Histotripsy FAQ

WHAT IS HISTOTRIPSY?

Pioneered at the University of Michigan, histotripsy offers a promising alternative to traditional cancer treatments, which often have significant side effects. Histotripsy is a non-invasive treatment performed under general anesthesia. Patients typically go home the same day.

The treatment works by using targeted ultrasound waves to form microbubbles within the tumor. The forces created as those bubbles form and collapse cause the mass to break apart, killing tumor cells and leaving the debris to be cleaned up by the immune system.

It is performed using a robotic platform that is specially designed to make sure the treatment is confined to the tumor only, so there is minimal to no effect on healthy tissue.

Histotripsy was developed over decades by University of Michigan researchers and received approval from the U.S. Food and Drug Administration in late 2023.

CAN I GET HISTOTRIPSY TREATMENT?

Histotripsy treatment has been approved as a treatment for cancers of the liver. Tumors that started in the liver (primary liver cancers like hepatocellular carcinoma or cholangiocarcinoma), or tumors that started elsewhere but spread to the liver (metastatic cancers from the colon, rectum, intestine, pancreas, breast, and elsewhere) may be treatable with histotripsy. There are certain tumor locations within the liver and tumor characteristics that may not be safely treated with histotripsy, and some of these situations may be better suited for other types of liver therapy.

HOW DO I KNOW IF I AM ELIGIBLE FOR HISTOTRIPSY TREATMENT?

At the present time, histotripsy treatment is only available for the treatment of liver tumors. You may be eligible for histotripsy if your liver tumor is smaller than 5 cm and if you have fewer than 6 tumors within the liver. If you also have tumors outside of the liver, you can only have fewer than 3 tumors outside the liver that have to be smaller than 1.5 cm each.

HOW CAN I BE EVALUATED FOR HISTOTRIPSY?

In order to be evaluated for histotripsy, you will need to have your primary oncologist submit a referral. We are unable to process requests that are not submitted by an oncologist.

Our liver specialists will meet you through the Rogel Cancer Center Multidisciplinary Liver Clinic to review your imaging and determine if you are eligible for histotripsy, or any other treatment. If you are physically in the state of Michigan, this initial visit can be performed by video. Following this initial visit, our physicians may discuss your case at our weekly Multidisciplinary Liver Tumor Board, where our entire team of experts including hepatologists, medical oncologists, radiologists, radiation oncologists, surgeons and transplant physicians can share their expertise to formulate a treatment plan.

If you are a patient interested in being considered for histotripsy treatment, please contact our University of Michigan Rogel Cancer Center Cancer AnswerLine at [email protected] or 800-865-1125.

If you are a provider interested in referring a patient to be considered for histotripsy treatment, please contact our University of Michigan Health M-LINE at 800-962-3555.

WHAT IS IT LIKE TO HAVE HISTOTRIPSY TREATMENT?

If you are eligible to be treated with histotripsy, you will be scheduled for an outpatient ultrasound screening evaluation of your liver before the actual histotripsy treatment. This evaluation is done to make sure that your liver tumor(s) can be accurately targeted and safely treated with histotripsy. If this evaluation confirms that your tumor(s) can be treated with histotripsy, you will be scheduled for treatment. On the day of your histotripsy treatment, you will be asked to avoid food or drinks for 4 hours prior to treatment. On arrival, you will meet an anesthesiologist and nurse. Histotripsy procedures are performed under general anesthesia in order to maximize treatment accuracy and safety. The procedure typically lasts anywhere from 1-3 hours, after which you will be monitored in a recovery area for 1-3 hours. Most procedures will be performed on an outpatient basis, allowing you to return home the same day. One month after treatment, you will have a contrast enhanced CT or MRI scan to evaluate the treated tumor(s).

CAN I GET TREATMENT IF MY TUMOR IS NOT IN MY LIVER?

At the present time, histotripsy is only approved for use with liver tumors. We anticipate that future studies will determine whether histotripsy can be safely and effectively used for tumors in other parts of the body outside of the liver. However, these studies have not yet begun, and we are not able to recruit patients for these studies at this time.

HOW SOON CAN I GET HISTOTRIPSY TREATMENT AT THE UNIVERSITY OF MICHIGAN?

Histotripsy is a brand-new technology that has only recently been made available for clinical use. We expect to begin performing histotripsy procedures at the University of Michigan in early 2024. Because of the high demand for histotripsy, we anticipate that there will be a waiting list of weeks to months for people who are eligible for treatment. However, we will do our best to accelerate this process safely.