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dc.contributor.authorGiles, SLen_US
dc.contributor.authorBrown, MRDen_US
dc.contributor.authorRivens, Ien_US
dc.contributor.authorDeppe, Men_US
dc.contributor.authorHuisman, Men_US
dc.contributor.authorKim, Y-Sen_US
dc.contributor.authorFarquhar-Smith, Pen_US
dc.contributor.authorWilliams, JEen_US
dc.contributor.authorTer Haar, GRen_US
dc.contributor.authordeSouza, NMen_US
dc.coverage.spatialUnited Statesen_US
dc.identifier.citationJ Vasc Interv Radiol, 2019, 30 (9), pp. 1351 - 1360.e1en_US
dc.description.abstractPURPOSE: This study compared changes in imaging and in pain relief between patients with intraosseous, as opposed to extraosseous bone metastases. Both groups were treated palliatively with magnetic resonance-guided high-intensity-focused ultrasound (MRgHIFU). MATERIALS AND METHODS: A total of 21 patients were treated prospectively with MRgHIFU at 3 centers. Intraprocedural thermal changes measured using proton resonance frequency shift (PRFS) thermometry and gadolinium-enhanced T1-weighted (Gd-T1W) image appearances after treatment were compared for intra- and extraosseous metastases. Pain scores and use of analgesic therapy documented before and up to 90 days after treatment were used to classify responses and were compared between the intra- and extraosseous groups. Gd-T1W changes were compared between responders and nonresponders in each group. RESULTS: Thermal dose volumes were significantly larger in the extraosseous group (P = 0.039). Tumor diameter did not change after treatment in either group. At day 30, Gd-T1W images showed focal nonenhancement in 7 of 9 patients with intraosseous tumors; in patients with extraosseous tumors, changes were heterogeneous. Cohort reductions in worst-pain scores were seen for both groups, but differences from baseline at days 14, 30, 60, and 90 were only significant for the intraosseous group (P = 0.027, P = 0.013, P = 0.012, and P = 0.027, respectively). By day 30, 67% of patients (6 of 9) with intraosseous tumors were classified as responders, and the rate was 33% (4 of 12) for patients with extraosseous tumors. In neither group was pain response indicated by nonenhancement on Gd-T1W. CONCLUSIONS: Intraosseous tumors showed focal nonenhancement by day 30, and patients had better pain response to MRgHIFU than those with extraosseous tumors. In this small cohort, post-treatment imaging was not informative of treatment efficacy.en_US
dc.format.extent1351 - 1360.e1en_US
dc.titleComparison of Imaging Changes and Pain Responses in Patients with Intra- or Extraosseous Bone Metastases Treated Palliatively with Magnetic Resonance-Guided High-Intensity-Focused Ultrasound.en_US
dc.typeJournal Article
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfJ Vasc Interv Radiolen_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Magnetic Resonance
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Therapeutic Ultrasound
pubs.embargo.termsNot knownen_US
icr.researchteamMagnetic Resonanceen_US
icr.researchteamTherapeutic Ultrasounden_US
dc.contributor.icrauthorGiles, Sharonen_US
dc.contributor.icrauthorRivens, Ianen_US
dc.contributor.icrauthorTer Haar, Gailen_US
dc.contributor.icrauthordeSouza, Nanditaen_US

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