High- and Low-Intensity Focused Ultrasound in the Treatment of Glioblastoma: a Systematic Review

Abstract

Purpose: To summarize existing data on the application of high-intensity focused ultrasound (HIFU) and low-intensity focused ultrasound (LIFU) in the treatment of intracerebral brain tumors. Special attention is paid to the practical application of LIFU in the field of drug therapy for glioblastomas. Materials and methods : The article presents a systematic review of international publications and clinical studies concerning the application of HIFU and LIFU, including data from experimental models, preclinical and clinical studies, covering biophysical mechanisms of ultrasound effects on tissues, parameters of its application, as well as results of therapy for various oncological and neurological diseases. Results : It is demonstrated that the LIFU method enables reversible neuromodulation, improves motor functions, and reduces the activity of inflammatory processes following iatrogenic exposure; it is capable of safely and reversibly altering the permeability of the blood-brain barrier (BBB) to facilitate the delivery of therapeutic agents into the brain. Combined application of LIFU and drug therapy allows enhancing the anti-tumor effect in patients with glial tumors. Conclusion : HIFU and LIFU methods are promising, complementary technologies with distinct mechanisms of action and clinical applications. HIFU provides effective and controlled tissue destruction via high-intensity thermal effects, while LIFU performs the function of neuromodulation and temporary reversible increase of BBB permeability. Modern developments and integration of these methods contribute to expanding therapeutic possibilities in the treatment of brain diseases and require further study to optimize protocols and enhance the clinical efficacy of the methods.