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)
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. OP-25-00550. DOI:10.1200/OP-25-00550. 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 case of bacteremia
Histotripsy of Pancreatic Cancer Liver Metastases: Early Outcomes and Imaging Findings. Mabud TS, et al. World J Surg. 2025 Jul;49(7):1899-1902. Single center 21 Median:
Clinical = 2.7 mo
Imaging = 1.3 mo
  • 100% technical success
  • All patients discharged by POD1 and no major complications
Histotripsy of Liver Metastases: Short-Term Safety and Imaging Findings. Mabud TS, et al. Cardiovasc Intervent Radiol. 2025 Nov;48(11):1594-1603. Single center 28 Mean:
Clinical = 2.9 mo
Imaging = 2.0 mo
  • 97% technical success, all patients discharged within 36 hrs
  • Immediate post treatment zones larger than pre-treatment tumors
  • 1 mo treatment zones smaller than immediate post procedure zones
  • 1 grade 3 complication related to bacteremia
Prospective analysis on the outcomes of histotripsy for primary and metastatic liver tumours. Chan AC, et al. Int J Surg. 2025 Nov 10. Single center 30 1 month
  • 95% technical success
  • 82.5% 1-month efficacy rate
  • No major complications (Clavien-Dindo grade III or above)
First FDA approved experience with histotripsy for liver cancer management. Jimenez-Soto C, et al. Int J Surg. 2025 Nov 19. doi: 10.1097/JS9.00000000000004070. Epub ahead of print. PMID: 41255274. Single center 27 3 months
  • Downstaging / bridge (9/27, 33%): 87.5% local tumor control at ≤ 3 months (7/8 evaluable patients); 3 patients successfully downstaged, 5 eligible for resection
  • Palliative (18/27, 67%): 33% growth remained controlled in first 3 months (3/9)
  • Non-targeted tumors decreased in 4 patients
Case Reports
Use of Histotripsy to Rapidly Relieve Biliary Obstruction in a Patient with Recurrent Hilar Cholangiocarcinoma. Ong ES, et al. Am Surg. 2025 Aug 28;31348251358442. Case report 1 6 months
  • No complications, normalization of bilirubin within 72 hours
  • Stable disease, sustained biliary patency at 6 mo
Bridging therapy with histotripsy prior to liver transplantation for hepatocellular carcinoma: a first case report. Uysal M, et al. Exp Hematol Oncol. 2025 Feb 25;14(1):20. Case report 1 2 months
  • Histopathology of explanted liver showed total necrosis, no residual viable tissue tumor
  • Patient successfully transplanted
Histotripsy for portal vein tumor thrombus in a patient with hepatocellular carcinoma: a case report. Burns K, Juarez TM. Front Oncol. 2025 Dec 2;15:1721814. Case report 1 7 months
  • Sequential histotripsy treatments to treat a PVTT
  • Successful destruction, no complications, liver regeneration
  • Durable control of treated PVTT at 7 months

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.

Footer last updated on June 30, 2025
X New Twitter Logo
© 2019-2025 HistoSonics®. All rights reserved.
HistoSonics
Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.