Successful Use of Magnetic Resonance-Guided Focused Ultrasound Surgery for Long-Term Pain Palliation in a Patient Suffering from Metastatic Bone Tumor

Abstract

Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is a non-invasive thermo-ablative technique for the treatment of various benign and malignant soft tissue and bone tumors, using focused ultrasound under real-time magnetic resonance imaging (MRI) guidance and control (1). This method of thermal ablation has proved effective in more than 5,000 uterine fibroid treatments and in more than 500 treatments of various other tumors (2). Recently, MRgFUS was tested for the palliation of pain caused by bone metastases, utilizing the acoustic properties of bone for absorption of ultrasonic energy to achieve palliation and has yielded very promising initial results (3, 4). Applying acoustic energy on the bone surface allows the creation of temperature rise in the part of the bone cortex enclosed in the beam path zone, thus indirectly ablating the adjacent periosteum and tumor tissue (4). Since the periosteum is considered to be a major source of pain in patients with metastatic bone lesions, ablating the source of pain should produce lasting pain relief. High absorption of energy in the bone allows using lower energies (compared to soft tissue MRgFUS treatment), thereby enhancing the safety profile of this procedure. Thus, MRgFUS offers a novel, alternative treatment option for painful bone metastases. The present report briefly discusses the successful use of Case Report pISSN 1738-2637 J Korean Soc Radiol 2011;65(2):133-138