​Treatment Procedure

This video explains how focused ultrasound can quickly reduce pain caused by bone metastases and describes the treatment procedure.

Alleviating pain caused by bone metastases: treatment procedure from ExAblate: Non-invasive treatment on Vimeo.

Most patients with advanced cancer that has migrated to their bones suffer from excruciating pain which severely affects quality of life. Although radiation is considered the standard of care for localized bone pain up to 35% of patients may not respond to treatment, and for those that do, the pain often recurs.
 
Now, there is a completely non-invasive treatment available called ExAblate, which doesn’t use any ionizing radiation.
It uses focused ultrasound waves to reduce the bone pain you feel. These are the same ultrasound waves that are used for diagnosing disease and are now used to treat painful bone tumors.
The procedure is conducted in an outpatient clinic and requires no hospitalization and only one session.
That means that you may go home shortly after your treatment. Most patients experience pain relief within days.
 
Screening Process
 
Based on your MRI or CT images, your physician will determine if you are a candidate for Focused Ultrasound treatment.
If you are a candidate, you will be scheduled for treatment and given a list of instructions.
 
When you arrive on treatment day our nurse prepares you for the procedure. This includes shaving the area where the ultrasound treatment will be provided, inserting an IV line with sedation, and possibly other drugs to help you relax during treatment.
 
The entire treatment takes place while you lie in the MRI. First you will be positioned on the ExAblate patient table which
contains the focused ultrasound equipment.
You will continuously receive analgesics and sedation to reduce discomfort and to allow you to remain in the same position throughout treatment.
You will also be given a stop button to pause treatment if you feel too much discomfort.
 
The physician conducts the treatment from the adjacent control room and continuously monitors you through the glass window
separating the MR room from the control room. A nurse and anesthesiologist will monitor you and check on you periodically.
 
Planning Treatment Process
 
Before the treatment begins, the physician takes MRI images of the painful area and creates a treatment plan.
After this is completed treatment begins.
 
The treatment consists of multiple applications of the focused ultrasound energy, called sonications. When the sonicate button is pressed,
the MR begins scanning and treatment begins. Each sonication lasts about 20 seconds and you may hear the MRI working.
Sonications are repeated until the entire planned tumor area has been treated.
The treatment team will let you know what sensations you may feel during treatment. For example, you may feel some warming
during the sonication, if it is too uncomfortable you can stop the treatment at any time using your hand-held stop button.
After the treatment, you will be sent to a recovery room for a couple of hours to allow the sedation or the anesthesia to wear off.
When the physician gives you the OK you can leave the hospital just as with any other medical procedure.
It’s a good idea to have someone there to drive you home.

Clinical trial results have shown that most patients experience symptom relief that lasts for at least three months.
Since there is no ionizing radiation, if pain recurs or a new met appears you can undergo another focused ultrasound treatment.