# Focused-ultrasound blood-brain barrier opening

Source: https://onco.cc/technologies/bbb-focused-ultrasound/  
OnCo record `bbb-focused-ultrasound` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Sound waves plus microbubbles briefly open the brain's protective barrier so chemotherapy or antibodies can get to the tumour.

## Summary

MR-guided (Insightec Exablate) or implantable (Carthera SonoCloud-9) ultrasound with intravenous microbubbles transiently and reversibly opens the BBB. Phase 1/2 trials show 4-6x higher brain concentrations of carboplatin, temozolomide, and albumin-bound paclitaxel, and enable liquid biopsy of glioma DNA released into blood. Efficacy trials (SonoCloud-9 with carboplatin, phase 3 SONOBIRD) are underway.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-09-06
- Principle: Acoustic cavitation of circulating microbubbles mechanically loosens endothelial tight junctions for several hours.
- Strengths: Non-invasive or single implant; Drug-agnostic delivery enhancement; Enables brain liquid biopsy
- Limitations: Volume treated per session; Efficacy unproven; Repeated sessions needed

## Sources

- Mainprize et al., Blood-brain barrier opening in primary brain tumours with non-invasive MR-guided focused ultrasound (Scientific Reports 2019): https://doi.org/10.1038/s41598-018-36340-0

## Connected records

- cancers: [Brain and spinal cord tumours (all types)](https://onco.cc/cancers/brain-tumours/), [Brain metastases (secondary brain tumours)](https://onco.cc/cancers/secondary-brain-tumours/), [Diffuse midline glioma, H3 K27-altered (including DIPG)](https://onco.cc/cancers/dipg-dmg/), [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/), [Paediatric high-grade glioma (excluding diffuse midline glioma)](https://onco.cc/cancers/paediatric-high-grade-glioma/)
- fronts: [Devices & Physical Therapies](https://onco.cc/fronts/devices/), [Surgery & Interventional](https://onco.cc/fronts/surgery/)
- technologies: [Focused ultrasound & histotripsy](https://onco.cc/technologies/hifu-histotripsy/), [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [MRI](https://onco.cc/technologies/mri/), [Sonodynamic therapy](https://onco.cc/technologies/sonodynamic-therapy/), [Transcranial focused ultrasound systems (Exablate Neuro, SonoCloud)](https://onco.cc/technologies/transcranial-focused-ultrasound-systems/)
- companies: [Carthera](https://onco.cc/companies/carthera/), [Insightec](https://onco.cc/companies/insightec/)
- terms: [Blood-brain barrier (BBB)](https://onco.cc/terms/blood-brain-barrier/)
- key papers: [Blood-Brain Barrier Opening in Primary Brain Tumors with Non-invasive MR-Guided Focused Ultrasound: A Clinical Safety and Feasibility Study](https://onco.cc/key-papers/paper-mainprize-sci-rep/)
- ideas: [A skull ultrasound implant that opens the barrier at every cycle](https://onco.cc/ideas/idea-bio2-implanted-ultrasound-repeat-dosing/), [Focused-ultrasound BBB opening to deliver ADCs and radioligands to glioma](https://onco.cc/ideas/idea-fus-plus-adc-glioma/), [Open the barrier so engineered immune cells can enter the brain](https://onco.cc/ideas/idea-bio2-fus-for-cell-entry/), [Ultrasound-assisted blood test instead of a brain biopsy](https://onco.cc/ideas/idea-bio2-sonobiopsy/)
- bottlenecks: [The brain: barrier and sanctuary](https://onco.cc/bottlenecks/b-brain-delivery/)
- institutions: [Robert H. Lurie Comprehensive Cancer Center of Northwestern University](https://onco.cc/institutions/northwestern-lurie/), [Sunnybrook Odette Cancer Centre](https://onco.cc/institutions/sunnybrook-odette/), [UVA Comprehensive Cancer Center](https://onco.cc/institutions/uva-cancer-center/)
- pathways: [The blood-brain barrier & brain metastasis](https://onco.cc/pathways/blood-brain-barrier-metastasis/)
- roadmaps: [Devices and physical therapies roadmap: heat and light → electric fields and focused sound → drug-releasing implants](https://onco.cc/roadmaps/devices-roadmap/)

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