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Annals of Oncology Advance Access published online on October 9, 2006
Annals of Oncology, doi:10.1093/annonc/mdl335
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© 2006 European Society for Medical Oncology
Received July 31, 2006
Accepted August 14, 2006

original article

MR-guided focused ultrasound surgery (MRgFUS) for the palliation of pain in patients with bone metastases--preliminary clinical experience

R. Catane 1, A. Beck 2, Y. Inbar 3, T. Rabin 1, N. Shabshin 3, S. Hengst 2, R. M. Pfeffer 1, A. Hanannel 4, O. Dogadkin 4, B. Liberman 5, and D. Kopelman 6 *

1 Sheba Medical Center, Department of Oncology, Tel-Hashomer, Israel; Tel-Aviv University, Tel-Aviv, Israel
2 Charite-Universitetsmedizin Berlin, Klinik for Strahlenheilkunde, Berlin, Germany
3 Sheba Medical Center, Department of Diagnostic Imaging, Tel-Hashomer, Israel; Tel-Aviv University, Tel-Aviv, Israel
4 InSightec Ltd, Haifa, Israel
5 Sheba Medical Center, Division of Orthopedic Surgery, Tel-Hashomer, Israel; Tel-Aviv University, Tel-Aviv, Israel
6 HaEmek Medical Center, Department of Surgery B', Afula, Israel; Technion, Israel Institute of Technology, Haifa, Israel

* To whom correspondence should be addressed.
D. Kopelman, E-mail: kopelmand{at}bezeqint.net


  Abstract

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.

Materials and 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.

Conclusion: MRgFUS may provide a safe and effective noninvasive alternative for the palliation of pain, caused by bone metastases.

Keywords: magnetic resonance-guided focused ultrasound surgery; bone metastases; pain management; thermal ablation.
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