title: Magnetic resonance-guided focused ultrasound surgery of breast cancer: reliability and effectiveness.
abstract: BACKGROUND
  Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a noninvasive technique that has been shown to coagulate benign and malignant tumors. The purpose of this study was to evaluate MRgFUS safety and effectiveness for the ablation of breast carcinomas.
  
  
  METHODS
  Thirty women with biopsy-proved breast cancer underwent MRgFUS treatment. Gadolinium-enhanced MR images were used for treatment planning and posttreatment radiologic assessment of treated tissue, and temperature-sensitive MR images provided real-time treatment monitoring. After MRgFUS, all 30 women underwent wide excision or mastectomy. The extent of thermal ablation was assessed with tumor histology.
  
  
  RESULTS
  Treatment was well tolerated, with a minimum of adverse effects, especially when performed under local anesthesia. On pathologic examination, mean (+/-SD) necrosis of the targeted breast tumors was 96.9 +/- 4% (median 100%, range 78% to 100%) of tumor volume. Fifteen (53.5%) of 28 evaluable patients had 100% necrosis of the ablated tumor; only 3 patients (10.7%) had less than 95% necrosis. In 28 (93.3%) patients, 100% of the malignancy was within the treatment field, and 98% and 95% of tumor lay within the treatment field in 2 remaining patients. Retrospective analysis in two patients with residual tumor showed treatment was not delivered to the full recommended area, reaffirming the need for precise localization and the value of contrast-enhanced images for treatment planning.
  
  
  CONCLUSIONS
  MRgFUS has great potential to become a viable noninvasive replacement for lumpectomy. Additional studies focusing on posttreatment image-based evaluation are needed.
authors.affiliation: Department of Breast Diseases, Breastopia Namba Hospital, Miyazaki, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Furusawa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Namba
authors.forename: Sharon
authors.initials: S
authors.lastname: Thomsen
authors.forename: Futoshi
authors.initials: F
authors.lastname: Akiyama
authors.forename: Achiude
authors.initials: A
authors.lastname: Bendet
authors.forename: Chiaki
authors.initials: C
authors.lastname: Tanaka
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakahara
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000601:surgery*; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008408:Mastectomy; D008875:Middle Aged; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D014464:Ultrasonic Therapy