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24.08.2023 | Interventional

MR-guided focused ultrasound therapy of extra-abdominal desmoid tumors: a multicenter retrospective study of 105 patients

verfasst von: Daniel M. Düx, Joe Darryl Baal, Rachelle Bitton, Joshua Chen, Ryan L. Brunsing, Vipul R. Sheth, Jarrett Rosenberg, Kisoo Kim, Eugene Ozhinsky, Raffi Avedian, Kristen Ganjoo, Matthew Bucknor, Andrew Dobrotwir, Pejman Ghanouni

Erschienen in: European Radiology | Ausgabe 2/2024

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Abstract

Objective

To assess the safety and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for the treatment extra-abdominal desmoids.

Methods

A total of 105 patients with desmoid fibromatosis (79 females, 26 males; 35 ± 14 years) were treated with MRgFUS between 2011 and 2021 in three centers. Total and viable tumors were evaluated per patient at last follow-up after treatment. Response and progression-free survival (PFS) were assessed with (modified) response evaluation criteria in solid tumors (RECIST v.1.1 and mRECIST). Change in Numerical Rating Scale (NRS) pain and 36-item Short Form Health Survey (SF-36) scores were compared. Treatment-related adverse events were recorded.

Results

The median initial tumor volume was 114 mL (IQR 314 mL). After MRgFUS, median total and viable tumor volume decreased to 51 mL (95% CI: 30–71 mL, n = 101, p < 0.0001) and 29 mL (95% CI: 17–57 mL, n = 88, p < 0.0001), respectively, at last follow-up (median: 15 months, 95% CI: 11–20 months). Based on total tumor measurements (RECIST), 86% (95% CI: 75–93%) had at least stable disease or better at last follow-up, but 50% (95% CI: 38–62%) of remaining viable nodules (mRECIST) progressed within the tumor. Median PFS was reached at 17 and 13 months for total and viable tumors, respectively. NRS decreased from 6 (IQR 3) to 3 (IQR 4) (p < 0.001). SF-36 scores improved (physical health (41 (IQR 15) to 46 (IQR 12); p = 0.05, and mental health (49 (IQR 17) to 53 (IQR 9); p = 0.02)). Complications occurred in 36%, most commonly 1^st/2^nd degree skin burns.

Conclusion

MRgFUS reduced tumor volume, reduced pain, and improved quality of life in this series of 105 patients with extra-abdominal desmoid fibromatosis.

Clinical relevance statement

Imaging-guided ablation is being increasingly used as an alternative to surgery, radiation, and medical therapy for the treatment of desmoid fibromatosis. MR-guided high-intensity focused ultrasound is an incisionless ablation technique that can be used to reduce tumor burden effectively and safely.

Key Points

• Desmoid fibromatosis was treated with MR-guided high-intensity focused ultrasound in 105 patients.

• MR-guided focused ultrasound ablation reduced tumor volume and pain and improved quality of life.

• MR-guided focused ultrasound is a treatment option for patients with extra-abdominal desmoid tumors.

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Titel: MR-guided focused ultrasound therapy of extra-abdominal desmoid tumors: a multicenter retrospective study of 105 patients
verfasst von: Daniel M. Düx
Joe Darryl Baal
Rachelle Bitton
Joshua Chen
Ryan L. Brunsing
Vipul R. Sheth
Jarrett Rosenberg
Kisoo Kim
Eugene Ozhinsky
Raffi Avedian
Kristen Ganjoo
Matthew Bucknor
Andrew Dobrotwir
Pejman Ghanouni
Publikationsdatum: 24.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2024
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10073-9

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MR-guided focused ultrasound therapy of extra-abdominal desmoid tumors: a multicenter retrospective study of 105 patients