{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:10:37Z","timestamp":1753877437858,"version":"3.41.2"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T00:00:00Z","timestamp":1629244800000},"content-version":"vor","delay-in-days":229,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017615","name":"Sheikh Zayed Institute for Pediatric Surgical Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017615","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017551","name":"Children\u2019s National Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017551","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with Neurofibromatosis Type 1 (NF1) and plexiform neurofibromas (PN) often have radiographically diagnosed distinct nodular lesions (DNL) which can cause pain and weakness. Magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) can precisely and accurately deliver heat to thermally ablate target tissue. The aim of this study is to evaluate whole-body MRIs from patients with NF1 and DNL, applying volumetrics and a consistent treatment planning approach to determine the feasibility of MR-HIFU ablation of DNL.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective review of whole-body MRI scans from patients with NF1 and PN from CNH and NCI was performed. DNL are defined as lesions &amp;gt;3 cm, distinct from PN and lacking the \u201ccentral dot\u201d feature. Criteria for MR-HIFU thermal ablation include target location 1\u20138 cm from skin surface; &amp;gt;1 cm from visible plexus, spinal canal, bladder, bowel, physis; and ability to ablate \u226550% of lesion volume. Lesions in skull and vertebral body were excluded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 26 patients, 120 DNL were identified. The majority of DNL were located in an extremity (52.5%). Other sites included head\/neck (7%), chest (13%), and abdomen\/pelvis (28%). The predefined HIFU ablation criteria was not met for 47.5% of lesions (n = 57). The main limitation was proximity to a vital structure or organ (79%). Complete and partial HIFU ablation was feasible for 25% and 27.5% of lesions, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Based on imaging review of lesion location, technical considerations and ability to target lesions, thermal ablation with MR-HIFU may be a feasible noninvasive alternative for symptom management in patients with NF1 and symptomatic DNL.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/noajnl\/vdab116","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T13:52:01Z","timestamp":1629294721000},"source":"Crossref","is-referenced-by-count":1,"title":["Feasibility of magnetic resonance-guided high-intensity focused ultrasound treatment targeting distinct nodular lesions in neurofibromatosis type 1"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6821-7914","authenticated-orcid":false,"given":"Caitlin","family":"Tydings","sequence":"first","affiliation":[{"name":"Center for Cancer and Blood Disorders, Children\u2019s National Hospital, Washington, District of Columbia, USA"},{"name":"Sheikh Zayed Institute for Pediatric Surgical Innovation, Children\u2019s National Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavel","family":"Yarmolenko","sequence":"additional","affiliation":[{"name":"Sheikh Zayed Institute for Pediatric Surgical Innovation, Children\u2019s National Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Bornhorst","sequence":"additional","affiliation":[{"name":"Center for Cancer and Blood Disorders, Children\u2019s National Hospital, Washington, District of Columbia, USA"},{"name":"Gilbert Neurofibromatosis Institute, Children\u2019s National Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5323-6995","authenticated-orcid":false,"given":"Eva","family":"Dombi","sequence":"additional","affiliation":[{"name":"National Cancer Institute, Pediatric Oncology Branch, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Myseros","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Keating","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s National Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Bost","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Study Methodology, Children\u2019s Research Institute, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karun","family":"Sharma","sequence":"additional","affiliation":[{"name":"Sheikh Zayed Institute for Pediatric Surgical Innovation, Children\u2019s National Hospital, Washington, District of Columbia, USA"},{"name":"Department of Radiology, Children\u2019s National Hospital, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AeRang","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Cancer and Blood Disorders, Children\u2019s National Hospital, Washington, District of Columbia, USA"},{"name":"Sheikh Zayed Institute for Pediatric Surgical Innovation, Children\u2019s National Hospital, 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