Focused ultrasound-mediated drug delivery systems: a technological overview, possible musculoskeletal applications, and future directions

Abstract

Background

Innovation in focused ultrasound (FUS) has led to new applications for treating musculoskeletal pathologies, including oncologic, infectious, and degenerative diseases. Focused ultrasound-mediated drug delivery is particularly interesting in fields in which high selectivity and localized action are needed to avoid unwanted side effects or therapy failure, for example with antineoplastic and antimicrobial drugs.

Method

For this paper, a literature search of the PubMed database was performed using the keywords “focused ultrasound” and “musculoskeletal applications”.

Conclusion

This review article presents an overview of the currently available technologies for focused ultrasound-mediated drug delivery and their possible musculoskeletal applications, along with a discussion of recent promising preclinical and clinical results.

Key Points

• Focused ultrasound is able to deliver drugs in a very selective way.

• Focused ultrasound-mediated hyperthermia may be promising for treating bone infections.

• Focused ultrasound-mediated drug delivery may also be an elegant method for treating bone cancer and arthritis.

Citation Format

• Sassi R, Gazzotti S, Aparisi Gómez MP et al. Focused ultrasound-mediated drug delivery systems: a technological overview, possible musculoskeletal applications, and future directions. Rofo 2025; DOI 10.1055/a-2760-5392

Zusammenfassung

Hintergrund

Innovationen im Bereich des (hochintensiven) fokussierten Ultraschalls (FUS) haben zu neuen Anwendungen bei der Behandlung von Erkrankungen des Bewegungsapparats geführt, darunter onkologische, infektiöse und degenerative Erkrankungen. Die Verabreichung von Medikamenten mittels FUS ist besonders in den Bereichen interessant, in denen eine hohe Selektivität und lokalisierte Wirkung erforderlich sind, um unerwünschte Nebenwirkungen oder Therapieversagen zu vermeiden, beispielsweise bei antineoplastischen und antimikrobiellen Medikamenten.

Methodik

Eine Literatursuche wurde mittels der PubMed-Datenbank durchgeführt, wobei als primäre Schlüsselwörter „focused ultrasound“ und „musculoskeletal applications“ verwendet wurden. Anschließend wurde die Suche pro Unterthema verfeinert, indem das Schlüsselwort „drug delivery“, verknüpft mit Begriffen „cancer“, „bone cancer“, „bone infections“, „antibiotics“ und „osteoarthritis“, hinzugefügt wurde.

Schlussfolgerung

Dieser Übersichtsartikel bietet einen Überblick über die derzeit verfügbaren Technologien für die Verabreichung von Medikamenten mittels FUS und ihre möglichen Anwendungen am Bewegungsapparat sowie eine Diskussion der jüngsten vielversprechenden präklinischen und klinischen Ergebnisse.

Kernaussagen

• (Hochintensiver) Fokussierter Ultraschall kann Medikamente sehr selektiv verabreichen.

• Hyperthermie mit FUS könnte bei der Behandlung von Knocheninfektionen vielversprechend sein.

• Die Verabreichung von Medikamenten mit FUS könnte auch eine elegante Methode zur Behandlung von Knochenmalignomen und der Arthritis sein.

Keywords

Drug delivery systems - Thermal ablation - Sonoporation - Musculoskeletal application - Focused ultrasound

Publikationsverlauf

Eingereicht: 07. Februar 2025

Angenommen nach Revision: 20. November 2025

Artikel online veröffentlicht:
30. Januar 2026

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