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Oncologic Applications of Magnetic Resonance Guided Focused Ultrasound

  • Dario B. Rodrigues
  • Paul R. Stauffer
  • John Eisenbrey
  • Valeria Beckhoff
  • Mark D. Hurwitz
Chapter
Part of the Cancer Treatment and Research book series (CTAR)

Abstract

Focused ultrasound (FUS) is a noninvasive thermal therapy that utilizes energy generated from ultrasound waves to ablate a small target area. The ability of FUS to heat tumors to ablative temperatures in a very precise manner, thereby sparing surrounding tissues, has been equated to surgery with the advantages of reduced tissue trauma and recovery time. FUS may also be used to induce moderate temperature hyperthermia to enhance effects of radiation, chemotherapy, and potentially immunotherapy. The combination of magnetic resonance guidance with FUS (MRgFUS) provides the ability to plan, monitor, and steer treatments in near real-time, further contributing to the safety and effectiveness profile of FUS. Regulatory clearance for noninvasive palliative treatment of bone metastases has been realized. Additional palliative and curative treatments for a wide range of oncologic conditions including prostate, breast, gynecologic, gastrointestinal and brain cancers, and soft tissue tumors are in active development. This chapter provides an overview of MRgFUS including biological effects and physical parameters description. A comprehensive review of all currently approved and evolving oncological applications of MRgFUS then follows. Finally, an overview is provided of wide ranging leading edge research helping to define future applications for the field including the role of MRgFUS in multimodality cancer therapy.

Keywords

Focused ultrasound MR guidance Thermal ablation Bone metastases Prostate cancer Breast cancer Soft tissue sarcoma Brain cancer Liver cancer Pancreatic cancer Colorectal cancer 

Abbreviations

AE

Adverse events

AVM

Arteriovenous malformation

BBB

Blood brain barrier

BPI

Brief pain inventory

BPI-QoL

Brief pain inventory-Quality of life

CE

European conformity

CR

Complete response

CT

Computed tomography

DCE-MRI

Dynamic contrast-enhanced magnetic resonance imaging

DNA

Deoxyribonucleic acid

ECD

Endorectal cooling device

FDA

Food and drug administration

FUS

Focused ultrasound

HCC

Hepatocellular carcinoma

HIFU

High-intensity focused ultrasound

IBMCWP

International bone metastasis consensus working party

IIEF

International index of erectile function

IPSS

International prostate symptom score

MDA

MD Anderson criteria

MR

Magnetic resonance

MRgFUS

Magnetic resonance guided focused ultrasound

MR-HIFU

Magnetic resonance high-intensity focused ultrasound

MRT

MR thermometry

NPV

Non-perfused volume

NR

No response

NRS

Numerical rating scale

OMED

Changes in analgesic intake

OR

Overall response

PD

Progressive disease

PP

Pain progression

PR

Partial response

PSA

Prostate specific antigen

QLQ-BM22

European Organization for Research and Treatment of Cancer—Quality of life questionnaire for patients with bone metastases

QoL

Quality of life

RF

Radio frequency

RR

Recurrence

UA

Ultrasound applicator

USgFUS

Ultrasound guided focused ultrasound

VAS

Visual analog scale

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Dario B. Rodrigues
    • 1
  • Paul R. Stauffer
    • 1
  • John Eisenbrey
    • 2
  • Valeria Beckhoff
    • 3
  • Mark D. Hurwitz
    • 1
  1. 1.Thermal Oncology Program, Department of Radiation OncologyThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Department of RadiologyThomas Jefferson UniversityPhiladelphiaUSA
  3. 3.Department of Biomedical EngineeringDrexel UniversityPhiladelphiaUSA

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