{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:32:28Z","timestamp":1778153548215,"version":"3.51.4"},"reference-count":58,"publisher":"Korean Society of Ultrasound in Medicine","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ultrasonography.org"],"crossmark-restriction":true},"short-container-title":["Ultrasonography"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:p>Pancreatic cancer remains highly lethal, with only limited improvements achieved with surgery, chemotherapy, radiotherapy, or immunotherapy. Focused ultrasound (FUS) offers complementary, noninvasive therapeutic modalities\u2014including thermal ablation, non-ablative mechanical stimulation, and histotripsy\u2014that can debulk tumors, palliate pain, enhance drug delivery through modulation of the dense stromal environment, and stimulate antitumor immunity. Extracorporeal high-intensity focused ultrasound is clinically feasible, while endoscopic and intraoperative approaches aim to overcome anatomical constraints. Preclinical studies demonstrate cavitation-mediated increases in tissue permeability and immune activation, and early clinical trials combining FUS with chemotherapy have reported encouraging signals in response rates and survival outcomes. Ongoing investigations are evaluating synergistic effects with immunotherapies and targeted drug delivery strategies. Key challenges\u2014including the deep anatomical location of the pancreas, its fibrotic microenvironment, and the low immunogenicity of pancreatic tumors\u2014necessitate the standardization of treatment parameters and improvements in image guidance. Overall, FUS represents a promising adjunct within multidisciplinary pancreatic cancer care.<\/jats:p>","DOI":"10.14366\/usg.25199","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:29:16Z","timestamp":1777526956000},"page":"195-204","update-policy":"https:\/\/doi.org\/10.14366\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Focused ultrasound as a therapeutic adjunct in pancreatic cancer: from thermal and mechanical effects to immune modulation"],"prefix":"10.14366","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6946-6042","authenticated-orcid":true,"given":"Jae Young","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1550-970X","authenticated-orcid":true,"given":"Cyril","family":"Lafon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7248-6076","authenticated-orcid":true,"given":"Petros","family":"Mouratidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6141-3261","authenticated-orcid":true,"given":"Timothy","family":"Bullock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7199-7272","authenticated-orcid":true,"given":"Joan","family":"Vidal-Jove","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0466-2613","authenticated-orcid":true,"given":"Jessica","family":"Gannon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4097-6257","authenticated-orcid":true,"given":"Eli","family":"Vlaisavljevich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0993-9300","authenticated-orcid":true,"given":"Holger","family":"Gr\u00fcll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0938-6475","authenticated-orcid":true,"given":"Tim","family":"Meakem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5593-3121","authenticated-orcid":true,"given":"Chrit","family":"Moonen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5473","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v27.i27.4298"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1097\/mpa.0000000000002489"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.can-14-0155"},{"key":"ref4","volume-title":"Foundation\u2019s 2024 year in review report now available [Internet]","year":"2025"},{"key":"ref5","volume-title":"Pancreatic cancer workshop white paper now available [Internet]","year":"2025"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2362041105"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1109\/tuffc.2014.6722611"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1121\/1.3626152"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2013.02.005"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2025.07.026"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2023.04.010"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.12.019"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1080\/02656736.2023.2233720"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1109\/tuffc.2025.3596530"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1109\/tuffc.2021.3055138"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultsonch.2015.05.026"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-022-09271-8"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.00545"},{"key":"ref19","first-page":"e230074","volume-title":"High-intensity focused ultrasound surgery for tumor ablation: a review of current applications","author":"De Maio","year":"2024"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1066990"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14112577"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1080\/02656736.2021.1899311"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14030638"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i9.904"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1103\/physrevapplied.22.024024"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.can-15-0296"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-55388-0"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016160024"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1098\/rsif.2021.0266"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.7150\/thno.92089"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1109\/tuffc.2021.3078094"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1012799"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1109\/tuffc.2021.3100267"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2019-000200"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14071612"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.12.038"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcancer.2020.01.002"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1474343"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1126\/science.1198443"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.ccr-24-1660"},{"key":"ref41","first-page":"1173686","volume-title":"Interrogating the CD27:CD70 axis in alphaCD40-dependent control of pancreatic adenocarcinoma","author":"Gamache","year":"2023"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.7150\/thno.73218"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1109\/tbme.2025.3568594"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2022.06.017"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20220729"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1002\/adhm.202302425"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymthe.2022.02.012"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15010196"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1038\/s41551-021-00779-w"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2025.02.035"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02760-3"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-023-06063-y"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241612681"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i44.16480"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-016-4239-0"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2013.06.004"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-018-5355-9"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1080\/02656736.2021.1905189"}],"container-title":["Ultrasonography"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-ultrasonography.org\/upload\/usg-25199.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-ultrasonography.org\/journal\/view.php?doi=10.14366\/usg.25199","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-ultrasonography.org\/upload\/usg-25199.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:29:18Z","timestamp":1777526958000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-ultrasonography.org\/journal\/view.php?doi=10.14366\/usg.25199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":58,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.14366\/usg.25199","relation":{},"ISSN":["2288-5919","2288-5943"],"issn-type":[{"value":"2288-5919","type":"print"},{"value":"2288-5943","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]},"assertion":[{"value":"2025-10-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}