Progress in pharmaceutical research has brought relief to millions of patients. The average cost of bringing a drug to market, however, has escalated to almost US$ 1 billion and the process typically takes 10–15 years. Despite the high investment in research and development, the US Food and Drug administration (FDA) estimates that a drug entering clinical trial today has only an 8% chance of reaching the market. Common reasons for attrition, such as the lack of efficacy or undesirable side-effects, are even more prominent when novel targets – the biology of which is often insufficiently explored – are introduced into the research and development drug pipeline.

By some accounts the pharmaceutical industry is facing a productivity crisis. This decline occurred despite a doubling of research and development (R&D) spending by U.S.-based pharmaceutical companies between 1995 and 2002. The same pattern is apparent in worldwide statistics, where the annual number of new active substances approved in major markets fell by 50 percent during the 1990s, while private-sector pharmaceutical R&D spending tripled. These numbers have prompted headlines about “dry,” “weak,” or “strangled” pipelines. Much of this cost is actually associated with those drugs that do not make it to market; therefore the higher the attrition rate, the higher the cost of those drugs that eventually do make it. At present, there is an inverse relationship between research and development expenditure by the pharmaceutical industry and the number of drugs receiving regulatory approval.

This is most regretable for patients who are looking for new treatments for life-threatening diseases such as cancer, and detrimental for the pharmaceutical industry, who will generate insufficient profits to develop the drugs of tomorrow.

The integration of therapeutic interventions with diagnostic imaging has been recognized as one of the next technological developments that will have a major impact on medical treatments. Therapeutic applications using ultrasound, for example thermal ablation, hyperthermia or ultrasound induced drug delivery, are examples for image-guided interventions that are currently investigated. While thermal ablation using MR-HIFU is entering the clinic, ultrasound mediated drug delivery is still in a research phase, but holds promise to enable new applications in localized treatments. The use of ultrasound for the delivery of drugs has been demonstrated in particular the field of cardiology and oncology for a variety of therapeutics ranging from small drug molecules to biologics and nucleic acids exploiting temperature or pressure mediated delivery schemes.