Pain Palliation in Patients with Bone Metastases Using Magnetic Resonance-Guided Focused Ultrasound with Conformal Bone System: A Preliminary Report.
10.3349/ymj.2015.56.2.503
- Author:
Bio JOO
1
;
Mi Suk PARK
;
Soo Hyeon LEE
;
Hye Jin CHOI
;
Seung Tack LIM
;
Sun Young RHA
;
Itay RACHMILEVITCH
;
Young Han LEE
;
Jin Suck SUH
Author Information
1. Department of Diagnostic Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. radpms@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Magnetic Resonance-guided Focused Ultrasound;
bone metastases;
pain palliation;
high-intensity focused ultrasound
- MeSH:
Adult;
Aged;
Bone Neoplasms/secondary/*therapy;
Contrast Media;
Female;
High-Intensity Focused Ultrasound Ablation/adverse effects/*methods;
Humans;
Magnetic Resonance Imaging, Interventional/*methods;
Magnetic Resonance Spectroscopy;
Male;
Middle Aged;
Pain;
*Pain Management;
*Palliative Care;
Prospective Studies;
Tomography, X-Ray Computed;
Treatment Outcome;
Young Adult
- From:Yonsei Medical Journal
2015;56(2):503-509
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated the safety and effectiveness of the Magnetic Resonance-guided Focused Ultrasound (MRgFUS) with the ExAblate Conformal Bone System for the palliation of painful bone metastases. MATERIALS AND METHODS: Our Institutional Review Board approved this study, and all patients gave informed consent prior to enrollment. A total of six painful metastatic bone lesions in five patients were treated using MRgFUS with the ExAblate Conformal Bone System for pain palliation. The follow-up sessions were at 3 days, 2 weeks, 1, 2, and 3 months, and 1 year after treatment. Efficacy was evaluated by the changes in visual analog scale (VAS) scores. At 3-months and 1-year follow-ups, unenhanced computed tomography and contrast-enhanced MR imaging examinations were performed. All adverse events were assessed to evaluate treatment safety. RESULTS: All patients showed significant pain relief within 2 weeks. Two patients experienced complete pain reduction that lasted for 1 year. Two other patients showed pain relief measured as VAS scores of 2 and 4 on their last follow-up. Although the remaining patient had experienced significant pain relief in two lesions, the VAS score re-increased on his last follow-up. The size of the enhancing soft tissue mass in metastatic lesions decreased, and new bone formation was seen on follow-up images. Although adverse events were not serious, non-specific leg pain and second degree skin burn were noted. CONCLUSION: MRgFUS was demonstrated to be effective palliative treatment within 2 weeks in selected patients with painful bone metastases.
