Keywords:
Interventional non-vascular, Oncology, Pelvis, Ultrasound, Percutaneous, Ablation procedures, Neoplasia, Metastases
Authors:
M. H. A. F. Shaaban1, M. F. Tolba2, R. H. Hashem2; 1Cairo , Maadi/EG, 2Cairo/EG
DOI:
10.26044/ecr2019/C-3744
Aims and objectives
Cancer pain can be effectively managed in about 90% of patients with stepwise use of the WHO analgesic ladder system (1)
80% of the patients with cancer their pain is often severe enough that treatment with opioid analgesics is required.
(2)
Although there has been progress in the management of cancer-related pain,
the current treatments still have negative effects on quality of life and survival rates (3)
Pain related to the cancer can be caused by a direct mass effect of the tumor,
which compresses or infiltrates nerve structures; the tumor microenvironment,
in which modulating agents that sensitize or directly stimulate nociceptors are released; injury to local nociceptors,
which alters the nerve impulse transmission (4)Cancer-related pain can be acute or chronic (5)
For cancer-related pain that is nonresponsive to medication treatment,
interventional analgesic procedures such as regional anesthetic nerve block and neuroaxial neurolysis,
and implantable drug delivery systems can be used They are invasive,
and multiple treatment sessions are required.
(6)
High-intensity focused ultrasound (US) is another option for ablative therapy that offers several advantages.
It is noninvasive,
allows for real-time imaging for lesion localization .(7) High-intensity focused ultrasound (HIFU) shows faster post procedure recovery (8)
It is an emerging technique involving the use of high-energy ultrasound waves to precisely ablate a well-circumscribed target volume with magnetic resonance (MR) imaging or ultrasonographic (US) guidance,
without damaging the surrounding healthy structures.
Depending on the type of imaging guidance,
the term MR imaging–guided focused ultrasound or US-guided focused ultrasound can be used.
Use of this technology has yielded promising results in cases of malignant and nonmalignant conditions .(9) Focused ultrasound devices are composed of a generator that produces ultrasound energy and a transducer that focuses the waves into a beam aimed at a well-defined target region (6)
Objectives
to determine the role of ultrasound (US) guided HIFU in the control of pain in lesions of various etiology.
To determine its efficacy in pain alliation in neoplastic and non neoplastic lesions