{
  "abstract": "Background: Histotripsy is a non-thermal focused-ultrasound ablation technology that produces mechanical tissue fractionation through controlled acoustic cavitation. In hepatocellular carcinoma (HCC), its relevance remains investigational, particularly in settings where conventional thermal ablation may be constrained by heat-sink effects, vascular or biliary proximity, limited hepatic reserve, or the need for repeated local therapy. This review evaluates the evidence without assuming an established clinical role.\n\nMethods: We performed a structured narrative review with systematic literature identification and evidence classification. The structured core search covered PubMed/MEDLINE, Scopus, Embase, and Google Scholar from database inception through February 2026; a targeted update through 20 September 2026 was used to identify newly published clinical studies, safety reports, and reviews. Evidence was classified as direct HCC, mixed liver-tumour, non-HCC clinical extrapolation, or preclinical/mechanistic evidence.\n\nResults: Evidence remains early-stage and heterogeneous. #HOPE4LIVER reported 95.5% technical success and 6.8% major complications in mixed primary and metastatic liver-tumour cohorts, with incomplete HCC-specific outcome reporting. The Hong Kong prospective cohort included 19 patients with HCC, all Child-Pugh A, and reported 95% technical success, 82.5% complete response at 1 month, and no grade III or higher complications. Real-world reports also document vascular injury, haemorrhage, and pseudoaneurysm, underscoring that relative resistance of collagen-rich structures should not be interpreted as proven vascular or biliary safety.\n\nConclusion: Histotripsy should be regarded as an investigational non-thermal ablation technology for HCC. Current data support technical feasibility and preliminary clinical signals, but not superiority, equivalence, or guideline-defined positioning relative to established therapies. HCC-specific prospective cohorts, standardized safety reporting, long-term oncological outcomes, and comparative studies are required.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan",
    "Department of Urology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan",
    "Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei, Taiwan",
    "AI Development Center, Fu Jen Catholic University, New Taipei, Taiwan",
    "Teaching and Research Department, Saint Paul’s Hospital, Taoyuan, Taiwan",
    "Division of Oncology, Department of Internal Medicine, Saint Paul’s Hospital, Taoyuan, Taiwan",
    "Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan",
    "Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan",
    "Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan",
    "Department of Healthcare Administration, College Of Medical and Health Science, Asia University, Taichung, Taiwan",
    "Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan",
    "Centers for Regional Anesthesia and Pain Medicine,Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ming-Feng Chiang"
    },
    {
      "affs": [
        1
      ],
      "name": "Shyh-Chyi Chang"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Ben-Chang Shia",
      "orcid": "0000-0003-2854-8361"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Yi-Si Liu"
    },
    {
      "affs": [
        4
      ],
      "name": "Chiung-Yun Lo"
    },
    {
      "affs": [
        5
      ],
      "name": "Hai-Pei Hsu"
    },
    {
      "affs": [
        6,
        7,
        8,
        9,
        10,
        11
      ],
      "name": "Szu-Yuan Wu",
      "orcid": "0000-0001-5637-558X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6q196zts07k67.bib",
  "cited_by": 0,
  "doi": "10.2147/jhc.s630056",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13738221/",
  "id": "6q196zts07k67",
  "issns": [
    "2253-5969"
  ],
  "landing_url": "https://doi.org/10.2147/jhc.s630056",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
    [
      "openalex",
      "2204|Ultrasound and Hyperthermia Applications"
    ]
  ],
  "openalex": "W7225012667",
  "pdf_url": "https://www.dovepress.com/article/download/121698",
  "pmcid": "PMC13738221",
  "pmid": "42992179",
  "published": "2026-11-01",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/6q196zts07k67.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:14Z",
      "native_id": "PMC13738221",
      "source": "pmc",
      "url": "https://doi.org/10.2147/jhc.s630056"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Histotripsy for Hepatocellular Carcinoma in Asia-Pacific: Current Evidence, Evidence Gaps, and Future Research Priorities",
  "title_text": "Histotripsy for Hepatocellular Carcinoma in Asia-Pacific: Current Evidence, Evidence Gaps, and Future Research Priorities",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:14Z",
  "url": "https://research.draconitic.com/paper/6q196zts07k67",
  "venue": "Journal of Hepatocellular Carcinoma",
  "versions": []
}