Neurosurgery; DOI:10.1227/01.NEU.0000360379.95800.2F
OBJECTIVE: This work evaluated the clinical feasibility of transcranial magnetic resonance imaging–guided focused ultrasound surgery.
METHODS: Transcranial magnetic resonance imaging–guided focused ultrasound surgery offers a potential noninvasive alternative to surgical resection. The method combines a hemispherical phased-array transducer and patient-specific treatment planning based on acoustic models with feedback control based on magnetic resonance temperature imaging to overcome the effects of the cranium and allow for controlled and precise thermal ablation in the brain. In initial trials in 3 glioblastoma patients, multiple focused ultrasound exposures were applied up to the maximum acoustic power available. Offline analysis of the magnetic resonance temperature images evaluated the temperature changes at the focus and brain surface.
RESULTS: We found that it was possible to focus an ultrasound beam transcranially into the brain and to visualize the heating with magnetic resonance temperature imaging. Although we were limited by the device power available at the time and thus seemed to not achieve thermal coagulation, extrapolation of the temperature measurements at the focus and on the brain surface suggests that thermal ablation will be possible with this device without overheating the brain surface, with some possible limitation on the treatment envelope.
CONCLUSION: Although significant hurdles remain, these findings are a major step forward in producing a completely noninvasive alternative to surgical resection for brain disorders.
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Copyright © 2010 by the Congress of Neurological Surgeons
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Clinic Ultrasound Laboratory (クレメント超音波研究室)
Cleveland Clinic (クリーブランド・クリニック),
Lerner Research Institute
Case Western Reserve University
© 2014
For a comprehensive listing see PUBLICATIONS
Clement GT, Nomura H, Adachi H, Kamakura T, Feasibility of non-contact ultrasound for medical imaging, Physics in Medicine and Biology 2014; 58: 6263-6278
Tang SC, Jolesz FA, Clement GT. A Wireless Batteryless Implantable Ultrasonic Pulser-Receiver. IEEE Trans Ultrason Ferroelectr Freq Control 2011;58:1211-21.
Paltiel HJ, Padua HM, Gargollo PC, Cannon GM Jr, Alomari AI, Yu R, Clement GT. Volumetric ultrasound imaging of tissue perfusion: preliminary results in a rabbit model... Phys Med Biol 2011;56:2183-97.
McDannold N, Clement GT, Black P, Jolesz F, Hynynen K. Focused ultrasound surgery of brain tumors: Initial findings in three patients. Neurosurgery 2010;66:323-32; discussion 332.
Clement GT, Hynynen K. A non-invasive method for focusing ultrasound through the human skull. Phys Med Biol 2002;47(8):1219-36.