Magnetic Resonance Imaging-Guided, High-Intensity Focused Ultrasound for Brain Tumor Therapy

Ram, Zvi; Cohen, Zvi; Harnof, Sagi; Tal, Sigal; Faibel, Meir; Nass, Dvora; Maier, Stephan E.; Hadani, Moshe; Mardor, Yael

doi:10.1227/01.neu.0000254439.02736.d8

Cited by 171 publications

(58 citation statements)

References 15 publications

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“…Three patients with recurrent glioblastoma multiforme after craniotomy were subsequently treated, with 2 patients experiencing survival of greater than 30 months. (39) In this experiment sharply defined lesions were observed, similar to those seen by Lynn and Fry, and MR-imaging changes were demonstrated during the treatment. A current study at the Brigham and Women's Hospital is examining the effectives of MR-guided HIFU (MRgHIFU) treatment for glioma patients without performing a craniotomy.…”

Section: Tissue Ablationsupporting

confidence: 84%

High-Intensity Focused Ultrasound Surgery of the Brain

et al. 2009

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The field of MRI-guided high intensity focused ultrasound surgery (MRgFUS) is a rapidly evolving one with many potential applications in neurosurgery. This is the first of three articles on MRgFUS, this paper focuses on the historical development of the technology and it's potential applications to modern neurosurgery. The evolution of MRgFUS has occurred in parallel with modern neurological surgery and the two seemingly distinct disciplines share many of the same pioneering figures. Early studies on focused ultrasound treatment in the 1940's and 1950's demonstrated the ability to perform precise lesioning in the human brain, with a favorable risk-benefit profile. However, the need for a craniotomy, as well as lack of sophisticated imaging technology resulted in limited growth of HIFU for neurosurgery. More recently, technological advances, have permitted the combination of HIFU along with MRI guidance to provide an opportunity to effectively treat a variety of CNS disorders. Although challenges remain, HIFU-mediated neurosurgery may offer the ability to target and treat CNS conditions that were previously extremely difficult to perform. The remaining two articles in this series will focus on the physical principles of modern MRgFUS as well as current and future avenues for investigation.

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Section: Tissue Ablationsupporting

confidence: 84%

High-Intensity Focused Ultrasound Surgery of the Brain

et al. 2009

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“…Several groups already reported small series using computer-assisted MgfUS to treat functional and other conditions such as tumors. [1922242528] As computer-assisted MgfUS applications emerge, it is important to study its effects in as real as possible conditions and provide a platform for training and assessing competence in these procedures. Thiel cadavers using Thiel embalmment techniques[3233] provides better and more realistic operative and positioning conditions compared with animal models.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Thiel cadaveric model for MRI-guided stereotactic procedures in neurosurgery

et al. 2014

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Background:Magnetic resonance imaging (MRI)-guided deep brain stimulation (DBS) and high frequency focused ultrasound (FUS) is an emerging modality to treat several neurological disorders of the brain. Developing reliable models to train and assess future neurosurgeons is paramount to ensure safety and adequate training of neurosurgeons of the future.Methods:We evaluated the use of Thiel cadaveric model to practice MRI-guided DBS implantation and high frequency MRI-guided FUS in the human brain. We performed three training sessions for DBS and five sonications using high frequency MRI-guided FUS in five consecutive cadavers to assess the suitability of this model to use in training for stereotactic functional procedures.Results:We found the brains of these cadavers preserved in an excellent anatomical condition up to 15 months after embalmment and they were excellent model to use, MRI-guided DBS implantation and FUS produced the desired lesions accurately and precisely in these cadaveric brains.Conclusion:Thiel cadavers provided a very good model to perform these procedures and a potential model to train and assess neurosurgeons of the future.

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“…On T2-weighted imaging, Zone 1 is hypointense, surrounded by a strongly hyperintense Zone 2 demarcated by a hypointense rim. Zones 1 and 2 represent coagulation necrosis and cytotoxic edema(32–34). Finally, the poorly marginated, slightly hyperintense Zone 3 at the periphery represents vasogenic edema(34,35).…”

Section: Mrghifu Applicationsmentioning

confidence: 99%

“…Thermal ablation of gliomas was performed in three patients who had local recurrence after standard surgical resection and radiation therapy(32). These FUS procedures were carried out through a craniotomy to create an acoustic window, with 50% of the enhancing tumor volume ablated in one patient, and resolution of nearly all tumoral enhancement in a second.…”

Section: Mrghifu Applicationsmentioning

confidence: 99%

Transcranial MRI-Guided Focused Ultrasound: A Review of the Technologic and Neurologic Applications

Ghanouni

Pauly

Elias

et al. 2015

American Journal of Roentgenology

191

199

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MR guided focused ultrasound is a new, minimally invasive method of targeted tissue thermal ablation that may be of use to treat central neuropathic pain, essential tremor, Parkinson tremor, and brain tumors. The system has also been used to temporarily disrupt the blood-brain barrier to allow targeted drug delivery to brain tumors. This article reviews the physical principles of MR guided focused ultrasound and discusses current and potential applications of this exciting technology.

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Magnetic Resonance Imaging-Guided, High-Intensity Focused Ultrasound for Brain Tumor Therapy

Cited by 171 publications

References 15 publications

High-Intensity Focused Ultrasound Surgery of the Brain

High-Intensity Focused Ultrasound Surgery of the Brain

Evaluation of Thiel cadaveric model for MRI-guided stereotactic procedures in neurosurgery

Transcranial MRI-Guided Focused Ultrasound: A Review of the Technologic and Neurologic Applications

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