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Abstract

Medicine

Real-Time Magnetic Resonance Guided Focused Ultrasound for Painful Bone Metastases

Published: March 5th, 2021

DOI:

10.3791/60615

1Department of Radiation Oncology, Taipei Medical University Hospital, 2The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei Medical University, 3School of Dentistry, College of Oral Medicine, Taipei Medical University, 4Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, 5Taipei Cancer Center, Taipei Medical University, 6Graduate Institute of Biomedical Materials & Tissue Engineering, College of Biomedical Engineering, Taipei Medical University

Abstract

Bones are one of the most common sites of cancer metastasis, which usually causes pain and impairs quality of life. Radiation therapy combined with opioids is the standard treatment for painful bone metastases. This treatment achieves effective pain control in 60−74% of patients, but limited treatment choices with limited benefits are available for recurrent or residual painful bone metastases after radiotherapy. More than 40% of patients still experience moderate to severe bone pain after reirradiation. Magnetic resonance-guided focused ultrasound (MRgFUS) combines high-intensity focused ultrasound, which achieves thermal ablation of bone metastases and subsequent pain reduction, with real-time magnetic resonance (MR) thermometry to monitor the temperature of anatomic MR images, with an accuracy of 1 °C, spatial resolution of 1 mm, and temporal resolution within 3 s. As well as being increasingly used clinically for controlling metastatic bone pain, the use of MRgFUS for other diseases has also been tested. However, the use of MR software as a thermometer is the only technique available to verify the accuracy of the software and assure energy delivery. Here, we describe an efficient method of quality assurance we developed for thermal detection and energy delivery before each MRgFUS treatment and also propose a modified workflow to expedite the treatment course as well as to reduce patients' pain during the procedure.

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Keywords Magnetic Resonance Guided Focused Ultrasound

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