Journal Article

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

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

2017

Overview

Objectives To assess the feasibility, safety and preliminary efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment of extra-abdominal desmoid tumours. Methods Fifteen 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. Results After 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. Conclusions MRgFUS 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

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Abdomen / Ablation / Adolescent / Adult / Aged / Chemotherapy / Child / Connective tissue diseases / Diagnostic Radiology / FDA approval / Female / Fibromatosis, Aggressive - diagnostic imaging / Fibromatosis, Aggressive - pathology / Fibromatosis, Aggressive - surgery / High-Intensity Focused Ultrasound Ablation - methods / Humans / Imaging / Internal Medicine / Interventional / Interventional Radiology / Magnetic Resonance Imaging / Magnetic Resonance Imaging, Interventional - methods / Male / Medicine / Medicine & Public Health / Middle Aged / Morbidity / Neuroradiology / Oncology / Orthopedics / Pain / Patients / Radiation / Radiology / Retrospective Studies / Review boards / Soft Tissue Neoplasms - diagnostic imaging / Soft Tissue Neoplasms - pathology / Soft Tissue Neoplasms - surgery / Surgery / Surgery, Computer-Assisted / Treatment Outcome / Tumor Burden / Tumors / Ultrasonic imaging / Ultrasound / Young Adult