MR-guided focused ultrasound surgery (MRgFUS) for the palliation of pain in patients with bone metastases—preliminary clinical experience

Catane, Raphael; Beck, Alexander; Inbar, Yael; Rabin, Tatiana; Shabshin, Nogah; Hengst, S.; Pfeffer, Raphael; Hanannel, Arik; Dogadkin, Osnat; Liberman, Boaz; Kopelman, Doron

doi:10.1093/annonc/mdl335

Cited by 215 publications

(180 citation statements)

References 21 publications

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“…Prospective, single-arm multicenter trials have shown RFA and cryoablation to be safe and highly effective for treatment of symptomatic skeletal metastases [12][13][14][15][16]. A large randomized, controlled, multicenter phase III trial has shown Focused Ultrasound (FUS) to be effective in the treatment of painful bone metastases [17], confirming results of earlier retrospective reports [18]. Small case series also support benefit from other percutaneous methods of image-guided ablation, including microwave ablation, laser ablation, and irreversible electroporation to treat skeletal metastases, although the data are more limited [19][20][21][22][23][24][25][26].…”

Section: Resultsmentioning

confidence: 57%

Evaluation of CT Image Guided Radiofrequency Ablation in the Management of Painful Bone Metastases Originating from NSCLC

Botsa¹

2017

SOJAPM

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Section: Resultsmentioning

confidence: 57%

Evaluation of CT Image Guided Radiofrequency Ablation in the Management of Painful Bone Metastases Originating from NSCLC

Botsa¹

2017

SOJAPM

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“…Cortical bone is characterized by a high absorption of ultrasound and low thermal conductivity. This is an advantage in the treatment of painful bone metastases, since the maximum energy deposition occurs in the region of periosteal localized pain fibers [11]. On the whole, the procedure is quite time-consuming since the resulting ablation area is relatively small (between 50 and 300 mm 3 ).…”

Section: High-intensity Focused Ultrasound (Hifu)mentioning

confidence: 99%

Thermoablation of Bone Tumors

Ringe

Panzica

Falck

2016

Fortschr Röntgenstr

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The aim of this article is to review the significance of percutaneous thermal ablation in the treatment of bone tumors. We describe available ablation techniques as well as advantages and disadvantages in specific settings. In detail, radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation, high intensity focused ultrasound (HIFU) and cryoablation are presented. In the second part of this review curative and palliative indications for the treatment of benign and malignant bone tumors are discussed. This includes especially RFA, laser or cryoablation for the treatment of osteoid osteoma, as well as the palliative treatment of painful bone metastases, for example, by means of MWA or MR-guided HIFU. Key Points: ??The various thermoablative techniques demonstrate specific advantages and disadvantages. ??Radiofrequency ablation is the evidence-based method of choice for treating osteoid osteoma. ??Laser ablation is primarily suited for the treatment of small lesions of the hands and feet. ??The intrinsically analgesic effect of cryoablation is advantageous when treating painful lesions. ??Palliative treatment of painful bone metastases can for example be performed using MWA or MR-guided HIFU, by itself or combined with cementoplasty. Citation Format: ??Ringe KI, Panzica M, von Falck C. Thermoablation of Bone Tumors. Fortschr R?ntgenstr 2016; 188: 539???550

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“…In the case of the brain, when the skull surrounds the target the penetration of acoustic energy through the bone can cause such heating, a seemingly irresolvable problem. This effective heating of bone with FUS can be used to one's advantage with the palliative treatment of painful bone metastases (24).…”

Section: Thermal Ablation With Mrgfus: New Clinical Applicationsmentioning

confidence: 99%

“…While large studies have not yet been performed, initial results of MRgFUS treatment of bone metastases have been extremely promising (24) and potentially offer relatively fast and significant pain reduction. Figure 3 shows an example of MR thermometry during one of these treatments.…”

Section: Bonementioning

confidence: 99%

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Current status and future potential of MRI‐guided focused ultrasound surgery

Jólesz

McDannold

2008

Magnetic Resonance Imaging

112

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The combination of the imaging abilities of magnetic resonance imaging (MRI) with the ability to delivery energy to targets deep in the body noninvasively with focused ultrasound presents a disruptive technology with the potential to significantly affect healthcare. MRI offers precise targeting, visualization, and quantification of temperature changes and the ability to immediately evaluate the treatment. By exploiting different mechanisms, focused ultrasound offers a range of therapies, ranging from thermal ablation to targeted drug delivery. This article reviews recent preclinical and tests clinical of this technology. WHILE ITS POTENTIAL has been recognized for decades (1-4), focused ultrasound (FUS) therapy has been in the incubation phase for a long time. Although it has been tested in numerous animal experiments, its widespread clinical realization has lagged, primarily due to the lack of intraprocedural accurate temperature monitoring. When the idea of MRI-guidance was introduced in connection with FUS and MRI thermometry during sonication was demonstrated (5,6), it was anticipated that MR-guided FUS surgery (MRgFUS) would be widely accepted clinically within a few years. Despite these early expectations, there has been relatively slow progress in the clinical implementation of MRgFUS.Early development concentrated primarily on breast tumors (benign fibroadenoma (7,8) and malignant breast cancer (9,10)). These early implementations of the MRgFUS technology motivated the improvement of transducer technology from single-element transducers to MRI-compatible multielement phase arrays (11). There was also significant progress in MRI thermometry and its use to monitor and control sonications. Importantly, too, methods were developed to robustly quantify temperature changes (12). At first, only 2D temperature maps were obtained by MRI to allow for accurate targeting of the beam (13). Later these thermal images were used to generate maps of the thermal dose (14) that could then be used to tailor the energy deposition using closed-loop feedback control (15). This preclinical work led to the development of the first commercial system by InSightec (Haifa, Israel), the Exablate 2000, the first implementation of a fully integrated MRgFUS system that combined a phased array transducer, a computer-controlled robotic positioner, and a workstation that integrated control based on MR thermometry.The early limited clinical trials of breast tumor treatment (8 -10,16,17) were followed by the first major clinical application: the noninvasive therapy of benign uterine fibroids (18,19). The successful Phase I trial was followed by a multicenter . These clinical trials led to the approval of this technology for the treatment of uterine fibroids in several countries, including the United States. Examples of MR thermometry and postablation imaging of a uterine fibroid ablation are shown in Figure 1.The success of uterine fibroid ablation has invigorated the entire field. Technology has rapidly improved and clinical applications ke...

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MR-guided focused ultrasound surgery (MRgFUS) for the palliation of pain in patients with bone metastases—preliminary clinical experience

Abstract: MRgFUS may provide a safe and effective noninvasive alternative for the palliation of pain, caused by bone metastases.

Cited by 215 publications

References 21 publications

Evaluation of CT Image Guided Radiofrequency Ablation in the Management of Painful Bone Metastases Originating from NSCLC

Evaluation of CT Image Guided Radiofrequency Ablation in the Management of Painful Bone Metastases Originating from NSCLC

Thermoablation of Bone Tumors

Current status and future potential of MRI‐guided focused ultrasound surgery

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