An interventional study of Magnetic Resonance Image-guided High Intensity Focused Ultrasound (MR-HIFU) in Cancer and Bone Metastases, sponsored by Institute of Cancer Research, United Kingdom. Withdrawn at 1 site in United Kingdom. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2021-10-08.
Sponsored by Institute of Cancer Research, United Kingdom · Not applicable, Interventional, and Treatment
The primary objective of this study is to determine whether intra- and post-procedural MR changes are indicative of reduction in pain symptom scores. The trial will recruit a cohort of patients with painful bone metastases, who wish to consider MRgHIFU treatment. These patients will be identified in conjunction with the pain and palliative care teams, as well as clinical and medical oncologists. Patients will undergo MRgHIFU treatment using scanning and treatment planning methods that have been established in the patients treated within the multi-centre study. The treatment response rate for the cohort will be recorded. Intra- and post-procedural imaging metrics will be evaluated for their ability to detect tissue changes, which may be indicative of response. Patients will be followed-up for up to 90 days after treatment, and will attend for repeat imaging and pain review at days 30, 60 and 90 after treatment. Any changes in imaging metrics will be compared between responders and non-responders.
The primary aim of this study is to investigate whether the ablated tissue volume indicated by immediate post-treatment Gd-T1W imaging is indicative of reduction in pain scores (response) 30 days after treatment.
The secondary aims of this study are:
This is an exploratory study, which will recruit n=15 patients into one single cohort. Enrolment of the target population for the study is expected to take approximately 2 years. Patients will be eligible for the study if they wish to consider MRgHIFU treatment for pain palliation of a region of bony metastatic disease that is accessible to the MRgHIFU device. After providing their written informed consent to participate in the study, patients' suitability for treatment will be determined by a combined assessment of clinical review by a pain specialist, and an MR screening investigation to establish lesion targetability. Baseline clinical and imaging metrics will be recorded. Patients who fulfill all inclusion criteria, have none of the exclusion criteria, and who give informed consent, will be scheduled for MRgHIFU treatment to the target lesion. Treatment will be delivered under sedation on a day-case basis, according to protocols already established in our prior study. During treatment delivery, the investigators will assess imaging metrics of tissue change, which may be indicative of subsequent treatment response. Treatment would be expected to take approximately 1-2 hours, and after an observation period of approximately 2-4 hours, the patient will be discharged. Before discharge, follow-up instructions will be given to the patient. Patients' clinical and imaging responses to treatment will then be assessed at follow-up appointments up to 3 months after treatment.
Exclusion Criteria:
Magnetic Resonance guided High Intensity Focused Ultrasound (MRgHIFU) for Pain Palliation of Bone Metastases
Device: Magnetic Resonance Image-guided High Intensity Focused Ultrasound (MR-HIFU)
MRgHIFU treatment will be delivered using a Philips Sonalleve system, which integrates a high intensity phased array focused ultrasound transducer with our Philips 3T Achieva imaging system. An electromechanical transducer positioning system is used to deliver spatially and temporally controlled ultrasound energy and thermal heat to tissues non-invasively. The MR system is used to provide images to plan the therapy, and to guide and monitor the thermal ablation with thermal imaging during the treatment.
Measure the ablated tissue volume indicated by immediate post-treatment Gd-T1W imaging in responders and non-responders.
Time frame: Day 30
To report the treatment response rate.
Days 7, 14, 30, 60 and 90
Time frame: up to 90 days
To investigate whether ablated tissue volume indicated by Gd-T1W imaging at Day 30 remains stable at Days 60 and 90.
Time frame: up to 90 days
.To investigate whether intra-procedural PRFS metrics are different in responders and non-responders at Day 30
PRFS Metrics include thermal dose volume, temperature
Time frame: 30 days post treatment
To investigate whether intra- or post-procedural changes in ADC are different in responders and non-responders.
Time frame: Day 30
To investigate whether intra- or post-procedural changes in T2 are different in responders and non-responders.
Time frame: Day 30
The rate of treatment-related adverse events
Time frame: up to 3 months after treatment.
The effect of MRgHIFU treatment on patients' quality of life, recorded using Quality of Life Questionnaires (QLQ's).
using EORTC (European Organization for Research and Treatment of Cancer)- QLQ's
Time frame: up to 3 months after treatment.
The costs of MRgHIFU treatment.
Time frame: up to 3 months after treatment.
This study is withdrawn, as verified in Oct 2021. You cannot join it, but the record below documents what was studied.
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Institute of Cancer Research, United Kingdom