{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:46:00Z","timestamp":1787028360524,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,7]],"date-time":"2023-01-07T00:00:00Z","timestamp":1673049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union","award":["825859"],"award-info":[{"award-number":["825859"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) is an innovative treatment for patients with painful bone metastases. The adoption of MR-HIFU will be influenced by several factors beyond its effectiveness. To identify contextual factors affecting the adoption of MR-HIFU, we conducted a group concept mapping (GCM) study in four European countries. The GCM was conducted in two phases. First, the participants brainstormed statements guided by the focus prompt \u201cOne factor that may influence the uptake of MR-HIFU in clinical practice is...\u201d. Second, the participants sorted statements into categories and rated the statements according to their importance and changeability. To generate a concept map, multidimensional scaling and cluster analysis were conducted, and average ratings for each (cluster of) factors were calculated. Forty-five participants contributed to phase I and\/or II (56% overall participation rate). The resulting concept map comprises 49 factors, organized in 12 clusters: \u201ccompetitive treatments\u201d, \u201cphysicians\u2019 attitudes\u201d, \u201calignment of resources\u201d, \u201clogistics and workflow\u201d, \u201ctechnical disadvantages\u201d, \u201cradiotherapy as first-line therapy\u201d, \u201caggregating knowledge and improving awareness\u201d, \u201cclinical effectiveness\u201d, \u201cpatients\u2019 preferences\u201d, \u201creimbursement\u201d, \u201ccost-effectiveness\u201d and \u201chospital costs\u201d. The factors identified echo those from the literature, but their relevance and interrelationship are case-specific. Besides evidence on clinical effectiveness, contextual factors from 10 other clusters should be addressed to support adoption of MR-HIFU.<\/jats:p>","DOI":"10.3390\/ijerph20021084","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T01:36:17Z","timestamp":1673228177000},"page":"1084","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Factors Influencing the Adoption of Magnetic Resonance-Guided High-Intensity Focused Ultrasound for Painful Bone Metastases in Europe, A Group Concept Mapping Study"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4832-7294","authenticated-orcid":false,"given":"Julia","family":"Sim\u00f5es Corr\u00eaa Galendi","sequence":"first","affiliation":[{"name":"Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Cathrine","family":"Siefen","sequence":"additional","affiliation":[{"name":"Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora M.","family":"Moretti","sequence":"additional","affiliation":[{"name":"Institute for Food and Resource Economics, Chair for Technology, Innovation Management and Entrepreneurship, University of Bonn, 53115 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7602-0695","authenticated-orcid":false,"given":"Sin Yuin","family":"Yeo","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0993-9300","authenticated-orcid":false,"given":"Holger","family":"Gr\u00fcll","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany"},{"name":"Department of Chemistry, Faculty of Mathematics and Natural Sciences, University of Cologne, 50939 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5696-9828","authenticated-orcid":false,"given":"Grischa","family":"Bratke","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9793-3410","authenticated-orcid":false,"given":"Alessio Giuseppe","family":"Morganti","sequence":"additional","affiliation":[{"name":"Radiation Oncology, IRCCS Azienda Ospedaliero, Universitaria of Bologna, 40138 Bologna, Italy"},{"name":"Radiation Oncology, DIMES, Alma Mater Studiorum Bologna University, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Bazzocchi","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Gasperini","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5119-8358","authenticated-orcid":false,"given":"Francesca","family":"De Felice","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0167-9639","authenticated-orcid":false,"given":"Roberto","family":"Blanco Sequeiros","sequence":"additional","affiliation":[{"name":"Department of Radiology, Turku University Hospital, 20521 Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mira","family":"Huhtala","sequence":"additional","affiliation":[{"name":"Department of Oncology, Turku University Hospital, University of Turku, 20521 Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4820-7505","authenticated-orcid":false,"given":"Ingrid M.","family":"Nijholt","sequence":"additional","affiliation":[{"name":"Department of Radiology, Isala Hospital, 8025 AB Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7878-0970","authenticated-orcid":false,"given":"Martijn F.","family":"Boomsma","sequence":"additional","affiliation":[{"name":"Department of Radiology, Isala Hospital, 8025 AB Zwolle, The Netherlands"},{"name":"Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Bos","sequence":"additional","affiliation":[{"name":"Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena M.","family":"Verkooijen","sequence":"additional","affiliation":[{"name":"Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1726-9300","authenticated-orcid":false,"given":"Stephanie","family":"Stock","sequence":"additional","affiliation":[{"name":"Institute for Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, 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