ICube, Université de Strasbourg, CNRS, UMR 7357, Strasbourg, France.
Image Guided Therapy, Pessac, France.
Sci Rep. 2022 May 31;12(1):9095. doi: 10.1038/s41598-022-13213-1.
Magnetic Resonance (MR) Imaging-guided High Intensity focused Ultrasound (MRgHIFU) is a non-invasive, non-ionizing thermal ablation therapy that is particularly interesting for the palliative or curative treatment of musculoskeletal tumors. We introduce a new modular MRgHIFU device that allows the ultrasound transducer to be positioned precisely and interactively over the body part to be treated. A flexible, MR-compatible supporting structure allows free positioning of the transducer under MRI/optical fusion imaging guidance. The same structure can be rigidified using pneumatic depression, holding the transducer rigidly in place. Targeting accuracy was first evaluated in vitro. The average targeting error of the complete process was found to be equal to 5.4 ± 2.2 mm in terms of focus position, and 4.7° ± 2° in terms of transducer orientation. First-in-man feasibility is demonstrated on a patient suffering from important, uncontrolled pain from a bone metastasis located in the forearm. The 81 × 47 × 34 mm lesion was successfully treated using five successive positions of the transducer, under real-time monitoring by MR Thermometry. Significant pain palliation was observed 3 days after the intervention. The system described and characterized in this study is a particularly interesting modular, low-cost MRgHIFU device for musculoskeletal tumor therapy.
磁共振（MR）引导高强度聚焦超声（MRgHIFU）是一种非侵入性、非电离热消融治疗方法，特别适用于肌肉骨骼肿瘤的姑息或根治性治疗。我们介绍了一种新的模块化 MRgHIFU 设备，该设备允许超声换能器在待治疗的身体部位上进行精确和交互式定位。一个灵活的、兼容磁共振的支撑结构允许在磁共振/光学融合成像引导下自由定位换能器。通过气动减压，可以使相同的结构变硬，将换能器刚性地固定在适当位置。首先在体外评估了靶向准确性。研究发现，在焦点位置方面，整个过程的平均靶向误差等于 5.4±2.2 毫米，在换能器方向方面的平均靶向误差等于 4.7°±2°。在一名前臂骨转移导致严重、无法控制的疼痛的患者中，首次展示了该设备的临床可行性。通过实时监测磁共振测温，使用换能器的五个连续位置成功治疗了 81×47×34 毫米的病变。在干预 3 天后观察到明显的疼痛缓解。本研究中描述和表征的系统是一种特别有趣的模块化、低成本的 MRgHIFU 设备，适用于肌肉骨骼肿瘤治疗。
