|ECR 2018 / C-0884|
|High intensity focused ultrasound treatment for relapsing extra-abdominal desmoid tumours|
Methods and materials
Five patients with relapsing, pathologically proven desmoid tumors (three males, two females; age range 40–79 years) were treated with MR-HIFU. Two patients had desmoids located in the rectus abdominis muscle, one in the deltoid muscle, one in the intercostal muscles and one in the popliteal fossa. If applicable the whole tumor was targeted. Treatments were performed under regional anesthesia or a combination of local anesthesia and analgosedation, based on tumor location and patient preference. An MR-HIFU system with an in-table 1,2-MHz transducer was used with a 1,5-T MR system. Procedure planning was done using a sagittal 3D T2w TSE Image (TR 1000ms, TE 130ms field of view AP 250mm FH 250mm RL 132mm, bandwidth 832Hz). Sonication number, size of treatment cells and energy deposition were steadily adjusted based on the real-time temperature-energy response seen on the MR-thermomap. Tissue temperature of 60-70° Celsius was targeted. Immediately after treatment post-contrast images of the non-perfused tumor areas were used to evaluate treatment effect and if needed to validate subsequent sonications (Fig. 1). Changes in total tumor volumes were measured with a tumor tracking software. Adverse events were documented.
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