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MR-HIFU is a treatment technique that allows for surgery without incisions. This treatment takes place in an MRI scanner, where ultrasound is focused to create a focal point. This focal point can be used to treat tumor tissue without having to open the skin.

MR-HIFU offers benefits for a wide range of conditions, including the treatment of uterine fibroids and painful bone metastases. The research described in this thesis has contributed to further improvement of the MR-HIFU treatment for these conditions.

Methods have been devised to visualize the progress during MR-HIFU treatments of uterine fibroids without the need for a contrast agent. Additionally, a technique has been developed that uses artificial intelligence to automatically measure the size of fibroids and the uterus in MRI scans. This technique can save time and better inform patients about the results of their treatment.

Finally, a protocol has been written for a randomized study comparing the effectiveness of MR-HIFU with radiation therapy for the treatment of painful bone metastases. Six hospitals from four European countries are participating in this study.

The studies in this thesis clarify the role of MR-HIFU in the care pathway for uterine fibroids and bone metastases. This is necessary to eventually be able to provide MR-HIFU and its beneficial properties to a large group of patients through reimbursement by health insurers.