Home Diseases and Conditions Sarcoma

Sarcoma

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Development Stage

Early Stage

Focused ultrasound research is in the laboratory phase and is not yet available for patients.

Clinical Trials

Focused ultrasound for this condition is being researched in clinical trials.

International Approval

Focused ultrasound is approved to treat this condition outside the US. Patients can seek commercial treatment at participating international sites.

FDA Approved

The US Food and Drug Administration has approved focus ultrasound for this condition. Patients can seek commercial treatment at participating sites.

Early Stage

Clinical Trials

International

FDA Approved

Focused ultrasound for this condition is being researched in clinical trials.

Focused Ultrasound Therapy 

Focused ultrasound is a therapeutic technology that could transform the quality of life and decrease the cost of care for patients with the many types of malignant sarcomas. There are two large groups of sarcomas: osteosarcoma and soft tissue.  

Osteosarcoma (also called bone sarcoma) develops in the bones or cartilage. There are many different types of sarcomas, but common ones include: osteosarcoma, chondrosarcoma and Ewing sarcoma.  

Soft tissue sarcomas develop in the muscle, fat, nerves, blood vessels or connective tissue. Common soft tissue sarcomas are angiosarcoma, fibrosarcoma, leiomyosarcoma, liposarcoma, rhabdomyosarcoma, and undifferentiated pleomorphic sarcoma.  

This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging the surrounding normal tissue.  

How it Works 

Where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated. One is the use of thermal ablation, in which the energy does not harm the local tissue, but at the point of ultrasound beam convergence, the target gets very hot and leads to localized tissue destruction. Another technique uses mechanical histotripsy in a non-thermal way to disrupt and lead to a slurry of cellular debris from the targeted tissue. There are several other ways that focused ultrasound can be configured to deliver treatment for this disease.   

The primary options for treatment of sarcoma often includes medication and invasive surgery, and at times, amputation.  

For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost.   

Advantages 

  • Focused ultrasound is non-invasive, so it does not carry added concerns like surgical wound healing or infection.  
  • Focused ultrasound can reach the desired target without damaging surrounding tissue. 
  • It can be repeated, if necessary. 

Clinical Trials 

There is a clinical trial for those with undifferentiated, pleomorphic sarcoma in California.  

There is a clinical trial for those with a wide variety of soft tissue sarcomas (including all of these: malignant fibrous histiocytoma, undifferentiated (pleomorphic) sarcoma, fibrosarcoma and fibromyxoid sarcoma (fibroblastic sarcomas), leiomyosarcoma, liposarcoma, malignant peripheral nerve sheath tumor, retroperitoneal sarcoma, rhabdomyosarcoma, and synovial sarcoma).  

Regulatory Approval and Reimbursement  

Focused ultrasound treatment for sarcoma is not approved by regulatory bodies and is not likely to be covered by medical insurance companies.  

Notable Papers 

Vickers ER, Ruger LN, Hay AN, Luong NTC, Kett JS, Kooi SV, Coutermarsh-Ott SL, Daniel GB, Ziemlewicz TJ, Soliman SB, Malhotra GB, Maxwell AD, Vlaisavljevich E, Tuohy J. The first limb-sparing use of histotripsy for canine osteosarcoma. Sci Rep. 2026 Mar 23. doi: 10.1038/s41598-026-42319-z. PMID: 41872305 

Xu J, Chen Y, Wang Z, Fan Q, Sun Y, Qu X, Zhuang Y, Cui W, Ou Y. Ultrasound-responsive bone-targeting liposomes suppress osteosarcoma through enhanced ROS generation and immunogenic cell death. J Control Release. 2026 Feb 22;393:114746. doi: 10.1016/j.jconrel.2026.114746. PMID: 41734864 

Qian J, Wu W, Wang H, Shu C, Liu B. Ultrasound-Enhanced Delivery of the Quercetin Derivative ANL3 Activates the FOXO1A-NDRG2-SOD2 Axis to Induce Endoplasmic Reticulum Stress in Osteosarcoma. Cancer Biother Radiopharm. 2026 Feb 5:10849785251406063. doi: 10.1177/10849785251406063. PMID: 41642032 

Achari PF, Vickers E, Ruger L, Vlaisavljevich E, Tuohy J, Collins CJ. Assessment of histotripsy as a bone-sparing tumor ablation technique in ex vivo osteosarcoma tumor-affected limbs. Front Vet Sci. 2026 Jan 9;12:1652469. doi: 10.3389/fvets.2025.1652469. eCollection 2025. PMID: 41585516 

Vickers ER, Ruger LN, Coutermarsh-Ott SL, Daniel GB, Allen SP, Ziemlewicz TJ, Soliman SB, Malhotra GB, Maxwell AD, Vlaisavljevich E, Tuohy J. MRI for the Assessment of Histotripsy Ablation in a Canine Osteosarcoma Comparative Oncology Model. Ultrasound Med Biol. 2026 Jan;52(1):216-226. doi: 10.1016/j.ultrasmedbio.2025.09.017. Epub 2025 Oct 17. PMID: 41109828 

Ponomarchuk E, Tsysar S, Kvashennikova A, Pestova P, Papikyan L, Kadrev A, Danilova N, Malkov P, Chernyaev A, Buravkov S, Khokhlova V. Non-thermal ultrasound-guided fractionation of human leiomyosarcoma with boiling histotripsy: an ex vivo feasibility study. Ultrasonics. 2025 Oct 22;159:107876. doi: 10.1016/j.ultras.2025.107876. PMID: 41135484 

Filippou A, Evripidou N, Spanoudes K, Damianou C. Veterinary pilot study on focused ultrasound treatment of spontaneous canine and feline tumours: technical and feasibility assessment. J Ultrasound. 2025 Sep 22. doi: 10.1007/s40477-025-01085-w. PMID: 40983784 

Rehman S, McCarthy C, Chetan M, Li YL, Gillies M, Cosker T, Wu F, Lyon PC. Imaging and intervention for soft tissue tumours in the era of locoregional therapies and immunotherapy. Clin Radiol. 2025 Aug;87:106969. doi: 10.1016/j.crad.2025.106969. Epub 2025 May 24. PMID: 40533275 

Ong ES, Wehrle CJ, Alassas MM. Distant Tumor Response in the Pelvis After Histotripsy of a Metastatic Sarcoma of the Liver in a Patient With Differentiated Liposarcoma. Am Surg. 2025 Aug 28:31348251371287. doi: 10.1177/00031348251371287. PMID: 40873348 

Kuchimanchi N, Sul N, Gajula S, Mercante M, Tocco E, Mayhew MM, Dengel LT, Cavalcante L, Hadley L, Witt RG. Focused Ultrasound for Sarcomas: A Narrative Review. Curr Oncol. 2025 Aug 12;32(8):452. doi: 10.3390/curroncol32080452. PMID: 40862821 

Chetan M, Gillies M, Rehman S, McCarthy C, Cosker T, Wu F, Lyon PC. High-intensity focused ultrasound treatment of unresectable soft tissue sarcoma and desmoid tumours – a systematic review. Clin Radiol. 2025 Aug;87:106977. doi: 10.1016/j.crad.2025.106977. Epub 2025 Jun 2. PMID: 40570819  

Laganà AS, Romano A, Vanhie A, Bafort C, Götte M, Aaltonen LA, Mas A, De Bruyn C, Van den Bosch T, Coosemans A, Guerriero S, Haimovich S, Tanos V, Bongers M, Barra F, Al-Hendy A, Chiantera V, Leone Roberti Maggiore U. Management of Uterine Fibroids and Sarcomas: The Palermo Position Paper. Gynecol Obstet Invest. 2024;89(2):73-86. doi: 10.1159/000537730. Epub 2024 Feb 21. PMID: 38382486  

Zhu YQ, Zhao GC, Zheng CX, Yuan L, Yuan GB. Managing spindle cell sarcoma with surgery and high-intensity focused ultrasound: A case report. World J Clin Cases. 2023 Sep 26;11(27):6551-6557. doi: 10.12998/wjcc.v11.i27.6551. PMID: 37900255 

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