News | June 03, 2015

Two children with osteoid osteoma successfully treated using noninvasive magnetic resonance-guided high-intensity focused ultrasound

Children's National, Sheikh Zayed, MR-HIFU, focused ultrasound, osteoid osteoma

June 3, 2015 - Doctors from the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Health System are the first in the United States to treat osteoid osteoma using an experimental magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) method. Two patients, 16-year-old Alfredo Coreas and 10-year-old Niyati Shah, have been treated successfully in a research study aimed at testing the safety and feasibility of this noninvasive and precise treatment option.

"Our team set out to provide a noninvasive treatment option for children with osteoid osteoma and we're very pleased with the success of the first two treatments," said Karun Sharma, M.D., Ph.D., director of interventional radiology at Children's National and principal investigator for the osteoid osteoma trial. "Both children we treated were very active prior to the onset of their tumor, one a soccer player and the other a swimmer, but because of the pain from the tumor, they have been unable to enjoy their favorite activities, until now."

Osteoid osteoma, a benign but painful bone tumor that commonly occurs in children and young adults, was previously treated with orthopedic surgery that involved scraping the tumor from the bone or removing the affected part of the bone. The most commonly used treatment today is computed tomography (CT)-guided radiofrequency ablation (RFA). While this is a less invasive method, it still requires drilling through muscle and soft tissue into bone. RFA also exposes the patient and operator to ionizing radiation.

High-intensity focused ultrasound therapy uses focused sound wave energy to heat and destroy the targeted tumor under MRI guidance. This precise and controlled method does not require a scalpel or needle, greatly reducing the risk of complications like infections and bone fractures. It is also a faster treatment option, with expected total procedure time of an hour or less. In the U.S., MR-HIFU is used to treat uterine fibroids and painful bone metastases from several types of cancer in adults, but it has not been used in children.

This breakthrough is the latest from the Image-Guided Non-Invasive Therapeutic Energy (IGNITE) program, a collaboration of the Sheikh Zayed Institute and the departments of radiology, oncology, surgery, and anesthesiology at Children's National. The goal of the IGNITE program is to improve the quality of life and outcomes for pediatric patients through the development and clinical introduction of novel minimally invasive and noninvasive surgery technologies and combination therapy approaches. The team is led by Peter Kim, M.D., CM, Ph.D., vice president of the Sheikh Zayed Institute.

"The use of MR-HIFU ablation of osteoid osteoma is a perfect example of our mission in the Sheikh Zayed Institute to make pediatric surgery more precise, less invasive and pain-free," said Kim. "Our leading team of experts are also exploring the use of MR-HIFU as a noninvasive technique of ablating growth plates and pediatric solid tumors. We also have another clinical trial open for children and young adults with refractory soft tissue tumors, which is being performed in collaboration with Dr. Bradford Wood's team at the National Institutes of Health, and if successful, it would be the first in the world."

In addition to Sharma and Kim, the team for the ablation of osteoid osteoma clinical trial includes: AeRang Kim, M.D., Ph.D., pediatric oncologist; Matthew Oetgen, M.D., division chief of orthopedic surgery and sports medicine; Kaleb Friend, M.D., pediatric orthopedic surgeon; Pavel Yarmolenko, Ph.D., Haydar Celik, Ph.D., and Avinish Eranki, biomedical engineers; Viktoriya Beskin, MR technologist; and Janish Patel, M.D., and Domiciano Santos, M.D., pediatric anesthesiologists.

For more information: www.childrensnational.org


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