A HEALTHY FUTURE FOR FOCAL CONFORMAL THERAPEUTIC ULTRASOUND W.A. N’Djin1 1 LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France e-mail: apoutou.ndjin@inserm.fr Therapeutic ultrasound is in constant evolution. Focal/conformal strategies are now often sought after to improve the patient care, but their development remains challenging and requires bringing together new solutions. In open surgery, we proposed an unconventional toroidal focusing strategy for USgHIFU therapy of liver metastases. This solution allowed optimizing the energy distribution, to generate and juxtapose manually large ablations, little affected by vascularization and organ motions. A clinical study ran in France validated the concept of complementary tool to surgery. In interventional radiology, the use of single-/dual- frequency exposures for interstitial MRgHICU allowed 3D control of the energy deposition for conformal ablations. In Canada, a clinical study validated this approach for transurethral prostate ablation (extensions: United States, Europe). Our contributions to conformal/focal approaches also involved emerging MEMs technologies (CMUT transducers) and image guidance methods (3D US navigation, real-time HIFU beam visualization). The first in-vivo study for MRgHICU brain ablation with a CMUT catheter was initiated, as the development of an endocavitary prototype for USgHIFU prostate ablation. CMUTs exhibited groundbreaking characteristics (miniaturization, frequency modulation) which appeared interesting beyond ablative applications (e.g. neurostimulation). However, ultrasound innovations are not always sufficient to advance our knowledge on new therapeutic strategies. For studying ultrasound neurostimulation, we considered advanced electrophysiological techniques from neurosciences. Our recent observations confirmed focal ultrasound-induced electrical activities in several neural models and suggested a preponderant role of the radiation force. Future directions will reinforce openness towards emerging technologies and other disciplines for developing new generations of focal/conformal therapeutic ultrasound, especially in neurosciences.