Over the years, doctors and technicians who performed medical Ultrasound procedures examined the bubbles with wary concern. The phenomenon of cavitation—the formation and collapse of tiny gas bubbles due to changes in pressure—was considered an undesirable and virtually uncontrollable side effect. But in 2001, researchers at the University of Michigan began studying ways to use this phenomenon to destroy cancerous tumors and other problematic tissues.
The problem was that creating and controlling cavitation generated heat that harmed healthy tissue outside the target area. Zhen Xuwho was working on his doctoral dissertation. V biomedical engineering while bombarding pig heart tissue in a water tank Ultrasound when she made her breakthrough.
The key was the use of extremely powerful ultrasound to create a negative pressure of more than 20 megapascals, created by short pulses measured in microseconds but separated by relatively long intervals, ranging from a millisecond to a full second. These settings created bubbles that quickly formed and collapsed, rupturing nearby cells and turning the tissue into a kind of liquid mass while avoiding heat buildup. The result was a shape without a cut. operationa way to destroy tumors without scalpels, radiationor heat it up.
“The experiments worked,” says Xu, now a professor at Michigan, “but I also destroyed the ultrasound equipment I was using,” which was the most powerful available at the time. In 2009, she co-founded the company HistoSonicsto commercialize more powerful ultrasound machines, test treatments for various diseases and make a procedure called histotripsy widely available.
So far the killer app is struggling Cancer. In 2023, the HistoSonics Edison system received FDA approval for treatment of liver tumors. In 2026, doctors will conclude key kidney cancer study and apply for regulatory approval. They will also launch a large-scale study to treat pancreatic diseases. Cancerconsidered one of the deadliest forms of the disease with a five-year survival rate of only 13 percent. Effective treatment of pancreatic cancer could be a major advance in the fight against one of the deadliest cancers.
Benefits of Histotripsy for Cancer Treatment
HistoSonics is not the only developer of histotripsy devices or techniques, but it is the first to market a purpose-built device. “What HistoSonics has developed is a symphony of technology that combines physics, biology and biomedical engineering,” says Bradford Woodinterventional radiologist at the National Institutes of Health, not affiliated with the company. His engineering efforts spanned multiple disciplines to create computer-controlled robotic systems that translate physical forces into therapeutic effects.
Over the past decade, studies have confirmed or discovered other benefits of histotripsy. Thanks to precise calibration, fibrous tissue such as blood vessels can be protected from damage even in the target area. And while other non-invasive methods may leave behind scar tissue, the liquefied debris created by histotripsy is removed by the body's natural processes.
In HistoSonics' early studies to treat pancreatic cancer, doctors used focused ultrasound pulses to ablate or destroy tumors deep inside the pancreas. “It’s a big achievement for the field to show that you can remove pancreatic tumors and that it’s well tolerated,” says Tatiana Khokhlovamedical ultrasound researcher at the University of Washington in Seattle who has worked on alternative histotripsy techniques.
Khokhlova says the key to reaping the benefits of histotripsy “will be to combine ablation of the primary pancreatic tumor with some other therapy.” The combination treatment may help fight recurrent cancer and tiny tumors that ultrasound may miss, as well as provide unexpected benefits.
Histotripsy is usually stimulate the immune responsehelping the body attack cancer cells that were not directly affected by ultrasound. Mechanical destruction of tumors likely leaves behind recognizable traces of cancer proteins that help the immune system learn to identify and destroy similar cells in other parts of the body, Wood explains. Researchers are currently studying ways to combine histotripsy with immunotherapy to enhance this effect.
According to HistoSonics' CEO, the company's ability to explore the potential of treating various diseases will only improve over time. Mike Blue. The company has fresh resources to accelerate research and development: a new ownership group that includes a billionaire Jeff Bezos, acquired HistoSonics in August 2025 at a valuation of US$2.25 billion.
Engineers are already testing a new guidance system that uses a kind of X-rays rather than ultrasound imagingwhich should expand use cases. The research and development team is also developing a feedback system that analyzes therapeutic ultrasound echoes to detect tissue destruction and integrates that information into real-time imaging, Blue says.
If these advances pan out, histotripsy could go well beyond the liver, kidneys and pancreas in the fight against cancer. What began as curiosity about bubbles could soon become the new mainstay of noninvasive medicine—a future in which surgeons wield sound waves rather than scalpels.
This article appears in the January 2026 print issue.
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