A patient at The Hospital for Sick Children (SickKids) is the first child in North America to have undergone a specialised procedure that uses ultrasound and magnetic resonance imaging (MRI) to destroy a tumour in his leg without piercing the skin. Doctors used an MRI to guide high-intensity ultrasound waves to destroy a benign bone tumour called osteoid osteoma. The lesion had caused 16-year-old Jack Campanile excruciating pain for a year. By the time he went to bed that night, the athletic teen experienced complete pain relief.
“With high-intensity focused ultrasound, we are moving from minimally-invasive to non-invasive therapy, significantly reducing risk to the patient and fast-tracking recovery,” said SickKids interventional radiologist, Dr Michael Temple, who led the team that performed the surgery. “The osteoid osteoma tumour was chosen as our pilot study because the lesion is easily accessible and while the procedure is sophisticated, it is relatively straightforward. The success of this first case is great news for Jack, and exciting for our team as we look at developing more complex incisionless treatments in the future.”
The procedure was performed by SickKids staff using a specialised MRI table at Sunnybrook Health Sciences Centre, with support from Sunnybrook’s MRI and Radiation Oncology staff. The team used the MRI to determine the exact location of the tumour and to help target the ultrasound waves to burn the whole tumour, one focal spot at a time at a high energy. The MRI also enabled them to monitor the temperature induced by the ultrasound to ensure that there was no unexpected increase in heat in surrounding tissues. Accurate positioning and monitoring are critical, as the ultrasound waves could damage surrounding tissues, nerves or skin.
A few hours after the procedure, Jack was discharged home, where his recovery has been reportedly smooth and quick, with no complications to date. Before the surgery, Jack’s pain was so debilitating that he needed to take pain medication up to four times daily. “The idea of being the first to undergo this new treatment was intriguing. I wanted to see what it would be like. If it did work, it would be a whole new world for medical procedures and treating osteoid osteoma,” Jack explains.
This breakthrough is the latest from SickKids’ Centre for Image-Guided Innovation and Therapeutic Intervention (CIGITI), a research programme that brings together surgeons, radiologists, software developers and engineers to develop innovative technologies in robotic and minimally-invasive surgery.
EH News Bureau