need more time to see results.
Your care team will discuss what results to expect. In some cases, focused ultrasound can provide long-lasting results, but it doesn’t work for everyone.
Our approach to advanced focused ultrasound technology
Focused ultrasound often involves specialists from several areas of medicine, depending on what’s being treated. At Penn Medicine, our teams work together to precisely target the treatment area and interpret complex imaging. As early adopters of MRgFUS and HIFU, we helped refine this technology to make procedures safer and more effective.
Your care is centered on what matters to you. The team takes time to understand your symptoms and goals, explains your options, and supports you through every decision. We also offer convenient consultations, second opinions, and follow-up care close to home.
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