Magnetic resonance-guided focused ultrasound for patients with painful bone metastases: phase III trial results.
BACKGROUND
Pain due to bone metastases is a common cause of cancer-related morbidity, with few options available for patients refractory to medical therapies and who do not respond to radiation therapy. This study assessed the safety and efficacy of magnetic resonance-guided focused ultrasound surgery (MRgFUS), a noninvasive method of thermal tissue ablation for palliation of pain due to bone metastases.


METHODS
Patients with painful bone metastases were randomly assigned 3:1 to receive MRgFUS sonication or placebo. The primary endpoint was improvement in self-reported pain score without increase of pain medication 3 months after treatment and was analyzed by Fisher's exact test. Components of the response composite, Numerical Rating Scale for pain (NRS) and morphine equivalent daily dose intake, were analyzed by t test and Wilcoxon rank-sum test, respectively. Brief Pain Inventory (BPI-QoL), a measure of functional interference of pain on quality of life, was compared between MRgFUS and placebo by t test. Statistical tests were two-sided.


RESULTS
One hundred forty-seven subjects were enrolled, with 112 and 35 randomly assigned to MRgFUS and placebo treatments, respectively. Response rate for the primary endpoint was 64.3% in the MRgFUS arm and 20.0% in the placebo arm (P < .001). MRgFUS was also superior to placebo at 3 months on the secondary endpoints assessing worst score NRS (P < .001) and the BPI-QoL (P < .001). The most common treatment-related adverse event (AE) was sonication pain, which occurred in 32.1% of MRgFUS patients. Two patients had pathological fractures, one patient had third-degree skin burn, and one patient suffered from neuropathy. Overall 60.3% of all AEs resolved on the treatment day.


CONCLUSIONS
This multicenter phase III trial demonstrated that MRgFUS is a safe and effective, noninvasive treatment for alleviating pain resulting from bone metastases in patients that have failed standard treatments.
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP). mark.hurwitz@jefferson.edu.
Mark D
MD
Hurwitz
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Pejman
P
Ghanouni
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Sergey V
SV
Kanaev
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Dmitri
D
Iozeffi
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
David
D
Gianfelice
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Fiona Mary
FM
Fennessy
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Abraham
A
Kuten
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Joshua E
JE
Meyer
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Suzanne D
SD
LeBlang
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Ann
A
Roberts
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Junsung
J
Choi
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
James M
JM
Larner
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Alessandro
A
Napoli
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Vladimir G
VG
Turkevich
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Yael
Y
Inbar
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Clare Mary C
CM
Tempany
Affiliations of authors: Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA (MDH); Department of Radiology, Brigham and Women's Hospital, Boston, MA (FMF, CMCT); Department of Radiology, Stanford University Medical Center, Stanford, CA (PG); Department of Radiation Oncology and Radiology, N. N. Petrov Institute of Oncology, St. Petersburg, Russian Federation (SK, VT); Department of MRI and FUS, Rostov State Research Institute of Oncology, Rostov on Don, Russian Federation (DI); Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Canada (DG); Department of Oncology, Rambam Medical Center, Haifa, Israel (AK); Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (JM); University MRI & Diagnositc Imaging Centers, Boca Raton, FL (SDL); Department of Radiology, University of California at San Diego, San Diego, CA (AR); Department of Diagnostic Imaging and Interventional Radiology,H. Lee Moffitt Cancer Center, Tampa, FL (JC); Department of Radiation Oncology, University of Virginia, Charlottesville, VA (JML); Department of Radiological, Oncological, and Pathological Sciences, Sapienza University of Rome, Rome, Italy (AN); Department of Radiation Oncology, Sheba Medical Center, Tel Hashomer, Israel (YI,RMP).
Raphael M
RM
Pfeffer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D005260:Female; D057086:High-Intensity Focused Ultrasound Ablation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D016037:Single-Blind Method; D014463:Ultrasonography; D055815:Young Adult