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Intracranial Applications of MR Imaging-Guided Focused Ultrasound
N Khanna1, D Gandhi1, A Steven1
1From the Department of Diagnostic Radiology and Nuclear Medicine (N.K., D.G., A.S., V.F., E.R.M.).
AJNR. American Journal of Neuroradiology
|August 20, 2016
Summary
Focused ultrasound, initially for cancer treatment, now offers noninvasive therapeutic applications. Its pulsed or continuous waves enable thermal ablation or mechanical effects like blood-brain barrier disruption for enhanced drug delivery.
Area of Science:
- Medical Physics
- Biotechnology
- Neurosurgery
Background:
- Focused ultrasound (FUS) was initially developed for treating prostate cancer and uterine fibroids.
- Advancements in overcoming transcranial acoustic wave distortion have expanded FUS applications.
- FUS utility is based on focal energy deposition through acoustic wave propagation.
Purpose of the Study:
- To explore the expanded role and mechanisms of focused ultrasound in various medical applications.
- To discuss the physical characteristics and biophysical mechanisms of FUS at the tissue level.
- To highlight current and emerging applications of FUS, emphasizing its noninvasive nature.
Main Methods:
- Utilizing high-intensity continuous exposure for thermal ablation, inducing coagulative necrosis.
- Employing high-intensity pulsed application for mechanical effects, including blood-brain barrier (BBB) disruption.
- Investigating low-intensity pulsed exposures for influencing neuronal activity while preserving cytoarchitecture.
Main Results:
- High-intensity continuous FUS causes thermal ablation and tissue necrosis.
- High-intensity pulsed FUS induces reversible BBB disruption, enhancing neurotherapeutic delivery.
- Low-intensity pulsed FUS can modulate neuronal activity without structural damage.
Conclusions:
- Focused ultrasound is a versatile, noninvasive modality with expanding therapeutic potential.
- FUS offers distinct effects (thermal ablation, mechanical disruption, neuronal modulation) based on its parameters.
- Its radiation-free, high-resolution characteristics position FUS favorably against other medical imaging and treatment techniques.
