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Semin intervent Radiol 2018; 35(04): 261-267
DOI: 10.1055/s-0038-1673363
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

HIFU for Bone Metastases and other Musculoskeletal Applications

Roberto Scipione
1   Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
,
Michele Anzidei
1   Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
,
Alberto Bazzocchi
2   Department of Radiology, Rizzoli Orthopedic Institute, University of Bologna, Bologna, Italy
,
Cesare Gagliardo
3   Section of Radiological Sciences, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy
,
Carlo Catalano
1   Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
,
Alessandro Napoli
1   Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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Publikationsdatum:
05. November 2018 (online)

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Abstract

High-intensity focused ultrasound (HIFU) is a totally noninvasive procedure that has shown promising results in the management of numerous malignant and nonmalignant conditions. Under magnetic resonance or ultrasound guidance, high-intensity ultrasound waves are focused on a small, well-defined target region, inducing biologic tissue heating and coagulative necrosis, thus resulting in a precise and localized ablation. This treatment has shown both great safety and efficacy profiles, and may offer a multimodal approach to different diseases, providing pain palliation, potential local tumor control, and, in some cases, remineralization of trabecular bone. In musculoskeletal field, HIFU received FDA approval for treating bone metastasis, but its application has also been extended to other conditions, such as osteoid osteoma, desmoid tumor, low-flow vascular malformation, and facet joint osteoarthritis. This article illustrates the basic principles of HIFU and its main effects on biologic tissues with particular attention on bone, provides a step-by-step description of the HIFU procedure, and discusses the commonly treated conditions, in particular bone metastases.

Keywords

High-intensity focused ultrasound - bone metastases - osteoid osteoma - pain palliation - interventional radiology