MRgFUS for liver and pancreas cancer treatments: the Umberto I hospital experience

Pancreatic cancer is the fourth cause of mortality worldwide while liver cancer is the sixth most common cancer worldwide. Despite the constant development of non-invasive ablative technique, these two tumours represent still a challenge for oncology due to relatively low survival and poor prognosis. Ultrasound-guided high intensity focused ultrasound (USgFUS) ablation has been proved as a feasible treatment option in patients with pancreatic cancer and hepatocellular carcinoma (HCC). Given relative intrinsic limit of the US guidance, we believe that MR-guided focused ultrasound surgery (MRgFUS) represents the natural evolution of USgFUS. MRgFUS combines the high intensity focused ultrasound (HIFU) induced ablation to the MR capability to depict the anatomical structure as well as to monitor realtime changes in temperature. Notwithstanding the recent widespread of MRgFUS to treat several solid tumours, there is still limited evidence on safety and efficacy of this technique to treat patients with advanced pancreatic carcinoma and HCC. In this paper we present the results of our experience and discuss advantages and limitations of this promising technique. Our results demonstrate the feasibility and safety of MRgFUS in pain relief as well as in decreasing tumor growth and tumor size in both pathologies. Moreover we observed no significant adverse or complications during and after the procedure.