{"entity":{"id":"bbb-focused-ultrasound","kind":"technology","name":"Focused-ultrasound blood-brain barrier opening","aka":[],"tldr":"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.","status":"phase-2","asOf":"2026-09-06","links":[{"label":"Mainprize et al., Blood-brain barrier opening in primary brain tumours with non-invasive MR-guided focused ultrasound (Scientific Reports 2019)","url":"https://doi.org/10.1038/s41598-018-36340-0"}],"tags":[],"related":[],"cancers":["glioblastoma"],"sections":["devices","surgery"],"technologies":["hifu-histotripsy","mri","liquid-biopsy"],"targets":[],"drugs":[],"companies":["insightec"],"institutions":[],"pathways":[],"terms":["blood-brain-barrier"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-mainprize-sci-rep"],"journals":[],"dependsOn":[],"notes":[],"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"]},"route":"/technologies/bbb-focused-ultrasound/","neighbours":{"cancer":[{"id":"brain-tumours","kind":"cancer","name":"Brain and spinal cord tumours (all types)","route":"/cancers/brain-tumours/"},{"id":"secondary-brain-tumours","kind":"cancer","name":"Brain metastases (secondary brain tumours)","route":"/cancers/secondary-brain-tumours/"},{"id":"dipg-dmg","kind":"cancer","name":"Diffuse midline glioma, H3 K27-altered (including DIPG)","route":"/cancers/dipg-dmg/"},{"id":"glioblastoma","kind":"cancer","name":"Glioma & glioblastoma","route":"/cancers/glioblastoma/"},{"id":"paediatric-high-grade-glioma","kind":"cancer","name":"Paediatric high-grade glioma (excluding diffuse midline glioma)","route":"/cancers/paediatric-high-grade-glioma/"}],"section":[{"id":"devices","kind":"section","name":"Devices & Physical Therapies","route":"/fronts/devices/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"technology":[{"id":"hifu-histotripsy","kind":"technology","name":"Focused ultrasound & histotripsy","route":"/technologies/hifu-histotripsy/"},{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mri","kind":"technology","name":"MRI","route":"/technologies/mri/"},{"id":"sonodynamic-therapy","kind":"technology","name":"Sonodynamic therapy","route":"/technologies/sonodynamic-therapy/"},{"id":"transcranial-focused-ultrasound-systems","kind":"technology","name":"Transcranial focused ultrasound systems (Exablate Neuro, SonoCloud)","route":"/technologies/transcranial-focused-ultrasound-systems/"}],"company":[{"id":"carthera","kind":"company","name":"Carthera","route":"/companies/carthera/"},{"id":"insightec","kind":"company","name":"Insightec","route":"/companies/insightec/"}],"term":[{"id":"blood-brain-barrier","kind":"term","name":"Blood-brain barrier (BBB)","route":"/terms/blood-brain-barrier/"}],"paper":[{"id":"paper-mainprize-sci-rep","kind":"paper","name":"Blood-Brain Barrier Opening in Primary Brain Tumors with Non-invasive MR-Guided Focused Ultrasound: A Clinical Safety and Feasibility Study","route":"/key-papers/paper-mainprize-sci-rep/"}],"idea":[{"id":"idea-bio2-implanted-ultrasound-repeat-dosing","kind":"idea","name":"A skull ultrasound implant that opens the barrier at every cycle","route":"/ideas/idea-bio2-implanted-ultrasound-repeat-dosing/"},{"id":"idea-fus-plus-adc-glioma","kind":"idea","name":"Focused-ultrasound BBB opening to deliver ADCs and radioligands to glioma","route":"/ideas/idea-fus-plus-adc-glioma/"},{"id":"idea-bio2-fus-for-cell-entry","kind":"idea","name":"Open the barrier so engineered immune cells can enter the brain","route":"/ideas/idea-bio2-fus-for-cell-entry/"},{"id":"idea-bio2-sonobiopsy","kind":"idea","name":"Ultrasound-assisted blood test instead of a brain biopsy","route":"/ideas/idea-bio2-sonobiopsy/"}],"bottleneck":[{"id":"b-brain-delivery","kind":"bottleneck","name":"The brain: barrier and sanctuary","route":"/bottlenecks/b-brain-delivery/"}],"institution":[{"id":"northwestern-lurie","kind":"institution","name":"Robert H. Lurie Comprehensive Cancer Center of Northwestern University","route":"/institutions/northwestern-lurie/"},{"id":"sunnybrook-odette","kind":"institution","name":"Sunnybrook Odette Cancer Centre","route":"/institutions/sunnybrook-odette/"},{"id":"uva-cancer-center","kind":"institution","name":"UVA Comprehensive Cancer Center","route":"/institutions/uva-cancer-center/"}],"pathway":[{"id":"blood-brain-barrier-metastasis","kind":"pathway","name":"The blood-brain barrier & brain metastasis","route":"/pathways/blood-brain-barrier-metastasis/"}],"roadmap":[{"id":"devices-roadmap","kind":"roadmap","name":"Devices and physical therapies roadmap: heat and light → electric fields and focused sound → drug-releasing implants","route":"/roadmaps/devices-roadmap/"}]}}