Magnetic Resonance Guided High Intensity Focused Ultrasound in Advanced Pancreatic Adenocarcinoma Treatment

Exclusion Criteria

• •Previous pancreatic surgery
• •Patients with contraindication for MR imaging such as implanted metallic devices that are not MRI-safe, size limitations, claustrophobia, etc.
• •Patients with known intolerance or allergy to MR contrast agent (gadolinium chelates) including advanced kidney disease (GFR \<30 mL/min/1.73 m2) or on dialysis
• •Pregnant and nursing patients will be excluded from the study because of a contraindication to administering MRI contrast agents to these patients
• •Patients unable to receive general anesthesia
• •Target is:
• •1. NOT visible by non-contrast MRI, OR
• •2. NOT accessible to ExAblate device
• •Individuals who are not able or willing to tolerate the required prolonged stationary position during treatment (can be up to 6 hrs of total table time)
• •Patients with acute medical condition (e.g. pneumonia, sepsis) that is expected to hinder them from completing this study
• •Patients with unstable cardiac status including:
• •1. Unstable angina pectoris on medication
• •2. Patients with documented myocardial infarction within six months of protocol entry
• •3. Congestive heart failure requiring medication (other than diuretic)
• •4. Patients on anti-arrhythmic drugs
• •5. Patients with severe hypertension (diastolic BP \> 100 on medication)
• •6. Patients with severe hematologic, neurologic, or other uncontrolled disease (e.g. platelets \< 50,000/microL, INR \> 1.5)
• •Patients who are taking anti-thrombotic medication
• •Severe cerebrovascular disease (multiple CVAs or CVA within 6 months)