CLINICAL EVIDENCE PORTFOLIO

Review of scientific and clinical research regarding histotripsy
Download Bibliography
Publication Type Patients Follow-up Key Observations
HistoSonics Sponsored Trials
First in-man histotripsy of hepatic tumors: the THERESA trial, a feasibility study. Vidal-Jove J, et al. Int J Hyperthermia. 2022;39(1):1115-1123. Sponsored feasibility trial 8 2 months
  • 100% technical success
  • Up to 90% involution at 8 weeks
  • No device / procedure related adverse events
The #HOPE4LIVER Single-Arm Pivotal Trial for Histotripsy of Primary and Metastatic Liver Tumors. Mendiratta-Lala M, et al. Radiology. 2024 Sep;312(3):e233051. Sponsored pivotal trial 44 30 days
  • 95% technical success
  • 7% major complication rate
The #HOPE4LIVER single-arm Pivotal Trial for Histotripsy of Primary and Metastatic Liver Tumors: 1-year Update of Clinical Outcomes. Ziemlewicz TJ, et al. Ann Surg. 2025 Apr 9. Sponsored pivotal trial 47 1 year
  • 90% local tumor control
  • 1 adverse device effect after 30 days
  • 1 yr overall survival 75% (HCC), 49% (mets)
Systematic Review
Histotripsy for liver tumours: a systematic review and meta-analysis of current clinical evidence. Wehrle DJ, et al. eClinicalMedicine. 2026. Systematic review 553 1 year
  • 10 papers | 553 patients
  • 94.1% technical success | ≥ 90% LTC at 3mo - 1 yr
  • 18.2% minor complications (Clavien-Dindo grade <3)
  • 7.0% major complications (Clavien-Dindo grade ≥3)
Independent Clinical Experience
The first international experience with histotripsy: a safety analysis of 230 cases. Wehrle CJ, et al. J Gastrointest Surg. 2025 Apr;29(4):102000. Multi-center 230 30 days
  • 94.8% reported no complications within 30 days
  • 1.3% Clavien-Dindo Grade V related to disease progression
  • 3.9% grade I or II related to skin irritation, fluid overload, AKI
Local Tumor Control of Liver Tumors After Histotripsy: A Preliminary National Multicenter Study. Wehrle CJ, et al. JCO Oncol Pract. Multi-center 47 90 days
  • 96% local tumor control at 90 days (82/85)
  • No reported major complications (Clavien-Dindo Grade ≥ IIIa)
  • 3 complications: 2 skin irritation, 1 bacteremia

For more information on histotripsy, please visit the Technology Section.

Last updated on December 19, 2025

Caution: Federal law (USA) restricts this device to sale by or on the order of a physician.

The is intended for the non-invasive mechanical destruction of liver tumors, including the partial or complete destruction of unresectable liver tumors via histotripsy. The FDA has not evaluated the for the treatment of any disease including, but not limited to, cancer or evaluated any specific cancer outcomes (such as local tumor progression, 5-year survival or overall survival). The System should only be used by persons who have completed training performed by HistoSonics Inc., and its use guided by the clinical judgment of an appropriately trained physician. Refer to the device Instructions for Use for a complete list of warnings, precautions and a summary of clinical trial results, including reported adverse events.

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