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Focused Ultrasound Procedure Comes To North America

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MRI-guided high-intensity focused ultrasound noninvasively destroyed a benign bone tumor in the leg of a Canadian teenager. That night, for the first time in months, he was able to sleep without being jolted awake by excruciating pain.

The July 17 treatment by a team from The Hospital for Sick Children (SickKids) in Toronto was the North American debut of the procedure for a pediatric patient. (High-frequency focused ultrasound has been used to treat such tumors in Europe since 2010.) The procedure kicked off a pilot clinical trial funded partly by the Focused Ultrasound Foundation. Neal F. Kassell, MD, the foundation’s founder and chairman, told DOTmed News that the foundation was also seeking Food and Drug Administration approval to add two U.S. sites to the trial.

The patient, 16-year-old Jack Campanile of Brampton, Ontario, said the tiny osteoid osteoma on his femur caused him agony. “If I didn’t treat the pain attack early enough, it would be so strong that it felt like someone was trying to bend my femur into the shape of a hockey stick,” he said, as quoted in a SickKids news release.

Michael Temple, MD, an interventional radiologist at SickKids, led the team that performed the procedure. He said it offered significant advantages over not only conventional surgery and but also such minimally invasive treatments as CT-guided radiofrequency ablation or laser ablation:

With high-intensity focused ultrasound, we are moving from minimally invasive to noninvasive therapy, significantly reducing risk to the patient and fast-tracking recovery. The osteoid osteoma tumor was chosen as our pilot study because the lesion is easily accessible, and while the procedure is sophisticated, it is relatively straightforward.

The procedure was performed at Sunnybrook Health Sciences Centre in Toronto, using a specialized MRI table.

“This achievement is both a technical and organizational feat and required several years of collaborative work and fine-tuning,” said James Drake, MB BCh, head of neurosurgery at SickKids. “We see huge potential in using this technology to develop new noninvasive therapies in a number of other medical and surgical areas, including the treatment of soft-tissue tumors, pediatric stroke, and epilepsy.”

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