Advancing Focused Ultrasound Technology for Musculoskeletal Applications and Cancer Treatment

Matthew Bucknor, MD's interest in focused ultrasound developed during his radiology residency at UCSF when Fergus Coakley, MD (former faculty and current chair of radiology at Oregon Health Sciences University) brought the technology here. At that time, Dr. Bucknor was unsure if he wanted to pursue a career in academic medicine, but upon realizing the potential of this technology, he knew that he wanted to help drive its advancement moving forward. Skip ahead just a few years, and Dr. Bucknor is a lead radiologist at the UC San Francisco Department of Radiology and Biomedical Imaging in performing focused ultrasound treatments.

As a musculoskeletal radiologist, Dr. Bucknor is interested in potential musculoskeletal applications of focused ultrasound. These include treatment of benign and malignant tumors of bone and soft tissue. He is a member of the UCSF Musculoskeletal Research Group and Musculoskeletal Quantitative Imaging Research (MQIR) interdisciplinary research group at UCSF. "The technology is ideal for treating the musculoskeletal system because disease processes within muscles and bones can be easily targeted and generally don't move (with the exception of the ribs)," said Dr. Bucknor in an interview with the Focused Ultrasound Foundation.

As a clinical researcher, Dr. Bucknor is also interested in oncology, and has thus far made significant contributions in the field of focused ultrasound cancer therapy beyond the musculoskeletal system. In his work, he is focused on research that directly impacts the care of cancer patients in the near term. This includes focused ultrasound to promote anti-tumor immune response effects and a trial of pre-operative MR-guided focused ultrasound for patients with soft tissue sarcomas.

Recognizing the importance of understanding the real-world value of novel therapeutic techniques, Dr. Bucknor was recently first author on a study to determine if magnetic resonance-guided focused ultrasound (MRgFUS) is cost-effective compared with medication, for refractory pain from bone metastases in the U.S. He, along with scientists from Stanford Radiology, University of Sao Paulo and the Department of Radiology at Maimonides Medical Center, constructed a Markov state transition to model costs, outcomes and cost-effectiveness. Their base-case analysis, published in the International Journal of Technology Assessment in Health Care (PubMed), determined that MRgFUS was the preferred strategy, but it also determined the crossover point at which Medication Only would instead become the preferred strategy. 

Dr. Bucknor collaborates with other investigators both at UCSF and beyond to combine focused ultrasound with novel immunotherapies to improve patient outcomes. It is this work that earned him the Andrew J. Lockhart Memorial Prize in 2020 by the Focused Ultrasound Foundation along with Pejman Ghanouni, MD, PhD from Stanford University with whom Dr. Bucknor worked with during his musculoskeletal radiology fellowship.

Dr. Bucknor and his team continue to pioneer a whole range of new uses for focused ultrasound technology including treatments for desmoid tumors, bone metastases, osteoid osteomas and sarcomas. He is joined in his lab by Eugene Ozhinsky, PhD, assistant adjunct professor and MRI physicist. For more information on the Focused Ultrasound (HIFU) Lab, visit their page

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