Osteoid Osteoma Treatment Guidelines Now Available
The first guidelines for using focused ultrasound to treat osteoid osteoma, a small and painful type of benign bone tumor, have now been published in the Journal of Therapeutic Ultrasound. In the paper, the authors recommend creating a multi-disciplinary team of physicians to manage and treat the often young patients who present with these tumors. The comprehensive guidelines, which have been developed in conjunction with the clinical trial for the Philips Sonalleve focused ultrasound system, provide a framework for patient selection (diagnosis, imaging, preparation, and planning) and treatment. Final thoughts discuss avoiding complications and analyzing outcomes.
“Although the treatment is still under investigation, we are putting out these best practices guidelines to maximize outcomes, reduce variability across treatment sites, and encourage the addition of new sites,” said Michael J. Temple, MD. “We also make suggestions for a patient-centered outcomes registry and future comparative studies.”
Because it is noninvasive and radiation-free, focused ultrasound could replace the current standards of care: percutaneous radiofrequency (RF) or laser thermal ablation.
“This paper is really an expert consensus statement,” said Suzanne LeBlang, MD, the Foundation’s Chief Medical Officer. “The international authors from five institutions each bring considerable focused ultrasound experience, and we have combined that experience to outline the factors that should lead to the best technical success and excellent patient response.”
The Foundation funded the pilot study that contributed to the formation of these guidelines and has recently funded new research at UCSF for a comparative study with RF ablation that is likely to start next year. Stanford and possibly one other site will participate in that project. READ MORE >
An impressive group of leaders in the field will moderate presentations and discussions within their areas of expertise. The list of 23 includes representatives from academia, industry, and government.
The Symposium’s preliminary program is also available, outlining the topics for each day. Monday will focus on Neurological Disorders, while Tuesday covers Cancer and Benign Tumors. Musculoskeletal, Cardiovascular, Emerging Applications, and Women’s Health will fill Wednesday’s lineup, and Thursday will conclude with topics around Commercial Success.
Dr. Sanjay Gupta Asks if FUS is the Next Big Thing
Reporting for Everyday Health, Dr. Sanjay Gupta follows Kimberly, whose Parkinson's symptoms were reduced following the experimental procedure. He explains the technology and then describes how focused ultrasound was used to improve Kimberly’s quality of life and stop the dyskinesia resulting from her treatment for Parkinson's disease.
June is Cancer Immunotherapy Awareness Month. The Foundation staff wore white in support of the Cancer Research Institute’s #WhiteOutCancer Campaign. Pre-clinical studies have led us to believe that focused ultrasound has a potential role in assisting cancer immunotherapy, and we can see how its impact could change the future of cancer treatment. Join us in whiting out cancer! Follow the Foundation on Facebook and Twitter.
RESEARCH NEWS
Nearly 100 people attended the event, and more than 150 watched the live video cast, which is now available on demand.
NIH Blood-Brain Barrier Workshop Features FUS Experts
A Trans-Agency Blood-Brain Interface Workshop designed to encourage discussion and foster future collaborations was held June 7-8 at the NIH Neuroscience Center. Experts from multiple fields identified key challenges and made recommendations for moving forward in the treatment of a broad range of central nervous system disorders, including traumatic brain injury, stroke, primary and metastatic brain cancers, Alzheimer’s and Parkinson’s disease. Two focused ultrasound expert presentations included data from studies funded by the Foundation: Todd Mainprize (BBB opening clinical trial) and Justin Hanes (nanoparticle and gene delivery across the BBB).
FUS Experts Speak at World Preclinical Blood-Brain Barrier Conference
The World Preclinical Congress on Blood-Brain Barrier was held June 15-16 in Boston. Approximately 125 attendees listened to Kullervo Hynynen, PhD (University of Toronto) and Zsofia Kovacs, PhD (NIH) discuss their experiences using focused ultrasound to open the BBB. The meeting also centered on the need to develop small molecules that can cross the BBB with favorable potency and efficacy.
“When it comes to MR-guided focused ultrasound, is there nothing it can’t do?” That is the question asked in the feature story of Radiology Today’s June issue. The story covers current and future indications, the challenges of reimbursement, and future outlook. ISTU is mentioned as a resource for focused ultrasound information and international collaboration, and the Foundation’s role in pushing the development of the technology is also highlighted.
Fibroid Relief and other stakeholder groups provided input into the study design and patient materials for the registry, called “Comparing Options for Management: Patient-Centered Results for Uterine Fibroids (COMPARE-UF).”
FUS Included in Federally Funded Study Comparing Fibroid Treatments
Researchers at Duke have launched a 10,000-patient nationwide, multi-year registry to collect treatment benefit data from women with symptomatic uterine fibroids. Patients will help determine which strategies are most effective, and focused ultrasound is included as one of six treatment options.
Enrollment is currently underway at clinics affiliated with nine medical centers across the country. Participants will be asked annually about their treatments, outcomes, and quality of life. The Patient-Centered Outcomes Research Institute (PCORI) is funding the study with a $20 million grant. The large group of involved stakeholders includes patients, clinicians, and representatives from clinical research organizations, professional societies, industry, insurance companies, and federal agencies.
During the American Society for Stereotactic and Functional Neurosurgery meeting held this week in Chicago, a trio of international focused ultrasound experts shared the results from two ongoing clinical trials in essential tremor (ET) and participated in a special session on state-of-the-art lesioning techniques. More than 350 neurosurgeons attended the ET abstract sessions presented by Drs. Daniel Jeanmonod (SoniModul AG, Solothurn, Switzerland) and Ryder Gwinn (Swedish Medical Center, Seattle, WA). The following day, various lesioning techniques were discussed, and Dr. W. Jeffrey Elias described his experience using focused ultrasound for ET.
2nd Quarter Research Award – Genetically Reprogramming Liver Cancer
Can primary liver tumors be genetically reprogrammed to stop growing and not return? These questions are being asked by Juergen Willmann, MD, and his group at Stanford. Because new approaches for treating hepatocellular carcinoma (HCC) are critically needed, the Foundation’s research awards program has selected this project for 2nd quarter funding. The pre-clinical study uses a focused ultrasound and microbubble delivery platform to introduce the microRNA to the liver tumor. Guided by a roadmap predicting the treatment outcomes in real-time, the adjustable approach allows delivery to the entire tumor volume.
Paul Fishman
"The Foundation’s support of this project has allowed us to be successful in obtaining funding from the VA to continue the work." – Paul Fishman
Foundation Funded Research Update
Stem cell delivery into the brain has the potential to provide new therapeutic options for Parkinson’s and other neurological disorders. In his project, titled Enhancement of FUS Mediated Delivery of Stem Cells to Brain, Paul S. Fishman, MD, PhD, and his team at the University of Maryland tried to determine if magnetically labeling these cells could enhance delivery after opening the blood-brain barrier (BBB) with focused ultrasound. If effective, this method would vastly improve the current invasive technique for injecting these cells directly into the brain. How did the team determine the most efficient method for attracting and releasing the cells in their target tissue?
Researchers in Spain found that using focused ultrasound to deliver a brain-derived neurotrophic factor improved stroke recovery in rats. See Biomaterials >
Is it possible that breathing-induced organ motion could replace electronic steering during focused ultrasound treatment of tumors in moving organs? A Swiss group’s feasibility study may answer some questions. See Physics in Medicine and Biology >
JTU Article of the Month – The Science of Acoustic Neuromodulation
Scientists at Harvard University have published biophysical models to examine how acoustic energy might influence or modulate neurons. They studied the electrical, chemical, and electro-mechanical coupling mechanisms to create new hypotheses that might explain mechanical aspects associated with neuronal activity. Read Acoustic Neuromodulation from a Basic Science Prospective >
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INDUSTRY NEWS
Carthera SonoCloud Safely Allows Chemotherapy to Reach Glioblastomas
In its first-in-human clinical trial that included 17 patients, Carthera’s SonoCloud pulsed ultrasound device safely and effectively opened the blood-brain barrier (BBB) to allow chemotherapy to reach recurrent glioblastoma tumors. These promising results were recently published in Science Translational Medicine.
Researchers activated the surgically implanted ultrasound device only during the treatment sessions, at escalating doses, to disrupt the BBB long enough for chemotherapy to reach the brain. The approach was well tolerated and showed evidence of effectiveness, although the report cautions that, “the potential efficacy of the treatment cannot be determined with respect to constraints of phase one study design and unknown variables of each patient history.”
Suzanne LeBlang explains treatment options to the crowd
Curawave is a new name for focused ultrasound treatment of uterine fibroids.
Fibroid Education Center Launches Curawave in Florida
With grant support from Insightec and promotional assistance from Fibroid Relief, the newly formed Fibroid Education Center held an event on June 12 in Boca Raton to launch its “Curawave” focused ultrasound treatment center. Nearly 300 people gathered at the Mizner Park Cultural Center to listen to presentations by radiologist Dr. Suzanne LeBlang and OB-GYN Dr. Rebecca Stern on uterine anatomy, surgical treatment options, and the Curawave focused ultrasound method. At the conclusion of the event, about half of the 200 fibroid patients who attended said they would like to be contacted by the center to determine if they are a candidate for Curawave.
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