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Nonthermal ablation with microbubble-enhanced focused ultrasound close to the optic tract without affecting nerve
Nathan McDannold1, Yong-Zhi Zhang, Chanikarn Power
1Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Journal of Neurosurgery
|September 10, 2013
Summary
Focused ultrasound (FUS) combined with microbubbles enables noninvasive ablation of deep brain tumors. This method creates precise lesions while preserving function in adjacent critical nerves.
Area of Science:
- Neurosurgery
- Oncology
- Biomedical Engineering
Background:
- Skull base tumors pose significant resection and radiosurgery challenges due to proximity to critical neural and vascular structures.
- Minimally invasive thermal ablation techniques, including focused ultrasound (FUS), are being explored for brain tumor treatment.
- Current FUS technology is limited by skull heating, restricting its application to regions distant from the skull bone.
Purpose of the Study:
- To evaluate a novel method combining focused ultrasound (FUS) with microbubble-based ultrasound contrast agents for targeted thermal ablation.
- To determine if this technique can circumvent skull heating limitations and enable ablation of deep brain structures.
- To assess the safety and efficacy of this approach in preserving adjacent neural structures.
Main Methods:
- Focused ultrasound (FUS) transducer applied to ablate skull base tissue targets in 29 rats.
- Low-intensity ultrasound exposures administered after intravenous injection of an ultrasound contrast agent (Definity).
- Histological analysis and visual evoked potential (VEP) measurements used to assess structural and functional damage to the optic tract and chiasm.
Main Results:
- Well-defined lesions were created in gray matter targets with minimal to no damage to adjacent optic tracts and chiasms.
- No significant changes in VEP recordings (magnitude or latency) were observed immediately or up to 4 weeks post-sonication.
- Histological examination revealed no delayed adverse effects in the optic nerve and retina.
Conclusions:
- The microbubble-targeted FUS technique shows promise for noninvasive, precise lesion creation in deep brain structures.
- This method effectively preserves the function of adjacent nerves by concentrating ultrasound effects on vasculature.
- Further research is needed for procedural monitoring and safety validation at deeper targets, but it offers a potential solution for FUS ablation while sparing nerves.
