Focused ultrasound for the treatment of bone metastases: effectiveness and feasibility

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

To evaluate the effectiveness and feasibility of high-intensity focused ultrasound (HIFU) for the treatment of bone metastases.

Methods

A single-center prospective study was made involving 17 consecutive patients with symptomatic bone metastases. Patients were treated by Focused Ultrasound (FUs) performed with magnetic resonance (MR) guidance. Surgical treatment or radiotherapy treatment was not indicated for patients who underwent FUs. Lesions were located in the appendicular and axial skeleton and consisted of secondary symptomatic lesions. The clinical course of pain was evaluated using the Visual Analog Scale (VAS) before treatment, at 1 week, and at 1 month after treatment and the Oral Morphine Equivalent Daily Dose (OMEDD) was also recorded. We used Wilcoxon signed rank test to assess change in patient pain (R CRAN software V 3.1.1).

Results

We observed a significant decrease in the pain felt by patients between pre- procedure and 1 week post-procedure ( p = 2.9.10–4), and pre-procedure and 1 month post-procedure ( p = 3.10–4). The proportion of responders according to the International Bone Metastases Consensus Working Party was: Partial Response 50% (8/16) and Complete Response 37.5% (6/16).

Conclusions

HIFU under MR-guidance seems to be an effective and safe procedure in the treatment of symptomatic bone lesions for patients suffering from metastatic disease. A significant decrease of patient pain was observed.

Trial registration

NCT01091883. Registered 24 March 2010. Level of evidence: Level 3.

Related collections

Most cited references 29

Record: found
Abstract: found
Article: not found

MR thermometry.

Viola Rieke, Kim Butts Pauly (2008)

Minimally invasive thermal therapy as local treatment of benign and malignant diseases has received increasing interest in recent years. Safety and efficacy of the treatment require accurate temperature measurement throughout the thermal procedure. Noninvasive temperature monitoring is feasible with magnetic resonance (MR) imaging based on temperature-sensitive MR parameters such as the proton resonance frequency (PRF), the diffusion coefficient (D), T1 and T2 relaxation times, magnetization transfer, the proton density, as well as temperature-sensitive contrast agents. In this article the principles of temperature measurements with these methods are reviewed and their usefulness for monitoring in vivo procedures is discussed. Whereas most measurements give a temperature change relative to a baseline condition, temperature-sensitive contrast agents and spectroscopic imaging can provide absolute temperature measurements. The excellent linearity and temperature dependence of the PRF and its near independence of tissue type have made PRF-based phase mapping methods the preferred choice for many in vivo applications. Accelerated MRI imaging techniques for real-time monitoring with the PRF method are discussed. Special attention is paid to acquisition and reconstruction methods for reducing temperature measurement artifacts introduced by tissue motion, which is often unavoidable during in vivo applications. (Copyright) 2008 Wiley-Liss, Inc.

0 comments Cited 198 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Transcranial magnetic resonance imaging- guided focused ultrasound surgery of brain tumors: initial findings in 3 patients.

Nathan McDannold, Greg T Clement, Peter Black … (2010)

This work evaluated the clinical feasibility of transcranial magnetic resonance imaging-guided focused ultrasound surgery. Transcranial magnetic resonance imaging-guided focused ultrasound surgery offers a potential noninvasive alternative to surgical resection. The method combines a hemispherical phased-array transducer and patient-specific treatment planning based on acoustic models with feedback control based on magnetic resonance temperature imaging to overcome the effects of the cranium and allow for controlled and precise thermal ablation in the brain. In initial trials in 3 glioblastoma patients, multiple focused ultrasound exposures were applied up to the maximum acoustic power available. Offline analysis of the magnetic resonance temperature images evaluated the temperature changes at the focus and brain surface. We found that it was possible to focus an ultrasound beam transcranially into the brain and to visualize the heating with magnetic resonance temperature imaging. Although we were limited by the device power available at the time and thus seemed to not achieve thermal coagulation, extrapolation of the temperature measurements at the focus and on the brain surface suggests that thermal ablation will be possible with this device without overheating the brain surface, with some possible limitation on the treatment envelope. Although significant hurdles remain, these findings are a major step forward in producing a completely noninvasive alternative to surgical resection for brain disorders.

0 comments Cited 112 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

High intensity focused ultrasound: surgery of the future?

Ross Cranston, Marcel G R Ter Veld, Z. Kennedy (2003)

For 50 years, high intensity focused ultrasound (HIFU) has been a subject of interest for medical research. HIFU causes selective tissue necrosis in a very well defined volume, at a variable distance from the transducer, through heating or cavitation. Over the past decade, the use of HIFU has been investigated in many clinical settings. This literature review aims to summarize recent advances made in the field. A Medline-based literature search (1965-2002) was conducted using the keywords "HIFU" and "high intensity focused ultrasound". Additional literature was obtained from original papers and published meeting abstracts. The most abundant clinical trial data comes from studies investigating its use in the treatment of prostatic disease, although early research looked at applications in neurosurgery. More recently horizons have been broadened, and the potential of HIFU as a non-invasive surgical tool has been demonstrated in many settings including the treatment of tumours of the liver, kidney, breast, bone, uterus and pancreas, as well as conduction defects in the heart, for surgical haemostasis, and the relief of chronic pain of malignant origin. Further clinical evaluation will follow, but recent technological development suggests that HIFU is likely to play a significant role in future surgical practice.

0 comments Cited 107 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Anne-Sophie Bertrand:

ORCID: http://orcid.org/0000-0002-4192-4467

06 18 91 62 45 , asbertrand3@hotmail.com

Antoine Iannessi: antoineiannessi@gmail.com

Romain Natale: romain.natale@nice.unicancer.fr

Hubert Beaumont: hubertbeaumont@hotmail.com

Sebastien Patriti: sebastien.patriti@nice.unicancer.fr

Jiang Xiong-Ying: dr.jiangxy@gmail.com

Guillaume Baudin: guillaume.baudin@nice.unicancer.fr

Antoine Thyss: antoine.thyss@nice.unicancer.fr

Journal

Journal ID (nlm-ta): J Ther Ultrasound

Journal ID (iso-abbrev): J Ther Ultrasound

Title: Journal of Therapeutic Ultrasound

Publisher: BioMed Central (London )

ISSN (Electronic): 2050-5736

Publication date (Electronic): 30 November 2018

Publication date PMC-release: 30 November 2018

Publication date Collection: 2018

Volume: 6

Electronic Location Identifier: 8

Affiliations

[1 ]Department of Interventional Radiology, Centre de Lutte contre le Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France

[2 ]Department of Radiotherapy, Centre de Lutte contre le Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France

[3 ]ISNI 0000 0001 2337 2892, GRID grid.10737.32, Department of Statistics, , University of Nice Sophia Antipolis, ; 28 Avenue Valrose, 06000 NICE, France

[4 ]Department of Oncology, Centre de Lutte anti-Cancer Antoine Lacassagne, 33 Avenue de Valombrose, 06100 NICE, France

Author information

Anne-Sophie Bertrand http://orcid.org/0000-0002-4192-4467

Article

Publisher ID: 117

DOI: 10.1186/s40349-018-0117-3

PMC ID: 6267064

SO-VID: 494d11e1-8d24-47c7-be24-317c339f9032

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 9 June 2018

Date accepted : 1 November 2018

Custom metadata

Keywords: high-intensity focused ultrasound,bone neoplasms,radiotherapy,pain,cancer

Data availability:

Keywords: high-intensity focused ultrasound, bone neoplasms, radiotherapy, pain, cancer

Focused ultrasound for the treatment of bone metastases: effectiveness and feasibility

Read this article at

Abstract

Background

Methods

Results

Conclusions

Trial registration

Related collections

Karger: Gastroenterology

Most cited references 29

MR thermometry.

Transcranial magnetic resonance imaging- guided focused ultrasound surgery of brain tumors: initial findings in 3 patients.

High intensity focused ultrasound: surgery of the future?

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 189

Cited by 8

Most referenced authors 334