How the Institute of Biomedical Engineering helped shape two decades of progress in Oxford’s Focused Ultrasound Programme, leading to the University of Oxford being named a Focused Ultrasound Foundation Centre of Excellence in 2023.
When Estella Devaney Fenn learned that a uterine fibroid was the cause of her severe symptoms, she was initially presented with two treatment choices: induction of menopause or open abdominal surgery. Both options carried significant implications. After seeking further information, she was referred to the High Intensity Focused Ultrasound (HIFU) facilities at the Churchill Hospital, which offered her a non-invasive alternative.
She described her relief at learning about focused ultrasound treatment and valued being able to explore an option that avoided surgery. The treatment, which uses concentrated ultrasound energy to heat and destroy targeted tissue while sparing surrounding structures, was straightforward for her, and she returned home the day after the procedure. Some symptoms persisted during recovery, which she had been advised would be expected as the body heals.
Her experience reflects the growing clinical role of focused ultrasound at Oxford. The technology increases the power of ultrasound by a factor of ten thousand and can target tumours with precision without leaving a wound. According to Professor David Cranston (Nuffield Department of Surgical Sciences), its non-invasive nature is particularly valuable for patients with uterine fibroids and for many cancer indications. It may also offer advantages for individuals seeking to preserve fertility.
A Long-term Engineering and Clinical Collaboration
Oxford’s focused ultrasound programme has developed over more than twenty years. The first steps were taken in 2002, when Professor Cranston introduced the original Model JC device from Haifu Technology Ltd into an annex at the Churchill Hospital. Working with his clinical colleagues, Professor Feng Wu, and lead physicist Professor Gail ter Haar, the team used the system in studies involving kidney and liver tumours.
These early investigations supported CE marking for tumour therapy and established the foundation for Oxford’s future research in the field. The original device was later replaced with the JC200, which was installed within the Radiology Department of the Churchill Hospital Cancer Centre. The new location enabled studies in oncology and treatment of benign conditions such as uterine fibroids.
Translational Research Momentum
Dr Paul Lyon arrived in Oxford in 2013 to undertake a NIHR Oxford BRC funded clinical DPhil that explored focused ultrasound for drug delivery. Working with Professor Constantin Coussios and Professor Robert Carlisle at the Institute of Biomedical Engineering, and Professor Fergus Gleeson in Radiology, he led the first in human study using lower energy focused ultrasound from the JC200 system to gently heat tumours to activate ThermoDox®, a heat sensitive formulation of doxorubicin. The work required extensive collaboration between oncologists, radiologists, and scientists, including Professor Michael Gray and the wider ultrasound engineering team at the IBME. The findings were published in Lancet Oncology in 2018.
Following this research, Dr Lyon completed his clinical radiology training and joined the thermal ablation service at Oxford University Hospitals in 2022. He became Clinical Director of the HIFU Unit in 2025, succeeding Professor Cranston. Under his leadership the service continues to expand its contribution to NHS care while supporting research in areas such as sarcoma and pancreatic cancer. The team is also investigating the potential of low energy ultrasound for drug delivery and immunomodulation.
Recognition and Renewal of the Programme
In 2023 the University of Oxford was named a Focused Ultrasound Foundation Centre of Excellence in recognition of more than two decades of clinical and scientific work. The Centre, co-directed by Professor Coussios and Dr Lyon, reflects the strong partnership between engineers at IBME, clinicians at Oxford University Hospitals, researchers in the Nuffield Department of Surgical Sciences, and the device manufacturer Haifu Technology Ltd.
The JC200 platform was comprehensively upgraded in 2025 to the newest device generation. The updated system was officially opened in January 2026 by Dr Rustam Rea, with BBC coverage including a patient interview. The upgrade provides enhanced technical capabilities that support both clinical treatment and research studies.
Towards New Clinical Trials
The improved performance of the JC200 system is now enabling a new phase of clinical trials at Oxford. These studies aim to build on the programme’s earlier translational achievements and to evaluate focused ultrasound across a broader range of conditions. The trials form part of a coordinated effort to deliver advanced therapeutic ultrasound within the NHS and to support the development of new centres across the United Kingdom and world-wide.
A Broader Landscape of Focused Ultrasound Research
The JC200 programme operates within a wider focused ultrasound research environment across the University. Professor Robin Cleveland, Director of the Institute of Biomedical Engineering, is working with neurosurgeons on studies of focused ultrasound applications in the brain. Professor Eleanor Stride is progressing towards clinical trials that combine focused ultrasound with nanoparticle based drug delivery. These projects highlight the range of scientific and clinical innovation underway in Oxford.
A Continuing Collaborative Enterprise
The progress of the Oxford focused ultrasound programme has been made possible by the sustained efforts of many clinicians, scientists, and engineers over the past twenty-five years. The launch of the upgraded JC200 system and the initiation of new clinical trials mark the latest step in a long collaborative journey and provide opportunities to offer patients new therapeutic options as the programme continues to advance. These trials could lead to expanding indications and greater availability of focused ultrasound treatment for cancer patients across the UK.
Dr. Paul Lyon looks to the future of the treatment. “I am delighted to have played a part in the HIFU journey in Oxford, bringing me to the University over a decade ago. The great clinical potential of focused ultrasound technology is clear, by virtue of its non-invasive nature, favourable safety profile and rapid recovery. Extending the benefits of the technology to treat oncology patients with unmet clinical need is an area I feel passionate about. Focused ultrasound may provide therapeutic thermal or non-thermal effects including ablation and targeted drug delivery. Whilst focused ultrasound is rapidly gaining traction worldwide, clinical adoption in oncology patients requires further multidisciplinary clinical research studies and potentially multicentre studies. It will be a huge privilege to be part of this next chapter in truly translatable clinical research.”
Professor David Cranston shared his thoughts. “It is exciting to see how Focused Ultrasound therapy has developed over the last 25 years, not only in Oxford but internationally. Our links with the National Ultrasound Engineering Research Centre in China and Chongqing Medical University, along with the Focused Ultrasound Foundation in the USA have enhanced our programme significantly and we look forward to our continued international collaboration.”