Focused Ultrasound Therapy
Focused ultrasound is an early-stage, non-invasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with desmoid tumors. This novel technology focuses beams of ultrasonic energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces thermal destruction of tissue enabling desmoids to be treated without surgery.
The primary options for treatment of desmoids include surgery with the possibility of chemotherapy or radiation which can be needed depending on the location of the tumor. For certain patients, focused ultrasound could provide a non-invasive alternative to surgery with less risk of complications and lower cost.
Desmoid Tumors and Focused Ultrasound
Desmoid tumors (also called aggressive fibromatosis) are benign but aggressive tumors that have been treated with focused ultrasound on some anecdotal cases with good results. Open surgery is a common plan for desmoids, but the local extension of the disease can result in a significant deformity. The use of focused ultrasound has enabled limb preserving/saving care without the risks of open surgery. Focused ultrasound can also be repeated, as recurrence of desmoids is a very common event.
- Focused ultrasound is non-invasive, so it does not carry added concerns such as surgical wound healing or infection.
- Focused ultrasound is radiation free.
- It can be repeated, if necessary.
A clinical trial at the Children’s National Medical Center, in Washington, DC, is currently enrolling children and young adult patients who have a wide variety of relapsed or refractory tumors for ablative therapy. Although this trial is treating malignancies, desmoid tumors are included due to their local aggressiveness.
A clinical trial at UT Southwestern Medical Center/Children’s Medical Center in Dallas, Texas, is using liposomal doxiorubicin for treatment for several tumors, including desmoids. Although this trial is treating malignancies, desmoid tumors are included due to their local aggressiveness. To inquire about this trial or to discuss participation, please click here.
Regulatory Approval and Reimbursement
The Model JC Haifu system has received regulatory approval in Europe for treatment of soft tissue tumors, including desmoid tumors. At present, focused ultrasound is not universally reimbursed for treatment of desmoid tumors.
Desmoid Tumor Research Foundation
The DTFR encourages you to join the DTRF Patient Registry to facilitate research efforts. With access to your experience as a patient, researchers will be able to continue learning and making new discoveries in the field of desmoid tumors. If you have ever had a desmoid tumor, you can participate.
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Scipione R, Anzidei M, Bazzocchi A, Gagliardo C, Catalano C, Napoli A. HIFU for Bone Metastases and other Musculoskeletal Applications. Semin Intervent Radiol. 2018 Oct;35(4):261-267. doi: 10.1055/s-0038-1673363. Epub 2018 Nov 5. Review.
Bucknor MD, Rieke V. MRgFUS for desmoid tumors within the thigh: early clinical experiences. J Ther Ultrasound. 2017 Feb 3;5:4. doi: 10.1186/s40349-017-0081-3. eCollection 2017.
Ghanouni P, Dobrotwir A, Bazzocchi A, Bucknor M, Bitton R, Rosenberg J, Telischak K, Busacca M, Ferrari S, Albisinni U, Walters S, Gold G, Ganjoo K, Napoli A, Pauly KB, Avedian R. Magnetic resonance-guided focused ultrasound treatment of extra-abdominal desmoid tumors: a retrospective multicenter study. Eur Radiol. 2017 Feb;27(2):732-740. doi: 10.1007/s00330-016-4376-5.
Shim J, Staruch RM, Koral K, Xie XJ, Chopra R, Laetsch TW. Pediatric Sarcomas Are Targetable by MR-Guided High Intensity Focused Ultrasound (MR-HIFU): Anatomical Distribution and Radiological Characteristics. Pediatr Blood Cancer. 2016 Oct;63(10):1753-60. doi: 10.1002/pbc.26079.
Avedian RS, Bitton R, Gold G, Butts-Pauly K, Ghanouni P. Is MR-guided High-intensity Focused Ultrasound a Feasible Treatment Modality for Desmoid Tumors? Clin Orthop Relat Res. 2016 Mar;474(3):697-704. doi: 10.1007/s11999-015-4364-0.PMID: 26040967
Ghanouni P, Butts Pauly K, Bitton R, Avedian R, Bucknor M,Gold G. MR guided focused ultrasound treatment of soft tissue tumors of the extremities — preliminary experience. J Ther Ultrasound. 2015; 3(Suppl 1): O69.Click here for additional references from PubMed.
Click here for additional references from PubMed.