Abstract
High-intensity focused ultrasound (HIFU) is a totally noninvasive procedure that has
shown promising results in the management of numerous malignant and nonmalignant conditions.
Under magnetic resonance or ultrasound guidance, high-intensity ultrasound waves are
focused on a small, well-defined target region, inducing biologic tissue heating and
coagulative necrosis, thus resulting in a precise and localized ablation. This treatment
has shown both great safety and efficacy profiles, and may offer a multimodal approach
to different diseases, providing pain palliation, potential local tumor control, and,
in some cases, remineralization of trabecular bone. In musculoskeletal field, HIFU
received FDA approval for treating bone metastasis, but its application has also been
extended to other conditions, such as osteoid osteoma, desmoid tumor, low-flow vascular
malformation, and facet joint osteoarthritis. This article illustrates the basic principles
of HIFU and its main effects on biologic tissues with particular attention on bone,
provides a step-by-step description of the HIFU procedure, and discusses the commonly
treated conditions, in particular bone metastases.
Keywords
High-intensity focused ultrasound - bone metastases - osteoid osteoma - pain palliation
- interventional radiology
