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McGill KC, Baal JD, Bucknor MD. Update on musculoskeletal applications of magnetic resonance-guided focused ultrasound. Skeletal Radiol 2024:10.1007/s00256-024-04620-8. [PMID: 38363419 DOI: 10.1007/s00256-024-04620-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
Magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive, incisionless, radiation-free technology used to ablate tissue deep within the body. This technique has gained increased popularity following FDA approval for treatment of pain related to bone metastases and limited approval for treatment of osteoid osteoma. MRgFUS delivers superior visualization of soft tissue targets in unlimited imaging planes and precision in targeting and delivery of thermal dose which is all provided during real-time monitoring using MR thermometry. This paper provides an overview of the common musculoskeletal applications of MRgFUS along with updates on clinical outcomes and discussion of future applications.
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Affiliation(s)
- Kevin C McGill
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, Suite M391, San Francisco, CA, 94143, USA.
| | - Joe D Baal
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, Suite M391, San Francisco, CA, 94143, USA
| | - Matthew D Bucknor
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, Suite M391, San Francisco, CA, 94143, USA
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2
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Mid-term efficacy grading evaluation and predictive factors of magnetic resonance-guided focused ultrasound surgery for painful bone metastases: a multi-center study. Eur Radiol 2023; 33:1465-1474. [PMID: 36074263 DOI: 10.1007/s00330-022-09118-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/04/2022] [Accepted: 08/17/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES MR imaging-guided focused ultrasound surgery (MRgFUS) is an emerging non-invasive treatment. It is helpful in investigating the mid-term grading efficacy and safety of MRgFUS, and possible risk factors in participants with painful bone metastases. METHODS This four-center prospective study enrolled 96 participants between June 2016 and May 2019 with painful bone metastases. The Numerical Rating Scale (NRS), Brief Pain Inventory-Quality of Life (BPI-QoL) score, morphine equivalent daily dose (MEDD), and the adverse events (AEs) were recorded before and at 1 week, 1 month, 2 months, and 3 months after MRgFUS. The repeated ANOVA tests were used to analyze the change in NRS and BPI-QoL, and logistic regression analysis was used to analyze the possible risk factors. RESULTS A total of 82 participants completed the 3-month follow-up period. And 16 (19.5%) participants were complete responders (CR), 46 (56.1%) participants were effective responders (ER), and the other 20 (24.4%) participants were non-responders (NR). The NRS (2.67 ± 2.47 at 3 months compared to 6.38 ± 1.70 before treatment) and BPI-QoL score (3.11 ± 2.51 at 3 months compared to 5.40 ± 1.85 before treatment) significantly decreased after the treatment at all time points (p < 0.001). Eleven adverse events were recorded and they were all cured within 1 to 52 days after treatment. The non-perfused volume (NPV) ratio (p = 0.001) and the bone metastases lesion type (p = 0.025) were the key risk factors. CONCLUSIONS MRgFUS can be used as a non-invasive, effective, and safe modality to treat painful bone metastases. NPV ratio and the lesion type may be used as affecting factors to predict the mid-term efficacy of MRgFUS. KEY POINTS • MRgFUS can be considered a non-invasive, effective, and safe modality to treat painful bone metastases. • The NRS and BPI-QoL score at 1 week, 1 month, 2 months, and 3 months all decreased significantly (p < 0.001) after receiving MRgFUS. Among 82 participants, 16 (19.5%) were complete responders, 46 (56.1%) were effective responders, and the other 20 (24.4%) were non-responders. • According to logistic regression analysis, non-perfused volume ratio and the bone metastases lesion type were the affecting factors to predict the mid-term efficacy of MRgFUS. The adjusted OR of non-perfused volume ratio was 0.86 (p = 0.001), and osteoblastic lesion type was 0.06 (p = 0.025).
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3
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Napoli A, De Maio A, Alfieri G, Gasperini C, Scipione R, Campanacci L, Siepe G, De Felice F, Siniscalchi B, Chiurchioni L, Tombolini V, Donati DM, Morganti AG, Ghanouni P, Catalano C, Bazzocchi A. Focused Ultrasound and External Beam Radiation Therapy for Painful Bone Metastases: A Phase II Clinical Trial. Radiology 2023; 307:e211857. [PMID: 36594834 DOI: 10.1148/radiol.211857] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background Recent consensus statements and clinical trials have assessed the value of MRI-guided focused ultrasound surgery for pain palliation of bone metastases; however, a comparison with external beam radiation therapy (EBRT) has not been performed. Purpose To compare safety and effectiveness data of MRI-guided focused ultrasound and EBRT in the treatment of bone metastases. Materials and Methods Participants with painful bone metastases, excluding skull and vertebral bodies, were enrolled in a prospective open-label nonrandomized phase II study between January 2017 and May 2019 and underwent either MRI-guided focused ultrasound or EBRT. The primary end point was the overall response rate at 1-month following treatment, assessed via the numeric rating scale (NRS) for pain (0-10 scale, with zero meaning "no pain" and 10 meaning "the worst pain imaginable"). Secondary end points were improvements at 12-month follow-up in NRS and quality of life (QoL) measures, including the Brief Pain Inventory (BPI), QoL-Questionnaire Cancer-15 Palliative Care (QLQ-C15-PAL), and QoL-Questionnaire Bone Metastases-22 (QLQ-BM22) and analysis of adverse events. Statistical analyses, including linear regression, χ2 test, and Student t test followed the per-protocol principle. Results Among 198 participants, 100 underwent MRI-guided focused ultrasound (mean age, 63 years ± 13 [SD]; 51 women), and 98 underwent EBRT (mean age, 65 years ± 14; 52 women). The overall response rates at 1-month follow-up were 91% (91 of 100) and 67% (66 of 98), respectively, in the focused ultrasound and EBRT arms (P < .001), and complete response rates were 43% (43 of 100) and 16% (16 of 98) (P < .001). The mean baseline NRS score was 7.0 ± 2.1 for focused ultrasound and 6.6 ± 2.4 for EBRT (P = .16); at 1-month follow-up, they were reduced to 3.2 ± 0.3 and 5.1 ± 0.3 (P < .001), respectively. QLQ-C15-PAL for physical function (P = .002), appetite (P < .001), nausea and vomiting (P < .001), dyspnea (P < .001), and QoL (P < .001) scores were lower in the focused ultrasound group. The overall adverse event rates were 15% (15 of 100) after focused ultrasound and 24% (24 of 98) after EBRT. Conclusion MRI-guided focused ultrasound surgery and external beam radiation therapy showed similar improvements in pain palliation and quality of life, with low adverse event rates. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Kelekis in this issue.
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Affiliation(s)
- Alessandro Napoli
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Alessandro De Maio
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Giulia Alfieri
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Chiara Gasperini
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Roberto Scipione
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Laura Campanacci
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Giambattista Siepe
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Francesca De Felice
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Benedetta Siniscalchi
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Lorenzo Chiurchioni
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Vincenzo Tombolini
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Davide Maria Donati
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Alessio Giuseppe Morganti
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Pejman Ghanouni
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Carlo Catalano
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
| | - Alberto Bazzocchi
- From the Department of Radiological, Pathological, and Oncological Sciences, Sapienza University of Rome, v.le Regina Elena 324, 00100 Rome, Italy (A.N., A.D.M., G.A., R.S., F.D.F., B.S., L. Chiurchioni, V.T., C.C.); Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (C.G., A.B.); Orthopaedic Service, Department of Musculoskeletal Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy (L. Campanacci, D.M.D.); Department of Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (G.S., A.G.M.); DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy (G.S., A.G.M.); and Department of Radiology, Stanford University, Stanford, Calif (P.G.)
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4
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Slotman DJ, Bartels MMTJ, Ferrer CJ, Bos C, Bartels LW, Boomsma MF, Phernambucq ECJ, Nijholt IM, Morganti AG, Siepe G, Buwenge M, Grüll H, Bratke G, Yeo SY, Blanco Sequeiros R, Minn H, Huhtala M, Napoli A, De Felice F, Catalano C, Bazzocchi A, Gasperini C, Campanacci L, Simões Corrêa Galendi J, Müller D, Braat MNGJA, Moonen C, Verkooijen HM. Focused Ultrasound and RadioTHERapy for non-invasive palliative pain treatment in patients with bone metastasis: a study protocol for the three armed randomized controlled FURTHER trial. Trials 2022; 23:1061. [PMID: 36582001 PMCID: PMC9798627 DOI: 10.1186/s13063-022-06942-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/17/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Cancer-induced bone pain (CIBP), caused by bone metastases, is a common complication of cancer and strongly impairs quality of life (QoL). External beam radiotherapy (EBRT) is the current standard of care for treatment of CIBP. However, approximately 45% of patients have no adequate pain response after EBRT. Magnetic resonance image-guided high-intensity focused ultrasound (MR-HIFU) may improve pain palliation in this patient population. The main objective of this trial was to compare MR-HIFU, EBRT, and MR-HIFU + EBRT for the palliative treatment of bone metastases. METHODS/DESIGN The FURTHER trial is an international multicenter, three-armed randomized controlled trial. A total of 216 patients with painful bone metastases will be randomized in a 1:1:1 ratio to receive EBRT only, MR-HIFU only, or combined treatment with EBRT followed by MR-HIFU. During a follow-up period of 6 months, patients will be contacted at eight time points to retrieve information about their level of pain, QoL, and the occurrence of (serious) adverse events. The primary outcome of the trial is pain response at 14 days after start of treatment. Secondary outcomes include pain response at 14 days after trial enrolment, pain scores (daily until the 21st day and at 4, 6, 12 and 24 weeks), toxicity, adverse events, QoL, and survival. Cost-effectiveness and cost-utility analysis will be conducted. DISCUSSION The FURTHER trial aims to evaluate the effectiveness and cost-effectiveness of MR-HIFU-alone or in combination with EBRT-compared to EBRT to relieve CIBP. The trial will be performed in six hospitals in four European countries, all of which are partners in the FURTHER consortium. TRIAL REGISTRATION The FURTHER trial is registered under the Netherlands Trials Register number NL71303.041.19 and ClinicalTrials.gov registration number NCT04307914. Date of trial registration is 13-01-2020.
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Affiliation(s)
- Derk J. Slotman
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Marcia M. T. J. Bartels
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Cyril J. Ferrer
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Clemens Bos
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Lambertus W. Bartels
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Martijn F. Boomsma
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands ,grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Erik C. J. Phernambucq
- grid.452600.50000 0001 0547 5927Department of Radiation Oncology, Isala Hospital, Zwolle, The Netherlands
| | - Ingrid M. Nijholt
- grid.452600.50000 0001 0547 5927Department of Radiology, Isala Hospital, Zwolle, The Netherlands
| | - Alessio G. Morganti
- grid.6292.f0000 0004 1757 1758DIMES, Alma Mater Studiorum - Bologna University, Bologna, Italy ,grid.6292.f0000 0004 1757 1758Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Giambattista Siepe
- grid.6292.f0000 0004 1757 1758Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Milly Buwenge
- grid.6292.f0000 0004 1757 1758DIMES, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Holger Grüll
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Grischa Bratke
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sin Yuin Yeo
- grid.6190.e0000 0000 8580 3777Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roberto Blanco Sequeiros
- grid.410552.70000 0004 0628 215XDepartment of Radiology, Turku University Hospital, Turku, Finland
| | - Heikki Minn
- grid.1374.10000 0001 2097 1371Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Mira Huhtala
- grid.1374.10000 0001 2097 1371Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Alessandro Napoli
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca De Felice
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlo Catalano
- grid.7841.aDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alberto Bazzocchi
- grid.419038.70000 0001 2154 6641Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Chiara Gasperini
- grid.419038.70000 0001 2154 6641Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Laura Campanacci
- grid.419038.70000 0001 2154 66413Rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Julia Simões Corrêa Galendi
- grid.6190.e0000 0000 8580 3777Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Dirk Müller
- grid.6190.e0000 0000 8580 3777Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Manon N. G. J. A. Braat
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Chrit Moonen
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Helena M. Verkooijen
- grid.7692.a0000000090126352Division of Imaging and Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
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5
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Sailer A, Ghanouni P, Schade GR, Napoli A, Vidal-Jove J, Raman SS, Mendiratta-Lala M, Ghai S, Abreu A, Sundaram KM, Westphalen A, Arora S. Therapeutic US Applications for the Abdomen and Pelvis. Radiographics 2022; 42:E182-E183. [PMID: 36190852 PMCID: PMC9539095 DOI: 10.1148/rg.220044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/22/2022] [Accepted: 07/28/2022] [Indexed: 03/25/2023]
Abstract
US and MRI-guided therapeutic US (TUS) can aid in the treatment of prostate, liver, and pancreatic cancer, as well as uterine fibroids and osseous metastases, and understanding the selection and optimization of treatment strategies is essential to furthering TUS advances and innovations.
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Affiliation(s)
- Anne Sailer
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Pejman Ghanouni
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - George R. Schade
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Alessandro Napoli
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Joan Vidal-Jove
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Steven S. Raman
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Mishal Mendiratta-Lala
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Sangeet Ghai
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Andre Abreu
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Karthik M. Sundaram
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Antonio Westphalen
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
| | - Sandeep Arora
- From the Section of Interventional Radiology, Dept of Radiology and
Biomedical Imaging, Yale School of Medicine, 333 Cedar St, PO Box 208042, Room
TE-2, New Haven, CT 06520 (A.S., S.A.); Dept of Rad/Body MRI, Dept of Radiology,
Stanford Univ, Lucas Ctr, Stanford, Calif (P.G.); Dept of Urology, Univ of
Washington School of Medicine, Seattle, Wash (G.R.S., A.W.); Dept of
Radiological Sciences, MRgFUS and Cardiovascular Imaging Unit, Sapienza Univ of
Rome, School of Medicine, Rome, Italy (A.N.); Institut Khuab for Interventional
Oncology, Comprehensive Tumor Ctr Barcelona, Barcelona, Spain (J.V.J.); Dept of
Interventional and Diagnostic Radiology, Univ of California Los Angeles, Los
Angeles, Calif (S.S.R.); Abdominal and Cross-Sectional Interventional Radiology,
Dept of Radiology, Univ of Michigan School of Medicine, Ann Arbor, Mich
(M.M.L.); Dept of Medical Imaging, Univ Health Network–Mount Sinai
Hosp–Women’s College Hosp, Univ of Toronto, Toronto, Canada
(S.G.); Inst of Urology, Univ of Southern California–USC School of
Medicine, Los Angeles, Calif (A.A.); and Dept of Radiology, Hosp of the Univ of
Pennsylvania, Philadelphia, Pa (K.M.S.)
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6
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Lena B, Florkow MC, Ferrer CJ, van Stralen M, Seevinck PR, Vonken EJPA, Boomsma MF, Slotman DJ, Viergever MA, Moonen CTW, Bos C, Bartels LW. Synthetic CT for the planning of MR-HIFU treatment of bone metastases in pelvic and femoral bones: a feasibility study. Eur Radiol 2022; 32:4537-4546. [PMID: 35190891 PMCID: PMC9213310 DOI: 10.1007/s00330-022-08568-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/31/2021] [Accepted: 01/05/2022] [Indexed: 12/12/2022]
Abstract
Objectives Visualization of the bone distribution is an important prerequisite for MRI-guided high-intensity focused ultrasound (MRI-HIFU) treatment planning of bone metastases. In this context, we evaluated MRI-based synthetic CT (sCT) imaging for the visualization of cortical bone. Methods MR and CT images of nine patients with pelvic and femoral metastases were retrospectively analyzed in this study. The metastatic lesions were osteolytic, osteoblastic or mixed. sCT were generated from pre-treatment or treatment MR images using a UNet-like neural network. sCT was qualitatively and quantitatively compared to CT in the bone (pelvis or femur) containing the metastasis and in a region of interest placed on the metastasis itself, through mean absolute difference (MAD), mean difference (MD), Dice similarity coefficient (DSC), and root mean square surface distance (RMSD). Results The dataset consisted of 3 osteolytic, 4 osteoblastic and 2 mixed metastases. For most patients, the general morphology of the bone was well represented in the sCT images and osteolytic, osteoblastic and mixed lesions could be discriminated. Despite an average timespan between MR and CT acquisitions of 61 days, in bone, the average (± standard deviation) MAD was 116 ± 26 HU, MD − 14 ± 66 HU, DSC 0.85 ± 0.05, and RMSD 2.05 ± 0.48 mm and, in the lesion, MAD was 132 ± 62 HU, MD − 31 ± 106 HU, DSC 0.75 ± 0.2, and RMSD 2.73 ± 2.28 mm. Conclusions Synthetic CT images adequately depicted the cancellous and cortical bone distribution in the different lesion types, which shows its potential for MRI-HIFU treatment planning. Key Points • Synthetic computed tomography was able to depict bone distribution in metastatic lesions. • Synthetic computed tomography images intrinsically aligned with treatment MR images may have the potential to facilitate MR-HIFU treatment planning of bone metastases, by combining visualization of soft tissues and cancellous and cortical bone. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-022-08568-y.
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Affiliation(s)
- Beatrice Lena
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands.
| | - Mateusz C Florkow
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands.
| | - Cyril J Ferrer
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
| | - Marijn van Stralen
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands.,MRIguidance BV, Gildstraat 91-A, 3572, EL, Utrecht, The Netherlands
| | - Peter R Seevinck
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands.,MRIguidance BV, Gildstraat 91-A, 3572, EL, Utrecht, The Netherlands
| | - Evert-Jan P A Vonken
- Division of Imaging and Oncology, Department of Radiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, AB, Zwolle, The Netherlands
| | - Derk J Slotman
- Department of Radiology, Isala Hospital, Dokter van Heesweg 2, 8025, AB, Zwolle, The Netherlands
| | - Max A Viergever
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands
| | - Chrit T W Moonen
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
| | - Clemens Bos
- Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan, 100 3584, CX, Utrecht, The Netherlands
| | - Lambertus W Bartels
- Image Sciences Institute, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, Q.02.4.45, 3584, CX, Utrecht, The Netherlands
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Bucknor MD, Baal JD, McGill KC, Infosino A, Link TM. Musculoskeletal Applications of Magnetic Resonance-Guided Focused Ultrasound. Semin Musculoskelet Radiol 2021; 25:725-734. [DOI: 10.1055/s-0041-1735472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AbstractMagnetic resonance-guided focused ultrasound (MRgFUS) is a novel noninvasive therapy that uses focused sound energy to thermally ablate focal pathology within the body. In the United States, MRgFUS is approved by the Food and Drug Administration for the treatment of uterine fibroids, palliation of painful bone metastases, and thalamotomy for the treatment of essential tremor. However, it has also demonstrated utility for the treatment of a wide range of additional musculoskeletal (MSK) conditions that currently are treated as off-label indications. Advantages of the technology include the lack of ionizing radiation, the completely noninvasive technique, and the precise targeting that offer unprecedented control of the delivery of the thermal dose, as well as real-time monitoring capability with MR thermometry. In this review, we describe the most common MSK applications of MRgFUS: palliation of bone metastases, treatment of osteoid osteomas, desmoid tumors, facet arthropathy, and other developing indications.
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Affiliation(s)
- Matthew D. Bucknor
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Joe D. Baal
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Kevin C. McGill
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Andrew Infosino
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
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