Histotripsy: Game-changing liver cancer treatment

After years of research, development and testing in clinical trials, histotripsy was approved for use with patients in late 2023 by the U.S. Food & Drug Administration. It is a non-invasive treatment for liver cancer patients. Histotripsy is considered a breakthrough, non-invasive treatment for liver cancer.

Liver cancers can start in the liver (primary) or start elsewhere and spread to the liver (metastasis). Conventional treatment options include surgery, radiation and/or chemotherapy. These treatments are more invasive, may have unpleasant side effects and may damage otherwise healthy tissue.

Benefits of histotripsy

Compared with conventional liver cancer treatment options, histotripsy offers several benefits, including:

• One-day procedure for most patients

• No incisions; no scars; no needles

• Lower risk of infection or complication

• Less pain

• Shorter recovery time (most patients can resume normal activities within 48-72 hours after the procedure)

Who is eligible for histotripsy?

You may be eligible for histotripsy treatment if:

• You have fewer than three primary or fewer than three metastatic liver tumors

• Your liver tumor is smaller than three centimeters at the greatest diameter

Patients who have more than three liver tumors or who have had a Whipple (pancreaticoduodenectomy) surgery for pancreatic cancer are currently not eligible for histotripsy.

Please speak with your oncologist to discuss whether you may be eligible for histotripsy based on the above criteria. If your oncologist thinks you might be a candidate for histotripsy, please have them send a referral to UW Health.

To ensure that the body lays perfectly still for precise calibration, histotripsy is performed under general anesthesia. Once the patient is asleep on the table, doctors identify the tumor and the targeted treatment area by using the histotripsy ultrasound technology in conjunction with prior MRI or CT scans.

After the treatment area is defined, the treatment begins. High amplitude, very short ultrasound pulses are focused into the liver tissue. Due to an increase in pressure, microbubbles form in the tissue. The rapid expansion and contraction of these microbubbles mechanically destroys the tumor cells. Various tissues respond differently to histotripsy, which may make it safe to use near blood vessels or bile ducts. The procedure time varies depending on the size and quantity of the tumor(s).

Currently, patients spend one night in the hospital for observation following the procedure. Following the procedure, some patients may experience mild pain or soreness from the treatment.

How do I learn more about histotripsy treatment?

If you are a UW Health patient, please contact your medical oncologist.

If you are not a UW Health patient, please contact our Welcome Center for patient registration.

Contact the Welcome Center by calling (608) 821-4819

• The Welcome Center will register you with UW Health and help transfer your medical records

• We may request a referral from your local provider or oncologist

Please be prepared to provide the following information:

• Relevant medical history records

  • Health care organization where care was previously provided

  • Cancer diagnosis and diagnosis date

  • Any prior treatments:

    • Surgeries

    • Chemotherapy or Immunotherapy

    • Radiation

    • Clinical Trial Participation

Medical images can be uploaded through LifeLink or submitted via CD. We require abdominal imaging (MRI preferred but CT accepted) from the last year.

Once these steps are completed, the Welcome Center will route your patient information to the Nurse Coordinator to begin next steps.