Magnetic resonance-guided focused ultrasound treatment of extra-abdominal desmoid tumors: a retrospective multicenter study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-05-05

AUTHORS

Pejman Ghanouni, Andrew Dobrotwir, Alberto Bazzocchi, Matthew Bucknor, Rachelle Bitton, Jarrett Rosenberg, Kristen Telischak, Maurizio Busacca, Stefano Ferrari, Ugo Albisinni, Shannon Walters, Garry Gold, Kristen Ganjoo, Alessandro Napoli, Kim Butts Pauly, Raffi Avedian

ABSTRACT

ObjectivesTo assess the feasibility, safety and preliminary efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment of extra-abdominal desmoid tumours.MethodsFifteen patients with desmoid fibromatosis (six males, nine females; age range, 7–66 years) were treated with MRgFUS, with seven patients requiring multiple treatments (25 total treatments). Changes in viable and total tumour volumes were measured after treatment. Efficacy was evaluated using an exact one-sided Wilcoxon test to determine if the median reduction in viable tumour measured immediately after initial treatment exceeded a threshold of 50 % of the targeted volume. Median decrease after treatment of at least two points in numerical rating scale (NRS) worst and average pain scores was tested with an exact one-sided Wilcoxon test. Adverse events were recorded.ResultsAfter initial MRgFUS treatment, median viable targeted tumour volume decreased 63 %, significantly beyond our efficacy threshold (P = 0.0013). Median viable total tumour volume decreased (105 mL [interquartile range {IQR}, 217 mL] to 54 mL [IQR, 92 mL]) and pain improved (worst scores, 7.5 ± 1.9 vs 2.7 ± 2.6, P = 0.027; average scores, 6 ± 2.3 vs 1.3 ± 2, P = 0.021). Skin burn was the most common complication.ConclusionsMRgFUS significantly and durably reduced viable tumour volume and pain in this series of 15 patients with extra-abdominal desmoid fibromatosis.Key Points• Retrospective four-centre study shows MRgFUS safely and effectively treats extra-abdominal desmoid tumours• This non-invasive procedure can eradicate viable tumour in some cases• Alternatively, MRgFUS can provide durable control of tumour growth through repeated treatments• Compared to surgery or radiation, MRgFUS has relatively mild side effects More... »

PAGES

732-740

Journal

TITLE

European Radiology

ISSUE

2

VOLUME

27

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-016-4376-5

DOI

http://dx.doi.org/10.1007/s00330-016-4376-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052956088

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27147222


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    "description": "ObjectivesTo assess the feasibility, safety and preliminary efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment of extra-abdominal desmoid tumours.MethodsFifteen patients with desmoid fibromatosis (six males, nine females; age range, 7\u201366\u00a0years) were treated with MRgFUS, with seven patients requiring multiple treatments (25 total treatments). Changes in viable and total tumour volumes were measured after treatment. Efficacy was evaluated using an exact one-sided Wilcoxon test to determine if the median reduction in viable tumour measured immediately after initial treatment exceeded a threshold of 50\u00a0% of the targeted volume. Median decrease after treatment of at least two points in numerical rating scale (NRS) worst and average pain scores was tested with an exact one-sided Wilcoxon test. Adverse events were recorded.ResultsAfter initial MRgFUS treatment, median viable targeted tumour volume decreased 63\u00a0%, significantly beyond our efficacy threshold (P\u2009=\u20090.0013). Median viable total tumour volume decreased (105\u00a0mL [interquartile range {IQR}, 217\u00a0mL] to 54\u00a0mL [IQR, 92\u00a0mL]) and pain improved (worst scores, 7.5\u2009\u00b1\u20091.9 vs 2.7\u2009\u00b1\u20092.6, P\u2009=\u20090.027; average scores, 6\u2009\u00b1\u20092.3 vs 1.3\u2009\u00b1\u20092, P\u2009=\u20090.021). Skin burn was the most common complication.ConclusionsMRgFUS significantly and durably reduced viable tumour volume and pain in this series of 15 patients with extra-abdominal desmoid fibromatosis.Key Points\u2022 Retrospective four-centre study shows MRgFUS safely and effectively treats extra-abdominal desmoid tumours\u2022 This non-invasive procedure can eradicate viable tumour in some cases\u2022 Alternatively, MRgFUS can provide durable control of tumour growth through repeated treatments\u2022 Compared to surgery or radiation, MRgFUS has relatively mild side effects", 
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