MR-guided Focused Ultrasound (MRgFUS) Ablation for the Treatment of Nonspinal Osteoid Osteoma

Geiger, Daniel; Napoli, Alessandro; Conchiglia, Armando; Gregori, Lorenzo; Arrigoni, Francesco; Bazzocchi, Alberto; Busacca, Maurizio; Moreschini, O.; Mastantuono, M.; Albisinni, Ugo; Masciocchi, Carlo; Catalano, Carlo

doi:10.2106/jbjs.m.00903

Cited by 73 publications

(68 citation statements)

References 26 publications

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“…To our knowledge there are no other reports of using high-intensity focused ultrasound to treat extremity soft tissue tumors. However, this technology is used for the treatment of bone tumors and although there are similarities between the techniques for treating bone versus soft tissue tumors, there are important differences [5,14]. Most notable is that bone absorbs ultrasound to a much higher degree than soft tissue, making it technically easier and safer to deliver ablative energy to bone tumors.…”

Section: Discussionmentioning

confidence: 99%

Is MR-guided High-intensity Focused Ultrasound a Feasible Treatment Modality for Desmoid Tumors?

Avedian

Bitton

Gold

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background MR-guided high-intensity focused ultrasound is a noninvasive treatment modality that uses focused ultrasound waves to thermally ablate tumors within the human body while minimizing side effects to surrounding healthy tissues. This technology is FDAapproved for certain tumors and has potential to be a noninvasive treatment option for extremity soft tissue tumors. Development of treatment modalities that achieve tumor control, decrease morbidity, or both might be of great benefit for patients. We wanted to assess the potential use of this technology in the treatment of extremity desmoid tumors. Questions/purposes (1) Can we use MR-guided highintensity focused ultrasound to accurately ablate a predetermined target volume within a human cadaver extremity? (2) Does MR-guided high-intensity focused ultrasound treatment stop progression and/or cause regression of extremity desmoid tumors? Methods Simulated tumor volumes in four human cadavers, created by using plastic markers, were ablated using a commercially available focused ultrasound system. Accuracy was determined in accordance with the International Organization of Standards location error by measuring the farthest distance between the ablated tissue and the plane corresponding to the target. Between 2012 and 2014, we treated nine patients with desmoid tumors using focused ultrasound ablation. Indications for this were tumor-related symptoms or failure of conventional treatment. Of those, five of them were available for MRI followup at 12 months or longer (mean, 18.2 months; range, 12-23 months). The radiographic and clinical outcomes of five patients who had desmoid tumors treated with focused ultrasound were prospectively recorded. Patients were assessed preoperatively with MRI and followed at routine intervals after treatment with MRI scans and clinical examination. Results The ablation accuracy for the four cadaver extremities was 5 mm, 3 mm, 8 mm, and 8 mm. Four patients' tumors became smaller after treatment and one patient has slight progression at the time of last followup. The mean decrease in tumor size determined by MRI measurements was 36% (95% confidence interval, 7%-66%). No patient has received additional adjuvant systemic or local treatment. Treatment-related adverse events included first-and second-degree skin burns occurring in

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Section: Discussionmentioning

confidence: 99%

Is MR-guided High-intensity Focused Ultrasound a Feasible Treatment Modality for Desmoid Tumors?

Avedian

Bitton

Gold

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…This reduces the potentially detrimental thermal smearing and energy dissipation effects to surrounding tissue due to blood perfusion. Because of these technical issues, ablation of a typical tumor requires sequential tiling of multiple sonications to create homogeneous thermal damage and coagulative necrosis of the entire target volume [16,17].…”

Section: High-intensity Focused Ultrasoundmentioning

confidence: 99%

Focused ultrasound for treatment of bone tumours

Rodrigues

Stauffer

Vrba

et al. 2015

International Journal of Hyperthermia

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“…Clinical studies show that the results are comparable with other uterus-preserving treatment methods [54]. In the meantime, other benign tumors (e. g. fibroadenomas, osteoid osteomas) have also been successfully treated with focused ultrasound [55].…”

Section: Mr-guided Focused Ultrasoundmentioning

confidence: 75%

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 2: Liver and Other Applications in Oncology

Barkhausen

Kahn

Krombach

et al. 2017

Fortschr Röntgenstr

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Background MRI is attractive for guiding and monitoring interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure flow and cardiac function. Methods Technical solutions have been developed for all procedural steps including imaging guidance, MR-safe catheters and instruments and patient monitoring. This has led to widening of the clinical applications. Interventional MRI is becoming increasingly important for the treatment of patients suffering from malignant diseases. The detectability of masses and consequently their accessibility for biopsy is higher, compared to other modalities, due to the high intrinsic soft tissue contrast of MRI. Temperature-dependent sequences allow for minimally invasive and tissue-sparing ablation (A-0 ablation). Conclusion Interventional MRI has become established in the clinical routine for a variety of indications, including biopsies and tumor ablation. Since the economic requirement of covering costs by reimbursement is met and interventional MRI decreases the mortality and morbidity of interventional procedures, broader application of interventional MRI can be expected in the clinical routine in the future. Key points Citation Format

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MR-guided Focused Ultrasound (MRgFUS) Ablation for the Treatment of Nonspinal Osteoid Osteoma

Abstract: MRgFUS may be an effective and safe alternative approach in the treatment of nonspinal osteoid osteoma. A complete clinical success rate of 90% was demonstrated without adverse events. MRgFUS is totally noninvasive and eliminates radiation exposure.

Cited by 73 publications

References 26 publications

Is MR-guided High-intensity Focused Ultrasound a Feasible Treatment Modality for Desmoid Tumors?

Is MR-guided High-intensity Focused Ultrasound a Feasible Treatment Modality for Desmoid Tumors?

Focused ultrasound for treatment of bone tumours

White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 2: Liver and Other Applications in Oncology

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