Bone Metastases

Focused Ultrasound Therapy

FDA Approved squareFocused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with painful metastatic cancer to the bone. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) of the pain-producing nerves around the cancer metastases without surgery, resulting in a significant reduction in pain.

The primary options for treatment of painful bone metastases include radiation and medications. In some cases surgery is considered.

For certain patients, focused ultrasound could provide a noninvasive alternative to conventional therapy with less risk of complications and lower cost.

Outside Approval Square

Advantages:

  • It is a non-invasive, low-morbidity treatment that allows for a quick return to normal life (usually the next day).
  • A single therapy session can provide rapid and durable resolution of bone metastasis pain.
  • Focused ultrasound pain relief does not have the adverse side effects of pain medications
  • It does not include radiation.
  • If necessary, it can be repeated.
Clinical Trials Square

Regulatory Approval and Reimbursement

The following geographical regions have one or more focused ultrasound devices approved to treat painful bone metastases: USA (FDA), Europe (CE Mark), Korea (KFDA), Asia, Canada, Israel, India, Latin America and Russia.

Treatments are reimbursed in Italy and Germany. Most major health insurers in the US also cover focused ultrasound for bone metastases. In other countries, coverage may be available on a case-by-case or site basis.

Clinical Trials

For a full list of known bone metastases clinical trials, please see here.

Please see here for a list of treatment sites in the US and the rest of the world.
See here for a list of laboratory research sites.

Notable Papers

Sharma KV, Yarmolenko PS, Eranki A, Partanen A, Celik H, Kim A, Oetgen M, Kim PCW. Magnetic Resonance Imaging-guided High-intensity Focused Ultrasound Applications in Pediatrics: Early Experience at Children's National Medical Center. Top Magn Reson Imaging. 2018 Feb;27(1):45-51.

Dababou S, Marrocchio C, Scipione R, Erasmus HP, Ghanouni P, Anzidei M, Catalano C, Napoli A. High-Intensity Focused Ultrasound for Pain Management in Patients with Cancer. Radiographics. 2018 Mar-Apr;38(2):603-623. doi: 10.1148/rg.2018170129. Epub 2018 Jan 30.

Harding D, Giles SL, Brown MRD, Ter Haar GR, van den Bosch M, Bartels LW, Kim YS, Deppe M, deSouza NM. Evaluation of Quality of Life Outcomes Following Palliative Treatment of Bone Metastaseswith Magnetic Resonance-guided High Intensity Focused Ultrasound: An International Multicentre Study. Clin Oncol (R Coll Radiol). 2018 Apr;30(4):233-242. doi: 10.1016/j.clon.2017.12.023. Epub 2018 Jan 6.

Hudson TJ, Looi T, Pichardo S, Amaral J, Temple M, Drake JM, Waspe AC. Simulating thermal effects of MR-guided focused ultrasound in cortical bone and its surrounding tissue. Med Phys. 2018 Feb;45(2):506-519. doi: 10.1002/mp.12704. Epub 2017 Dec 25.

Lee HL, Kuo CC, Tsai JT, Chen CY, Wu MH, Chiou JF. Magnetic Resonance-Guided Focused Ultrasound Versus Conventional Radiation Therapy for Painful Bone Metastasis: A Matched-Pair Study. J Bone Joint Surg Am. 2017 Sep 20;99(18):1572-1578. doi: 10.2106/JBJS.16.01248.

Click here for additional references from PubMed.

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