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Huisman M, Lam MK, Bartels LW, et al. Feasibility of volumetric MRI-guided high intensity focused ultrasound (MR-HIFU) for painful bone metastases. J Ther Ultrasound. 2014;2:16doi: 10.1186/2050-5736-2-16.
Huisman, M., Lam, M. K., Bartels, L. W., Nijenhuis, R. J., Moonen, C. T., Knuttel, F. M., Verkooijen, H. M., van Vulpen, M., & van den Bosch, M. A. (2014). Feasibility of volumetric MRI-guided high intensity focused ultrasound (MR-HIFU) for painful bone metastases. Journal of therapeutic ultrasound, 216. https://doi.org/10.1186/2050-5736-2-16
Huisman, Merel, et al. "Feasibility of volumetric MRI-guided high intensity focused ultrasound (MR-HIFU) for painful bone metastases." Journal of therapeutic ultrasound vol. 2 (2014): 16. doi: https://doi.org/10.1186/2050-5736-2-16
Huisman M, Lam MK, Bartels LW, Nijenhuis RJ, Moonen CT, Knuttel FM, Verkooijen HM, van Vulpen M, van den Bosch MA. Feasibility of volumetric MRI-guided high intensity focused ultrasound (MR-HIFU) for painful bone metastases. J Ther Ultrasound. 2014 Oct 10;2:16. doi: 10.1186/2050-5736-2-16. eCollection 2014. PMID: 25309743; PMCID: PMC4193684.
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J Ther Ultrasound. 2014 Oct 10;2:16. doi: 10.1186/2050-5736-2-16. eCollection 2014.

Feasibility of volumetric MRI-guided high intensity focused ultrasound (MR-HIFU) for painful bone metastases.

Journal of therapeutic ultrasound

Merel Huisman, Mie K Lam, Lambertus W Bartels, Robbert J Nijenhuis, Chrit T Moonen, Floor M Knuttel, Helena M Verkooijen, Marco van Vulpen, Maurice A van den Bosch

Affiliations

  1. Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands.
  2. Image Sciences Institute, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
  3. Department of Radiation Oncology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.

PMID: 25309743 PMCID: PMC4193684 DOI: 10.1186/2050-5736-2-16

Abstract

BACKGROUND: Magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) has recently emerged as an effective treatment option for painful bone metastases. We describe here the first experience with volumetric MR-HIFU for palliative treatment of painful bone metastases and evaluate the technique on three levels: technical feasibility, safety, and initial effectiveness.

METHODS: In this observational cohort study, 11 consecutive patients (7 male and 4 female; median age, 60 years; age range, 53-86 years) underwent 13 treatments for 12 bone metastases. All patients exhibited persistent metastatic bone pain refractory to the standard of care. Patients were asked to rate their worst pain on an 11-point pain scale before treatment, 3 days after treatment, and 1 month after treatment. Complications were monitored. All data were prospectively recorded in the context of routine clinical care. Response was defined as a ≥2-point decrease in pain at the treated site without increase in analgesic intake. Baseline pain scores were compared to pain scores at 3 days and 1 month using the Wilcoxon signed-rank test. For reporting, the STROBE guidelines were followed.

RESULTS: No treatment-related major adverse events were observed. At 3 days after volumetric MR-HIFU ablation, pain scores decreased significantly (p = 0.045) and response was observed in a 6/11 (55%) patients. At 1-month follow-up, which was available for nine patients, pain scores decreased significantly compared to baseline (p = 0.028) and 6/9 patients obtained pain response (overall response rate 67% (95% confidence interval (CI) 35%-88%)).

CONCLUSIONS: This is the first study reporting on the volumetric MR-HIFU ablation for painful bone metastases. No major treatment-related adverse events were observed during follow-up. The results of our study showed that volumetric MR-HIFU ablation for painful bone metastases is technically feasible and can induce pain relief in patients with metastatic bone pain refractory to the standard of care. Future research should be aimed at standardization of the treatment procedures and treatment of larger numbers of patients to assess treatment effectiveness and comparison to the standard of care.

Keywords: Bone metastases; Feasibility; Focused ultrasound; Magnetic resonance imaging; Oncology; Palliative treatment

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