PURPOSE: 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.
PURPOSE: 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: Anne Sailer; Pejman Ghanouni; George R Schade; Alessandro Napoli; Joan Vidal-Jove; Steven S Raman; Mishal Mendiratta-Lala; Sangeet Ghai; Andre Abreu; Karthik M Sundaram; Antonio Westphalen; Sandeep Arora Journal: Radiographics Date: 2022-10 Impact factor: 6.312
Authors: Rory Geoghegan; Le Zhang; Alan Priester; Holden H Wu; Leonard Marks; Shyam Natarajan Journal: IEEE Trans Biomed Eng Date: 2022-07-18 Impact factor: 4.756
Authors: Hong Chen; Gary Y Hou; Yang Han; Thomas Payen; Carmine F Palermo; Kenneth P Olive; Elisa E Konofagou Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2015-09 Impact factor: 2.725
Authors: Lazzaro di Biase; Emma Falato; Maria Letizia Caminiti; Pasquale Maria Pecoraro; Flavia Narducci; Vincenzo Di Lazzaro Journal: Neurol Res Int Date: 2021-06-29