Pejman Ghanouni MD, PhD, Presenter: Research Grant, General Electric Company Research Grant, InSightec Ltd

1) Therapeutic options for palliation of painful metastases to bone. 2) Patient selection for MR guided focused ultrasound palliation of painful bone metastases. 3) Results of Phase III pivotal study of ExAblate MR guided focused ultrasound for palliation of painful bone metastases. 4) Technical aspects of successful patient treatment. 5) Immediate post-treatment imaging-based assessment of results. 6) Future applications of MR guided focused ultrasound for the management of osseous metastatic disease.

Cancer patients commonly have metastases to bone; as the survival of cancer patients is prolonged by more effective therapies, the prevalence of patients with metastases to bone is also increasing. Bone metastases are often painful, and often diminish the quality of life. Radiation therapy (RT) is the standard of care for the treatment of bone metastases, but a significant subset of patients do not respond to RT. MR guided focused ultrasound non-invasively achieves localized tissue ablation and provides a proven method of pain relief in patients who do not respond to radiation therapy. MR imaging provides a combination of tumor targeting, real-time monitoring during treatment, and immediate verification of successful treatment. The results of the pivotal Phase III trial that led to FDA approval of the ExAblate MR guided focused ultrasound device for the palliation of painful metastases to bone will be reviewed. In particular, patient selection, the technical aspects of successful patient treatment, and post-treatment assessment of results will be described. Concepts for future development of this technology with regard to the management of osseous metastatic disease will also be presented.

Ghanouni, P, Palliation of Painful Metastases to Bone.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/13012022.html