https://febs.onlinelibrary.wiley.com/doi/pdf/10.1016/j.molonc.2008.04.001

Imaging and cancer: A review

MRI-guided focused ultrasound (MRgFUS) surgery is a noninvasive thermal ablation method that uses magnetic resonance imaging (MRI) for target definition, treatment planning, and closed-loop control of energy deposition. Integrating FUS and MRI as a therapy delivery system allows us to localize, target, and monitor in real time, and thus to ablate targeted tissue without damaging normal structures. This precision makes MRgFUS an attractive alternative to surgical resection or radiation therapy of benign and malignant tumors. Already approved for the treatment of uterine fibroids, MRgFUS is in ongoing clinical trials for the treatment of breast, liver, prostate, and brain cancer and for the palliation of pain in bone metastasis. In addition to thermal ablation, FUS, with or without the use of microbubbles, can temporarily change vascular or cell membrane permeability and release or activate various compounds for targeted drug delivery or gene therapy. A disruptive technology, MRgFUS provides new therapeutic approaches and may cause major changes in patient management and several medical disciplines.

/pdf/mri-guided-focused-ultrasound-surgery-3628lbjd9e.pdf

MRI-Guided Focused Ultrasound Surgery

Therapeutic embolization is a common procedure in interventional radiology. A wide variety of agents are available, and each has its own place and use. Additionally, many new agents have appeared on the market in the past several years. The aim of this review article is to give a brief description of available agents, guide appropriate selection, and familiarize the reader regarding appropriate use and limitations.

An Overview of Embolic Agents

Focused ultrasound surgery (FUS) is a noninvasive image-guided therapy and an alternative to surgical interventions. It presents an opportunity to revolutionize cancer therapy and to affect or change drug delivery of therapeutic agents in new focally targeted ways. In this article the background, principles, technical devices, and clinical cancer applications of image-guided FUS are reviewed.

/pdf/focused-ultrasound-surgery-in-oncology-overview-and-2t4sqmpzit.pdf

Focused ultrasound surgery in oncology: overview and principles.

MRI-guided focused ultrasound treatments.

Focused ultrasound surgery (FUS) is a method of noninvasive focal thermal ablation. Temperature-sensitive phase-difference magnetic resonance (MR) imaging allows monitoring of the focal point and measurement of tissue temperature elevation in real time, ensuring delivery of a therapeutic dose. A newly developed respiratory monitoring system enables us to track liver tumors, which move with respiration. We report our initial experience using MR-guided FUS with respiratory gating in successfully treating a hepatocellular carcinoma 15 mm in diameter.

/pdf/a-case-of-hepatocellular-carcinoma-treated-by-mr-guided-4l0rmxn80k.pdf

A case of hepatocellular carcinoma treated by MR-guided focused ultrasound ablation with respiratory gating.

Long-term Outcomes of Coil Packing for Visceral Aneurysms: Correlation between Packing Density and Incidence of Coil Compaction or Recanalization

Purpose
The aim of this study was to assess the feasibility and effectiveness of magnetic resonance (MRI)-guided focused ultrasound (MRIgFUS) ablation for uterine fibroids and to identify the candidates for this treatment.

Magnetic resonance imaging-guided focused ultrasound ablation of uterine fibroids: early clinical experience.

Purpose
The aim of this study was to assess the incidence, degree, and predictors of hepatic arterial damage (HAD) after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

Angiographic evaluation of hepatic arterial damage after transarterial chemoembolization for hepatocellular carcinoma

The purpose of this retrospective study was to investigate the efficacy of transarterial chemoembolization (TACE) using cisplatin as a second-line treatment for advanced hepatocellular carcinoma (HCC) unresponsive to TACE using epirubicin–Lipiodol emulsion at our institution. Between January 2006 and March 2009, 51 patients with unresectable HCC underwent TACE using cisplatin. All patients had shown persistent viable tumor or tumor progression after at least 2 sessions of TACE using epirubicin–Lipiodol emulsion. TACE procedures consisted of arterial injection of a mixture of Lipiodol and cisplatin (30–100 mg [mean 57 ± 21]) (n = 29) or arterial infusion of cisplatin (30–100 mg [mean 87 ± 19]) solution (n = 22) followed by injection of 1-mm porous gelatin particles. Early tumor response was assessed by contrast-enhanced computed tomography (CT) according to Response Evaluation Criteria in Solid Tumors (RECIST) and European Association for the Study of the Liver (EASL) criteria. Overall survival and progression-free survival was calculated using the Kaplan–Meier method. Toxicity was assessed according to NCI-CTCAE version 3 criteria. Response rates were 11.8 and 27.5% by RECIST and EASL criteria, respectively. Overall survival rates were 61.9, 48.2, and 28.9% at 1, 2, and 3 years, respectively, and the median survival time was 15.4 months. Progression-free survival rate was 35.2% at 1 year, and median progression-free survival time was 3.1 months. No major complications were observed, and the occurrence of postembolization syndrome was minimal. Grade 3 to 4 toxicities included thrombocytopenia (5.8%), increased aspartate aminotransferase (AST) level (35.3%), and increased alanine aminotransferase (ALT) level (23.5%). Switching the TACE anticancer drug from epirubicin to cisplatin might be the feasible option for advanced HCC, even when considered resistant to the initial form of TACE.

Transarterial chemoembolization with cisplatin as second-line treatment for hepatocellular carcinoma unresponsive to chemoembolization with epirubicin-Lipiodol emulsion.

Koji Mikami

Papers

A case of hepatocellular carcinoma treated by MR-guided focused ultrasound ablation with respiratory gating.

Long-term Outcomes of Coil Packing for Visceral Aneurysms: Correlation between Packing Density and Incidence of Coil Compaction or Recanalization

Magnetic resonance imaging-guided focused ultrasound ablation of uterine fibroids: early clinical experience.

Angiographic evaluation of hepatic arterial damage after transarterial chemoembolization for hepatocellular carcinoma

Transarterial chemoembolization with cisplatin as second-line treatment for hepatocellular carcinoma unresponsive to chemoembolization with epirubicin-Lipiodol emulsion.