Focused Ultrasound Treatment, Present and Future

Area of Science:

• Neurosurgery
• Medical Imaging
• Ultrasound Technology

Background:

• Focused ultrasound's potential for intracranial applications was recognized early but hindered by skull-induced wave attenuation and scattering.
• Magnetic resonance image guided focused ultrasound (MRgFUS) has evolved, successfully treating various non-neurological conditions.
• Advancements in the 21st century have overcome previous limitations, enabling broader clinical use worldwide.

Purpose of the Study:

• To review the current status and future prospects of MRgFUS in neurosurgery.
• To highlight the integration of MRgFUS with imaging modalities for enhanced precision.
• To discuss the potential of MRgFUS for treating intracranial diseases.

Main Methods:

• Utilizing third-generation transcranial focused ultrasound for thermocoagulation.
• Creating intracranial lesions with high precision (1 mm) and controlled dimensions (2-6 mm).
• Employing real-time MR imaging for temperature monitoring, transitioning from reversible to irreversible therapeutic heating.
• Integrating computed tomography (CT) bone imaging with MRI for comprehensive monitoring.

Main Results:

• MRgFUS enables precise creation of intracranial lesions.
• Real-time MR thermometry allows for accurate temperature control during treatment.
• The technology facilitates minimally-invasive procedures with outcomes comparable to conventional brain surgery.
• MRgFUS shows promise for treating epilepsy, brain tumors, and other cranial conditions.

Conclusions:

• MRgFUS represents a significant advancement in minimally-invasive neurosurgery.
• The combination of MRgFUS, CT, and MRI offers a powerful tool for intracranial interventions.
• This technology is poised to revolutionize functional and cranial neurosurgery, expanding treatment options for complex neurological disorders.