Whole-Body Bone Scan Findings after High-Intensity Focused Ultrasound (HIFU) Treatment

Abstract

Purpose This study aims to examine the findings of 99m Tcdiphosphonate bone scans in cancer patients with a history of HIFU treatment. Methods Bone scan images of patients with a history of HIFU treatment for primary or metastatic cancer from January 2006 to July 2010 were retrospectively reviewed. Cases of primary bone tumor or HIFU treatment reaching only the superficial soft tissue layer were excluded. Results Bone scan images of 62 patients (26 female, 36 male; mean age 57±9 years) were studied. HIFU treatment was performed in the liver (n=40), pancreas (n=16), and breast (n=6). Mean interval time between HIFU treatment and bone scan was 106±105 days (range: 1-572 days). Of 62 scans, 43 showed diffusely decreased uptake of bone within the path of HIFU treatment: antero-axillary and/or posterior arcs of right 5th to 11th ribs in 34 cases after treatment of hepatic lesions; anterior arcs of 2nd to 5th ribs in 5 cases after treatment for breast tumors; and posterior arcs of left 9th to 11th ribs or thoracolumbar vertebrae in 4 cases after treatment for pancreas tumor. Of 20 patients who had bone scans more than twice, five showed recovered uptake of the radiotracer in the involved ribs in the follow-up bone scan. Conclusion Of 62 bone scans in patients with a history of HIFU treatment for primary or metastatic cancer, 69% presented diffusely decreased uptake in the bone in the path of HIFU treatment.

High intensity focused ultrasound (HIFU) applied to hepato-bilio-pancreatic and the digestive system—current state of the art and future perspectives

“…Forty-four studies reported on the clinical use of HIFU (7,(10)(11)(12)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) to treat liver lesions , while 19 series were found on HIFU treatment for pancreatic cancers (6,(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73) and 4 studies included patients suffering from both liver and pancreatic cancers (74)(75)(76)(77), reporting on a total of 1,682 and 823 cases for the liver and pancreas, respectively. However, the real number of patients who benefited from HIFU treatment is much larger, since a recent review article from Zhou reported on over 3,000 cases of advanced pancreatic cancer treated with HIFU alone or in combination with chemotherapy (CHT) or radiotherapy (RT) (78).…”

Enhancement of HIFU thermal therapy in perfused tissue models using micron-sized FTAC-stabilized PFOB-core endovascular sonosensitizers

“…However, MRgHIFU in highly perfused tumors is challenging because higher energy is required to compensate for the cooling of the tissues induced by blood flow, called the heat sink effect [16]. Subsequently, critical side effects are produced, such as skin or bone burning, post focal energy deposition or side lobe effects [17][18][19]. Jung et al [20] reported a significant number of adverse effects occurring after HIFU treatment of hepatic tumors, hepatic metastasis and pancreatic cancers such as skin burning, edema, and, in all patients, pain.…”

Micron-sized PFOB liquid core droplets stabilized with tailored-made perfluorinated surfactants as a new class of endovascular sono-sensitizers for focused ultrasound thermotherapy

“…In addition, even when US energy is concentrated to the focal point, it can also be deposited along the US beam in front or behind the focus point and cause severe side effects such as skin and bone burning. 8,[12][13][14] Furthermore, given a treatment planning, interpatient variation in the volume and shape of the lesion may be difficult to control and to reproduce. 15 The ablative effects of HIFU are due to the focusing of high energy beams in a small region on the order of the wavelength, i.e.…”