MR-guided focused ultrasound surgery (MRgFUS) for the palliation of pain in patients with bone metastases--preliminary clinical experience.
BACKGROUND
Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a noninvasive thermal ablation technique, shown to be clinically effective in the treatment of uterine fibroids and is being evaluated as a method of thermal ablation of benign and malignant breast tumors. To evaluate the safety and initial efficacy of MRgFUS for the palliation of pain caused by bone metastases, in patients for whom other treatments are either not effective or not feasible.


METHODS
Thirteen patients suffering from symptomatic bone metastases underwent MRgFUS procedure. Treatment safety was evaluated by assessing the incidence and severity of device-related complications up to 6 months after treatment. Effectiveness of pain palliation was evaluated by visual analog scale, pain questionnaires and changes in the patients' medication.


RESULTS
Fifteen procedures were carried out. Mean follow-up was 59 days. Twelve patients received adequate treatment and were available for follow-up. Two patients died due to disease progression during the first month after treatment. No severe adverse events were recorded. The remaining 10 patients reported prolonged improvement in pain score and/or reduced analgesic dosage.


CONCLUSIONS
MRgFUS may provide a safe and effective noninvasive alternative for the palliation of pain, caused by bone metastases.
Catane
R
R
Sheba Medical Center, Department of Oncology, Tel-Hashomer, Israel; Tel-Aviv University, Tel-Aviv.
Beck
A
A
Charite-Universitetsmedizin Berlin, Klinik for Strahlenheilkunde, Berlin, Germany.
Inbar
Y
Y
Sheba Medical Center, Department of Diagnostic Imaging, Tel-Hashomer; Tel-Aviv University, Tel-Aviv.
Rabin
T
T
Sheba Medical Center, Department of Oncology, Tel-Hashomer, Israel; Tel-Aviv University, Tel-Aviv.
Shabshin
N
N
Sheba Medical Center, Department of Diagnostic Imaging, Tel-Hashomer; Tel-Aviv University, Tel-Aviv.
Hengst
S
S
Charite-Universitetsmedizin Berlin, Klinik for Strahlenheilkunde, Berlin, Germany.
Pfeffer
R M
RM
Sheba Medical Center, Department of Oncology, Tel-Hashomer, Israel; Tel-Aviv University, Tel-Aviv.
Hanannel
A
A
In Sightec Ltd, Haifa.
Dogadkin
O
O
In Sightec Ltd, Haifa.
Liberman
B
B
Sheba Medical Center, Division of Orthopedic Surgery, Tel-Hashomer; Tel-Aviv University, Tel-Aviv.
Kopelman
D
D
HaEmek Medical Center, Department of Surgery B', Afula; Technion, Israel Institute of Technology, Haifa, Israel. Electronic address: kopelmand@bezeqint.net.
D001859:Bone Neoplasms / Q000556:secondary / Q000628:therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D059408:Pain Management; D010166:Palliative Care; D016896:Treatment Outcome; D014464:Ultrasonic Therapy