Abstract：
BACKGROUND: The percutaneous thermal ablation techniques (pTA) are radiofrequency ablation, cryoablation, and microwave ablation, suitable for the treatment of bone oligometastases. Magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive ablation technique.
OBJECTIVE: To compare the effectiveness and safety of MRgFUS and pTA for treating bone oligometastases and their complications.
METHODS: Studies were selected with a PICO/PRISMA protocol: pTA or MRgFUS in patients with bone oligometastases; non-exclusive curative treatment. Exclusion criteria were: primary bone tumor; concurrent radiation therapy; palliative therapy; and absence of imaging at follow-up. PubMed, BioMed Central, and Scopus were searched. The modified Newcastle-Ottawa Scale assessed articles quality. For each treatment (pTA and MRgFUS), we conducted two separate random-effects meta-analyses to estimate the pooled effectiveness and safety. The effectiveness was assessed by combining the proportions of treated lesions achieving local tumor control (LTC); the safety by combining the complications rates of treated patients. Meta-regression analyses were performed to identify any outcome predictor.
RESULTS: A total of 24 articles were included. Pooled LTC rate for MRgFUS was 84% (N = 7, 95% CI 66-97%, I2 = 74.7%) compared to 65% of pTA (N = 17, 95% CI 51-78%, I2 = 89.3%). Pooled complications rate was similar, respectively, 13% (95% CI 1-32%, I2 = 81.0%) for MRgFUS and 12% (95% CI 8-18%, I2 = 39.9%) for pTA, but major complications were recorded with pTA only. The meta-regression analyses, including technique type, study design, tumor, and follow-up, found no significant predictors.
CONCLUSIONS: The effectiveness and safety of the two techniques were found comparable, even though MRgFUS is a noninvasive treatment that did not cause any major complication. Limited data availability on MRgFUS and the lack of direct comparisons with pTA may affect these findings.
CONCLUSIONS: MRgFUS can be a valid, safe, and noninvasive treatment for bone oligometastases. Direct comparison studies are needed to confirm its promising benefits.
OBJECTIVE: To compare the effectiveness and safety of MRgFUS and pTA for treating bone oligometastases and their complications.
METHODS: Studies were selected with a PICO/PRISMA protocol: pTA or MRgFUS in patients with bone oligometastases; non-exclusive curative treatment. Exclusion criteria were: primary bone tumor; concurrent radiation therapy; palliative therapy; and absence of imaging at follow-up. PubMed, BioMed Central, and Scopus were searched. The modified Newcastle-Ottawa Scale assessed articles quality. For each treatment (pTA and MRgFUS), we conducted two separate random-effects meta-analyses to estimate the pooled effectiveness and safety. The effectiveness was assessed by combining the proportions of treated lesions achieving local tumor control (LTC); the safety by combining the complications rates of treated patients. Meta-regression analyses were performed to identify any outcome predictor.
RESULTS: A total of 24 articles were included. Pooled LTC rate for MRgFUS was 84% (N = 7, 95% CI 66-97%, I2 = 74.7%) compared to 65% of pTA (N = 17, 95% CI 51-78%, I2 = 89.3%). Pooled complications rate was similar, respectively, 13% (95% CI 1-32%, I2 = 81.0%) for MRgFUS and 12% (95% CI 8-18%, I2 = 39.9%) for pTA, but major complications were recorded with pTA only. The meta-regression analyses, including technique type, study design, tumor, and follow-up, found no significant predictors.
CONCLUSIONS: The effectiveness and safety of the two techniques were found comparable, even though MRgFUS is a noninvasive treatment that did not cause any major complication. Limited data availability on MRgFUS and the lack of direct comparisons with pTA may affect these findings.
CONCLUSIONS: MRgFUS can be a valid, safe, and noninvasive treatment for bone oligometastases. Direct comparison studies are needed to confirm its promising benefits.
摘要：
背景：经皮热消融技术（pTA）是射频消融，冷冻消融,和微波消融，适用于治疗骨寡转移。磁共振引导聚焦超声（MRgFUS）是一种无创消融技术。
目的：比较MRgFUS和pTA治疗骨寡转移酶及其并发症的有效性和安全性。
方法：选择PICO/PRISMA方案：pTA或MRgFUS治疗骨寡转移患者的研究；非排他性治愈性治疗。排除标准为：原发性骨肿瘤；同步放射治疗；姑息治疗；随访时无影像学检查。PubMed,BioMedCentral,Scopus被搜查了.改良的纽卡斯尔-渥太华量表评估文章质量。对于每种治疗（pTA和MRgFUS），我们进行了两项单独的随机效应荟萃分析,以评估汇总的有效性和安全性.通过结合达到局部肿瘤控制（LTC）的治疗病变的比例来评估有效性；通过结合治疗患者的并发症发生率来评估安全性。进行荟萃回归分析以确定任何结果预测因子。
结果：共纳入24篇。MRgFUS的合并LTC率为84%(N=7，95%CI66-97%，I2=74.7%）与65%的pTA（N=17，95%CI51-78%，I2=89.3%）。合并并发症发生率相似，分别,13%（95%CI1-32%，I2=81.0%)，MRgFUS和12%(95%CI8-18%，I2=39.9%)pTA，但仅pTA记录了主要并发症。荟萃回归分析，包括技术类型，研究设计，肿瘤，和后续行动，没有发现重要的预测因素。
结论：发现两种技术的有效性和安全性具有可比性，尽管MRgFUS是一种无创性治疗,不会引起任何重大并发症.MRgFUS的数据有限以及缺乏与pTA的直接比较可能会影响这些发现。
结论：MRgFUS可以是有效的，安全,和骨寡转移的非侵入性治疗。需要进行直接比较研究，以确认其可观的益处。
目的：比较MRgFUS和pTA治疗骨寡转移酶及其并发症的有效性和安全性。
方法：选择PICO/PRISMA方案：pTA或MRgFUS治疗骨寡转移患者的研究；非排他性治愈性治疗。排除标准为：原发性骨肿瘤；同步放射治疗；姑息治疗；随访时无影像学检查。PubMed,BioMedCentral,Scopus被搜查了.改良的纽卡斯尔-渥太华量表评估文章质量。对于每种治疗（pTA和MRgFUS），我们进行了两项单独的随机效应荟萃分析,以评估汇总的有效性和安全性.通过结合达到局部肿瘤控制（LTC）的治疗病变的比例来评估有效性；通过结合治疗患者的并发症发生率来评估安全性。进行荟萃回归分析以确定任何结果预测因子。
结果：共纳入24篇。MRgFUS的合并LTC率为84%(N=7，95%CI66-97%，I2=74.7%）与65%的pTA（N=17，95%CI51-78%，I2=89.3%）。合并并发症发生率相似，分别,13%（95%CI1-32%，I2=81.0%)，MRgFUS和12%(95%CI8-18%，I2=39.9%)pTA，但仅pTA记录了主要并发症。荟萃回归分析，包括技术类型，研究设计，肿瘤，和后续行动，没有发现重要的预测因素。
结论：发现两种技术的有效性和安全性具有可比性，尽管MRgFUS是一种无创性治疗,不会引起任何重大并发症.MRgFUS的数据有限以及缺乏与pTA的直接比较可能会影响这些发现。
结论：MRgFUS可以是有效的，安全,和骨寡转移的非侵入性治疗。需要进行直接比较研究，以确认其可观的益处。
