Pancreatic Cancer Study Shows Potential Survival Benefit
Joan Vidal-Jove
Focused ultrasound (FUS) is a potentially safe and effective treatment modality and may increase survival in unresectable pancreatic cancer, according to a study recently published in Ultrasonics Sonochemistry.
Ablation was achieved in 82% of the tumors, with the responses lasting 8 weeks post-procedure. At the end of the combined treatment, 11 patients (25%) had complete responses (9 Stage III and 2 Stage IV). Major complications included one case of severe pancreatitis with GI bleeding and two cases of third degree skin burns that required plastic surgery. The median survival was 13 months (6 months to 2.7 years). The Kaplan-Meier curve showed 33.5% survival for 4.2 years in patients treated with FUS plus chemotherapy.
“We are very satisfied with these results,” said Dr. Vidal-Jove. “The work of our team proves that focused ultrasound helps patients with unresectable pancreatic cancer, improving their survival with a less aggressive approach. We are planning a multicenter study comparing standard treatment with chemotherapy versus focused ultrasound plus chemotherapy in this group of patients.”
"We found that the application of pulsed FUS with stem cell infusions resulted in the cells homing to targeted muscles or kidneys." – Joseph Frank, MD
Focused Ultrasound Enabling Regenerative Medicine
Joseph Frank, Chief of the Frank Laboratory in Radiology and Imaging Sciences at the National Institutes of Health (NIH), recently visited the Foundation to present a webinar about his team’s work using focused ultrasound to boost stem cell homing. Stem cells are often used in the field of regenerative medicine to help rebuild tissue that has been damaged or lost due to disease. Frank’s team has been using non-thermal, pulsed FUS to direct or “home” stem cells to a particular location in the body, creating a “transient molecular zip code” – a technique that could transform regenerative medicine.
"Engaging and educating the medical physics community is key as FUS transitions into standard clinical practice. Their experience with therapeutic device quality control can benefit FUS users, and they are the logical owners of the technology in the clinic." – Matt Eames, PhD
Therapeutic Ultrasound Featured at AAPM
Matt Eames, PhD, the Foundation’s Director of Extramural Research, presented on the physics, bioeffects, and applications of focused ultrasound (FUS) in radiation oncology at the Ultrasound Therapy and Imaging Symposium in Anaheim, California July 12-14. The symposium, a component of the annual American Association of Physicists in Medicine meeting, included a primer on FUS therapies, updates on image guidance, and new approaches.
UVA medical physicist David Schlesinger, PhD, co-presented the two-part session. Both talks are available on the AAPM website:
The abstracts from the Foundation’s 4th International Symposium, Current and Future Applications of Focused Ultrasound 2014, have now been published in a special supplement to the Journal of Therapeutic Ultrasound. Each abstract is available for download in PDF format, or the entire set can be accessed together.
Swiss Government to Create Focused Ultrasound Brain Treatment Registry
Researchers at the Center for MR Image-guided Focused Ultrasound at the University of Zurich Children’s Hospital are pioneering the development of focused ultrasound for the brain in Europe. Despite receiving the CE mark, the treatment is not yet widely accepted and is reimbursed only on a case-by-case basis. To obtain the data needed to include it in the national catalogue of reimbursable procedures, the government is initiating a registry to assess the cost and outcomes of focused ultrasound for pain and movement disorders. The registry begins in July and will follow patients for five years.
A cancer patient with a rod inserted into her hip had successful focused ultrasound treatment.
World's First FUS Treatment on Patient with Orthopedic Hardware
Researchers at Stanford University have been able to use MR-guided focused ultrasound (MRgFUS) to treat a patient’s cancer pain in her right hip, after failed radiation and placement of orthopedic hardware.
Metal orthopedic implants can hinder the ability to visualize and target a treatment area with MRgFUS. Stanford radiologist Pejman Ghanouni, MD, PhD, and MRI physicist Brian Hargreaves, PhD, are collaborating on a project funded by a National Institutes of Health grant to develop ways of enabling MRgFUS treatment for patients with metal hardware. They have made advances that allow them to see the tumor and measure the treatment effect and are working on methods to make MR thermometry more reliable.
Desmoid tumors are rare, benign, but aggressive, connective tissue masses that may cause serious health problems.
Focused Ultrasound as Treatment Option for Desmoid Tumors
Researchers at Stanford University recently completed a preliminary investigation, published in Clinical Orthopaedics and Related Research, using focused ultrasound to stop progression and/or cause regression of desmoid tumors located in the arms or legs. Five patients who were experiencing tumor-related symptoms or failure of conventional treatment received focused ultrasound. Four of the tumors regressed and one slightly progressed in size, but no patient received additional adjuvant systemic or local treatment. Although further investigation is needed, focused ultrasound may be a feasible non-invasive treatment for desmoid tumors and other soft tissue neoplasms--especially when limited traditional treatment options are available
Research Roundup
Recently published focused ultrasound (FUS) research includes:
a comprehensive review of its use in treating the brain, including central neuropathic pain, essential tremor, Parkinsonian tremor, brain tumors, and temporary disruption of the blood-brain barrier for targeted drug delivery
collaborative reviews on using FUS to treat breast cancer and uterine fibroids
a study suggesting ultrasound contrast agents may enhance treatment of uterine fibroids
Researchers at Tarbiat Modares University in Tehran, Iran evaluated the in vivo antitumor effect of dual-frequency, low intensity sonication plus a sonosensitizer for the treatment of spontaneous breast adenocarcinoma in a mouse model. Which regime of dose repetition and fractionation delayed tumor growth?
"We are continuously conducting independent, post-market studies in efforts to build support for additional coverage by insurers." – Dee Kolanek, INSIGHTEC
Bone Mets Treatment to be Reimbursed in 18 Additional States
More than 6.2 million members of Blue Cross Blue Shield in Massachusetts, Mississippi, Idaho, Arizona, and in the Wellmark group will now be covered for INSIGHTEC's ExAblate® focused ultrasound procedure for bone metastases, bringing the total number of US covered lives to approximately 32 million. These additions follow earlier affirmative policy changes.
