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Evangelia Tsolaki, Angela Downes, William Speier, W Jeff Elias, Nader Pouratian
Magnetic Resonance-guided Focused UltraSound (MRgFUS) offers an incisionless approach to treat essential tremor (ET). Due to lack of evident internal anatomy on traditional structural imaging, indirect targeting must still be used to localize the lesion. Here, we investigate the potential predictive value of probabilistic tractography guided thalamic targeting by defining how tractography-defined targets, lesion size and location, and clinical outcomes interrelate. MR imaging and clinical outcomes from 12 ET patients that underwent MRgFUS thalamotomy in a pilot study at the University of Virginia were evaluated in this analysis...
2018: NeuroImage: Clinical
Anna Maria Ierardi, Valeria Savasi, Salvatore Alessio Angileri, Mario Petrillo, Sara Sbaraini, Antonio Pinto, Francesco Hanozet, Anna Maria Marconi, Gianpaolo Carrafiello
Uterine fibroids are the most common benign pelvic tumor of the female genital tract and tend to increase with age; they cause menorrhagia, dysmenorrhea, pelvic pressure symptoms, back pain, and subfertility. Currently, the management is based mainly on medical or surgical approaches. The nonsurgical and minimally invasive therapies are emerging approaches that to the state of the art include uterine artery embolization (UAE), image-guided thermal ablation techniques like magnetic resonance-guided focused ultrasound surgery (MRgFUS) or radiofrequency ablation (RF), and percutaneous microwave ablation (PMWA)...
2018: BioMed Research International
Piotr Szkodziak, Filip Szkodziak, Kamila Trzeciak, Piotr Czuczwar
Uterine fibroids are benign uterine tumors. In women during the reproductive period, uterine fibroids occur in about 25%, whereas after this time, they are observed in more than 40% of women. In the majority of women (about 20-50%), such tumors do not cause discomfort and do not require treatment. Asymptomatic uterine fibroids usually undergo only regular medical control, whereas symptomatic fibroids are an indication for treatment. Current treatment methods include surgical, pharmacological and minimally invasive treatment...
December 2017: Przeglad Menopauzalny, Menopause Review
Daniel Coluccia, Carlyn A Figueiredo, Megan YiJun Wu, Alexandra N Riemenschneider, Roberto Diaz, Amanda Luck, Christian Smith, Sunit Das, Cameron Ackerley, Meaghan O'Reilly, Kullervo Hynynen, James T Rutka
Glioblastoma (GBM) is the most common and aggressive primary brain tumor resulting in high rates of morbidity and mortality. A strategy to increase the efficacy of available drugs and enhance the delivery of chemotherapeutics through the blood brain barrier (BBB) is desperately needed. We investigated the potential of Cisplatin conjugated gold nanoparticles (GNP-UP-Cis) in combination with MR-guided Focused Ultrasound (MRgFUS) to intensify GBM treatment. Viability assays demonstrated that GNP-UP-Cis greatly inhibits the growth of GBM cells compared to free cisplatin and shows marked synergy with radiation therapy...
February 19, 2018: Nanomedicine: Nanotechnology, Biology, and Medicine
Joseph Corea, Patrick Ye, Dongjin Seo, Kim Butts-Pauly, Ana Claudia Arias, Michael Lustig
In magnetic resonance guided focused ultrasound (MRgFUS) therapy sound waves are focused through the body to selectively ablate difficult to access lesions and tissues. A magnetic resonance imaging (MRI) scanner non-invasively tracks the temperature increase throughout the tissue to guide the therapy. In clinical MRI, tightly fitted hardware comprised of multichannel coil arrays are required to capture high quality images at high spatiotemporal resolution. Ablating tissue requires a clear path for acoustic energy to travel but current array materials scatter and attenuate acoustic energy...
February 21, 2018: Scientific Reports
Laure Bretsztajn, Wladyslaw Gedroyc
Magnetic resonance-guided focused ultrasound surgery (MRgFUS) allows for precise non-invasive thermal ablation of target tissues for a wide range of clinical applications. It is an innovative and rapidly expanding technology which has already established itself as an effective and safe incisionless alternative in the treatment of various soft tissue tumours, with many more research studies underway to extend its therapeutic envelope. The non-invasiveness of the procedure makes FUS particularly attractive in functional neurosurgery, where existing treatment options are not suitable for all patients...
February 8, 2018: British Journal of Radiology
David S Hersh, Pavlos Anastasiadis, Ali Mohammadabadi, Ben A Nguyen, Sijia Guo, Jeffrey A Winkles, Anthony J Kim, Rao Gullapalli, Asaf Keller, Victor Frenkel, Graeme F Woodworth
Generating spatially controlled, non-destructive changes in the interstitial spaces of the brain has a host of potential clinical applications, including enhancing the delivery of therapeutics, modulating biological features within the tissue microenvironment, altering fluid and pressure dynamics, and increasing the clearance of toxins, such as plaques found in Alzheimer's disease. Recently we demonstrated that ultrasound can non-destructively enlarge the interstitial spaces of the brain ex vivo. The goal of the current study was to determine whether these effects could be reproduced in the living brain using non-invasive, transcranial MRI-guided focused ultrasound (MRgFUS)...
2018: PloS One
Na Young Jung, Chang Kyu Park, Won Seok Chang, Hyun Ho Jung, Jin Woo Chang
OBJECTIVE Although neurosurgical procedures are effective treatments for controlling involuntary tremor in patients with essential tremor (ET), they can cause cognitive decline, which can affect quality of life (QOL). The purpose of this study is to assess the changes in the neuropsychological profile and QOL of patients following MR-guided focused ultrasound (MRgFUS) thalamotomy for ET. METHODS The authors prospectively analyzed 20 patients with ET who underwent unilateral MRgFUS thalamotomy at their institute in the period from March 2012 to September 2014...
February 2018: Neurosurgical Focus
Layton Lamsam, Eli Johnson, Ian D Connolly, Max Wintermark, Melanie Hayden Gephart
Magnetic resonance-guided focused ultrasound (MRgFUS) has been used extensively to ablate brain tissue in movement disorders, such as essential tremor. At a lower energy, MRgFUS can disrupt the blood-brain barrier (BBB) to allow passage of drugs. This focal disruption of the BBB can target systemic medications to specific portions of the brain, such as for brain tumors. Current methods to bypass the BBB are invasive, as the BBB is relatively impermeable to systemically delivered antineoplastic agents. Multiple healthy and brain tumor animal models have suggested that MRgFUS disrupts the BBB and focally increases the concentration of systemically delivered antitumor chemotherapy, immunotherapy, and gene therapy...
February 2018: Neurosurgical Focus
Maya Harary, Walid I Essayed, Pablo A Valdes, Nathan McDannold, G Rees Cosgrove
OBJECTIVE Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy was recently approved for use in the treatment of medication-refractory essential tremor (ET). Previous work has described lesion appearance and volume on MRI up to 6 months after treatment. Here, the authors report on the volumetric segmentation of the thalamotomy lesion and associated edema in the immediate postoperative period and 1 year following treatment, and relate these radiographic characteristics with clinical outcome. METHODS Seven patients with medication-refractory ET underwent MRgFUS thalamotomy at Brigham and Women's Hospital and were monitored clinically for 1 year posttreatment...
February 2018: Neurosurgical Focus
Maya Harary, David J Segar, Kevin T Huang, Ian J Tafel, Pablo A Valdes, G Rees Cosgrove
Focused ultrasound (FUS) has been under investigation for neurosurgical applications since the 1940s. Early experiments demonstrated ultrasound as an effective tool for the creation of intracranial lesions; however, they were limited by the need for craniotomy to avoid trajectory damage and wave distortion by the skull, and they also lacked effective techniques for monitoring. Since then, the development and hemispheric distribution of phased arrays has resolved the issue of the skull and allowed for a completely transcranial procedure...
February 2018: Neurosurgical Focus
Nasser Mohammed, Devi Patra, Anil Nanda
OBJECTIVE Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel technique that uses high-intensity focused ultrasound to achieve target ablation. Like a lens focusing the sun's rays, the ultrasound waves are focused to generate heat. This therapy combines the noninvasiveness of Gamma Knife thalamotomy and the real-time ablation of deep brain stimulation with acceptable complication rates. The aim of this study was to analyze the overall outcomes and complications of MRgFUS in the treatment of essential tremor (ET)...
February 2018: Neurosurgical Focus
Shintaro Ichikawa, Utaroh Motosugi, Makiko Omori, Katsuhiro Sano, Yoshie Omiya, Shuji Hirata, Hiroshi Onishi
We evaluated the value of magnetic resonance elastography (MRE) for the prediction of response to magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids. Eleven patients were enrolled. A fractional change of >30% in Symptoms Severity Score (SSS) was defined as a 'substantial symptomatic improvement' at 12 months after treatment. The fractional stiffness value reduction in the patients with a substantial improvement in SSS was significantly higher than that in those without (P = 0.0446)...
January 18, 2018: Magnetic Resonance in Medical Sciences: MRMS
Senay Mihcin, Andreas Melzer
Focused ultrasound (FUS/HIFU) relies on ablation of pathological tissues by delivering a sufficiently high level of acoustic energy in situ of the human body. Magnetic Resonance guided FUS (MRgFUS/HIFU) and Ultrasound guided (USgFUS/HIFU) are image guided techniques combined with therapeutic FUS for monitoring purposes. The principles and technologies of FUS/HiFU are described in this paper including the basics of MR guidance techniques and MR temperature mapping. Clinical applications of FUS/HIFU gained CE and FDA approvals for the treatment of various benign and few malignant lesions in the last two decades...
January 18, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Young Goo Kim, Eun Jung Kweon, Won Seok Chang, Hyun Ho Jung, Jin Woo Chang
Transcranial magnetic resonance-guided focused ultrasound (MRgFUS) surgery has recently gained favor as a novel, noninvasive alternative to conventional neurosurgery. In contrast to traditional ablative interventions, transcranial MRgFUS surgery is entirely imaging-guided and uses continuous temperature measurements at the target and surrounding tissue taken in real-time. Unlike Gamma Knife radiosurgery, MRgFUS surgery can make a lesion immediately and does not use ionizing radiation. Moreover, since no metallic device is implanted, MR imaging-based diagnosis is not restricted throughout life...
2018: Progress in Neurological Surgery
Allison H Payne, Gregory W Hawryluk, Yoshimi Anzai, Henrik Odéen, Megan A Ostlie, Ethan C Reichert, Amanda J Stump, Satoshi Minoshima, Donna J Cross
Spinal cord injury (SCI) affects thousands of people every year in the USA, and most patients are left with some permanent paralysis. Therapeutic options are limited and only modestly affect outcome. To address this issue, we used magnetic resonance imaging-guided focused ultrasound (MRgFUS) as a non-invasive approach to increase permeability in the blood-spinal cord barrier (BSCB). We hypothesize that localized, controlled sonoporation of the BSCB by MRgFUS will aid delivery of therapeutics to the injury. Here, we report our preliminary findings for the ability of MRgFUS to increase BSCB permeability in the thoracic spinal cord of a normal rat model...
December 2017: Neural Regeneration Research
Roy Mashiach, Yael Inbar, Jaron Rabinovici, Aya Mohr Sasson, Aviva Alagem-Mizrachi, Ronit Machtinger
OBJECTIVE: Intracavitary uterine fibroids and fibroids that distort the uterine cavity are associated with excessive vaginal bleeding and infertility. While intracavitary fibroids smaller than 4 cm are usually treated safely by operative hysteroscopy, larger fibroids may require multiple surgeries or more extensive surgery with possible damage to the integrity of the uterine wall. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a noninvasive approach for treating uterine fibroids, mainly the intramural type...
February 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ying Meng, Yuexi Huang, Benjamin Solomon, Kullervo Hynynen, Nadia Scantlebury, Michael L Schwartz, Nir Lipsman
Essential tremor (ET) is the most common type of tremor in adults. While ET does not result in decreased life expectancy, the disabilities associated with ET can have a significant impact on quality of life, mood, functional activities, and socialization. Patients suffering from ET not sufficiently treated with first line medications may be eligible for alternative strategies such as deep brain stimulation, radiofrequency ablation, and MRI guided focused ultrasound (MRgFUS). High-intensity MRgFUS is an emerging modality to treat ET, its attraction for patients being that it is noninvasive and associated with short recovery time, as patients are home the day after treatment...
December 13, 2017: Journal of Visualized Experiments: JoVE
Christopher R Dillon, Alexis Farrer, Hailey McLean, Scott Almquist, Douglas Christensen, Allison Payne
PURPOSE: This study validates that phase aberrations in breast magnetic resonance-guided focused ultrasound (MRgFUS) therapies can be corrected in a clinically relevant time frame to generate more intense, smaller and more spatially accurate foci. MATERIALS AND METHODS: Hybrid Angular Spectrum (HAS) ultrasound calculations in an MRI-based tissue model were used to compute phase aberration corrections for improved experimental MRgFUS heating in four heterogeneous breast-mimicking phantoms (N = 18 total locations)...
December 26, 2017: International Journal of Hyperthermia
Hans Weber, Pejman Ghanouni, Aurea Pascal-Tenorio, Kim Butts Pauly, Brian A Hargreaves
PURPOSE: To explore the temperature-induced signal change in two-dimensional multi-spectral imaging (2DMSI) for fast thermometry near metallic hardware to enable MR-guided focused ultrasound surgery (MRgFUS) in patients with implanted metallic hardware. METHOD: 2DMSI was optimized for temperature sensitivity and applied to monitor focus ultrasound surgery (FUS) sonications near metallic hardware in phantoms and ex vivo porcine muscle tissue. Further, we evaluated its temperature sensitivity for in vivo muscle in patients without metallic hardware...
December 7, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
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