title: Magnetic resonance-guided focused ultrasound treatment of extra-abdominal desmoid tumors: a retrospective multicenter study.
abstract: OBJECTIVE
  To assess the feasibility, safety and preliminary efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment of extra-abdominal desmoid tumours.
  
  
  METHODS
  Fifteen patients with desmoid fibromatosis (six males, nine females; age range, 7-66 years) were treated with MRgFUS, with seven patients requiring multiple treatments (25 total treatments). Changes in viable and total tumour volumes were measured after treatment. Efficacy was evaluated using an exact one-sided Wilcoxon test to determine if the median reduction in viable tumour measured immediately after initial treatment exceeded a threshold of 50 % of the targeted volume. Median decrease after treatment of at least two points in numerical rating scale (NRS) worst and average pain scores was tested with an exact one-sided Wilcoxon test. Adverse events were recorded.
  
  
  RESULTS
  After initial MRgFUS treatment, median viable targeted tumour volume decreased 63 %, significantly beyond our efficacy threshold (P = 0.0013). Median viable total tumour volume decreased (105 mL [interquartile range {IQR}, 217 mL] to 54 mL [IQR, 92 mL]) and pain improved (worst scores, 7.5 ± 1.9 vs 2.7 ± 2.6, P = 0.027; average scores, 6 ± 2.3 vs 1.3 ± 2, P = 0.021). Skin burn was the most common complication.
  
  
  CONCLUSIONS
  MRgFUS significantly and durably reduced viable tumour volume and pain in this series of 15 patients with extra-abdominal desmoid fibromatosis.
  
  
  CONCLUSIONS
  • Retrospective four-centre study shows MRgFUS safely and effectively treats extra-abdominal desmoid tumours • This non-invasive procedure can eradicate viable tumour in some cases • Alternatively, MRgFUS can provide durable control of tumour growth through repeated treatments • Compared to surgery or radiation, MRgFUS has relatively mild side effects.
authors.affiliation: Department of Radiology, Stanford University School of Medicine, Stanford, California.
authors.forename: Pejman
authors.initials: P
authors.lastname: Ghanouni
authors.affiliation: Department of Radiology, The Royal Women's Hospital, Parkville, Victoria, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Dobrotwir
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bazzocchi
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, California.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bucknor
authors.affiliation: Department of Radiology, Stanford University School of Medicine, Stanford, California.
authors.forename: Rachelle
authors.initials: R
authors.lastname: Bitton
authors.affiliation: Department of Radiology, Stanford University School of Medicine, Stanford, California.
authors.forename: Jarrett
authors.initials: J
authors.lastname: Rosenberg
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Telischak
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Busacca
authors.affiliation: Department of Oncology, The Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari
authors.affiliation: Department of Diagnostic and Interventional Radiology, The Rizzoli Orthopaedic Institute, Bologna, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Albisinni
authors.affiliation: Department of Radiology, Stanford University School of Medicine, Stanford, California.
authors.forename: Shannon
authors.initials: S
authors.lastname: Walters
authors.affiliation: Department of Radiology, Stanford University School of Medicine, Stanford, California.
authors.forename: Garry
authors.initials: G
authors.lastname: Gold
authors.affiliation: Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Ganjoo
authors.affiliation: Department of Radiology, Sapienza University, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Napoli
authors.affiliation: Department of Radiology, Stanford University School of Medicine, Stanford, California.
authors.forename: Kim Butts
authors.initials: KB
authors.lastname: Pauly
authors.affiliation: Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Raffi
authors.initials: R
authors.lastname: Avedian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D018222:Desmoid Tumors / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D057086:High-Intensity Focused Ultrasound Ablation / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: Desmoid fibromatosis; High-intensity focused ultrasound (HIFU); MR-guided focused ultrasound; MRgFUS; Thermal ablation