title: Magnetic resonance-guided focused ultrasound ablation in abdominal moving organs: a feasibility study in selected cases of pancreatic and liver cancer.
abstract: OBJECTIVE
  This study was designed to evaluate preliminarily the feasibility and safety of magnetic resonance-guided focused ultrasound (MRgFUS) for treatment of solid tumors in the upper abdomen.
  
  
  METHODS
  We enrolled one patient with hepatocellular carcinoma and two patients with pancreatic adenocarcinoma for MRgFUS ablation. Treatments were performed on a 3T scanner under controlled respiration. Treatment response was evaluated at 1, 3, and 6 months by assessing the nonperfused volume (NPV) of ablated tissue at MR and the degree of pain severity and pain interference.
  
  
  RESULTS
  In the patient with HCC, NPV was 100% after treatment and 85% at 3 and 6 months follow-up. Histological analysis after liver transplantation showed fibrosis in the ablated area with minimal local tumor recurrence. In the two patients with pancreatic adenocarcinoma, NPV was 80 and 85% after treatment and 70 and 80% at 3 and 6 months follow-up. Pain severity and pain interference respectively decreased from a mean of 7 and 6.7 points, respectively, to a mean of 3 and 2 points after treatment.
  
  
  CONCLUSIONS
  MRgFUS can be feasible and safe in selected patients with solid tumors in abdominal moving organs. However, this technique has several limitations due to the interposition of the rib cage or intestinal loops into the path of the ultrasonic beam, as well as to organ motion. Future technical developments are needed to implement advanced motion detection within the system to control organ and lesion position in real-time and keep the focus of the ultrasound beam on the targeted lesion.
authors.affiliation: Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy, michele.anzidei@gmail.com.
authors.forename: Michele
authors.initials: M
authors.lastname: Anzidei
authors.forename: Alessandro
authors.initials: A
authors.lastname: Napoli
authors.forename: Francesco
authors.initials: F
authors.lastname: Sandolo
authors.forename: Beatrice Cavallo
authors.initials: BC
authors.lastname: Marincola
authors.forename: Michele
authors.initials: M
authors.lastname: Di Martino
authors.forename: Pasquale
authors.initials: P
authors.lastname: Berloco
authors.forename: Sandro
authors.initials: S
authors.lastname: Bosco
authors.forename: Mario
authors.initials: M
authors.lastname: Bezzi
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010190:Pancreatic Neoplasms / Q000628:therapy*; D056888:Patient Positioning; D011788:Quality of Life
chemical_list: D003287:Contrast Media