Indications for HIFU in primary liver cancer - hepatocellular carcinoma (HCC):

  • Histologically verified HCC
  • Assessment of inoperability after consultations with two independent liver surgeons
  • The tumor is visualized by ultrasound – it is focal form with clear boundaries
  • Possibility of radical therapy in the first stages of the disease.  When the disease is advanced - local palliative treatment with HIFU can be applied
  • Combination of TAE + HIFU in cases with hypervascular infiltrative process
  • Application of HIFU in cases of  multifocal hepatocellular cancer -  with up to 4 nodular foci
  • The distance between the skin surface and  the farthest margin of the tumor is not more than 12 cm
  • The acoustic path of the FUS is safe and without  obstructions
  • Good general condition of the patient  -  > 70% by Karnofsky’ scale

Contraindications for HIFU in hepatocellular carcinoma:

  • Diffuse hepatocarcinoma
  • The tumor infiltrates more than 50% of the liver
  • Seriously decompensated liver function
  • A patient with cachexia and presence of distant metastases Infected liver foci
  • Class "C" by  the scale of Child
  • Thrombosis / tumor emboli / of the vena cava inferior
  • Prothrombin time <50%


  • Histologically verified malignancy
  • A contrast  enhanced CT study or  visualized with abdominal ultrasound liver foci
  • Liver lesions are inoperable with the  conventional surgery ( infiltration into large vessels , multi- centric metastases etc.).
  • Assessment of inoperability after consultations with two independent liver surgeons
  • A signed written refusal of  the patient  for a conventional surgical operation
  • At least two courses  of chemotherapy are applied according to the specifics of the underlying disease
  • Expected survival for more than 3 months
  • HIFU ablation is an alternative method for the palliative treatment of liver metastases which may be applied under the following conditions : the number of metastases in the liver is not more than 3-4 , they are not larger in size than 5 cm , the total amount does not exceed 10 cm


  • the metastatic process is spread in more than 50% of the liver
  • More than 4 metastatic foci; larger than 5 cm or the total amount of their size is exceeding 10 cm
  • Obstructive jaundice
  • Platelets <50,000 / UL
  • prothrombin time below 50%
  • Leukocytes / WBC /> 3.5
  • Contraindications for general anesthesia