Focused Ultrasound Therapy
Focused 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.
How it Works
Where the beams converge, focused 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, radiation-free alternative to conventional therapy with less risk of complications and lower cost. it is a 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, and focused ultrasound pain relief does not have the adverse side effects of pain medications. It can also be repeated, if necessary
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.
There is a phase IV, post approval clinical trial at many centers in the US that is looking at the pain palliation when magnetic resonance guided focused ultrasound is used to treat bone metastasis.
There is a clinical trial in Canada that is treating bone metastasis in children ages 5-17.
For a full list of known bone metastases clinical trials, please see here.
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Bucknor MD, Chan FP, Matuoka JY, Curl PK, Kahn JG. Cost-effectiveness analysis of magnetic resonance-guided focused ultrasound ablation for palliation of refractory painful bone metastases. Int J Technol Assess Health Care. 2020 Dec 3:1-7. doi: 10.1017/S0266462320001907.
Bitton RR, Rosenberg J, LeBlang S, Napoli A, Meyer J, Butts Pauly K, Hurwitz M, Ghanouni P. MRI-Guided Focused Ultrasound of Osseous Metastases: Treatment Parameters Associated With Successful Pain Reduction. Invest Radiol. 2020 Aug 26. doi: 10.1097/RLI.0000000000000721.
Drost L, Hynynen K, Huang Y, Lucht B, Wong E, Czarnota G, Yee C, Wan BA, Ganesh V, Chow E, David E. Ultrasound-Guided Focused Ultrasound Treatment for Painful Bone Metastases: A Pilot Study. Ultrasound Med Biol. 2020 Mar 4. pii: S0301-5629(20)30058-2. doi: 10.1016/j.ultrasmedbio.2020.01.032.
Click here for additional references from PubMed.
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