Sperling Medical Group

treating bone mets with mr-guided focused ultrasound (mrgfus)

What are bone mets?

Metastatic cancer means cancer that is spreading beyond its original source. The third most common area of spread (after lungs and liver) is to the bone. This is called bone metastasis, or bone mets. Bone mets can cause pain that is difficult to control. Conventional treatments (drugs, surgery, radiation) fail to provide adequate relief in at least 50% of cases. A new safe and effective outpatient treatment called MRI-Guided Focused Ultrasound (MRgFUS) can bring fast results and better quality of life.

What is MRgFUS?

MRI-guided Focused Ultrasound (MRgFUS) is an FDA-cleared, noninvasive and non-radioactive treatment using focused sound waves. Thanks to Magnetic Resonance Imaging (MRI) planning and guidance, precisely focused ultrasound energy can provide pain relief. Clinical studies have shown success in 64-100% of patients, most of whom experienced a range of relief and improved quality of life a week or less after treatment. There were few to no significant side effects.

The imaging and intervention experts at the Sperling Medical Group provide a state-of-the-art technology called the Exablate MRgFUS for the noninvasive treatment of pain resulting from bone mets.

What is the Exablate MRgFUS?

The ExAblate® MRgFUS is a fully integrated detection, mapping, delivery and monitoring system to ablate (destroy) metastatic bone lesions and their nerves that cause pain. High resolution magnetic resonance imaging (MRI) is used to map the location, shape and size of bone mets. Once the treatment is planned, ultrasound energy is beamed in a focused array at each lesion. The energy passes harmlessly through healthy tissue until it converges (come together) at the target. Their focal point creates intense heat that destroys the nerves in the bone with the target tumor, not surrounding healthy bone or tissue. For most patients, this greatly reduces or completely stops the pain in a matter of a week or less.

What is the procedure like?

Courtesy of INSIGHTEC, developer of Exablate

The treatment occurs inside the tunnel, or bore, of the MRI scanner. Depending on the location of the bone mets, the patient lies face up or face down on a table that slides into the bore. The device that delivers the focused ultrasound is located in the table. As the ultrasound is being delivered in overlapping short pulses called sonications, the MRI software tracks the temperature and monitors its effect. Sonications continue until the MRI shows that treatment is complete and correct. Most patients do not report uncomfortable pain during the procedure, but medication can be quickly given if needed.

Risks of MRgFUS

No treatment is completely risk free. Depending on the size of area to be treated, the following side effects have been reported:

  • Discomfort or pain during treatment – report this immediately so medication can be adjusted
  • Immediate or lingering discomfort from having to lie still for a long period – this may be avoided by careful positioning before treatment starts
  • Not all patients will experience long-term pain relief, as pain may come back at the site or in another location not suitable for MRgFUS

Discuss all possible side effects and risks with your doctor while considering MRgFUS for your treatment.

Exablate at the Sperling Medical Group

At the Sperling Medical Group, our caring and expert staff offers Exablate MRgFUS guided by the most advanced MRI equipment. Treating painful bone mets with Exablate MRgFUS has been shown to be safe and at least as effective as conventional treatments. Contact us for more information.


iCallstrom M, Dupuy D, Solomon S, Beres R et al. Percutaneous image-guided cryoablation of painful metastases involving bone.Cancer. 2013 Mar;119(5):1033-41.

iiRodrigues D, Stauffer P, Vrba D, Hurwitz M. Focused ultrasound for treatment of bone tumours. Int J Hyperthermia. 2015 May;31(3):260-71.

new and noteworthy

Recently Published

New article by Dr. Sperling in Radiology Life magazine on the advantages of image-guided treatments for a variety of conditions.

In the Media

Listen to Dr. Sperling’s recent interview on Health Professional Radio about prostate cancer detection, treatment