Related Experiment Video
Updated: Jul 22, 2026
14:10
Contrast Ultrasound Targeted Treatment of Gliomas in Mice via Drug-Bearing Nanoparticle Delivery and Microvascular Ablation
Published on: December 15, 2010
16.1K
Skull Lesions after MR-Guided High-Intensity Focused Ultrasound: A Case Series
Nolan H Dang1, Drew S Kern2,3, Justin M Honce4
1From the School of Medicine (N.H.D.), University of Colorado Anschutz Medical Campus, Aurora, Colorado.
AJNR. American Journal of Neuroradiology
|August 8, 2025
Summary
Skull lesions can occur after transcranial MR-guided high-intensity focused ultrasound (HIFUS) ablation for essential tremor and Parkinson's disease. Radiologists must recognize these asymptomatic findings to avoid misdiagnosis of metastatic disease.
Area of Science:
- Radiology
- Neurology
- Medical Physics
Background:
- Transcranial MR-guided high-intensity focused ultrasound (HIFUS) is used for essential tremor and Parkinson's disease.
- Skull marrow lesions are a potential post-treatment complication that can mimic metastatic disease.
Purpose of the Study:
- To investigate the incidence and characteristics of skull lesions following HIFUS ablation.
- To determine factors associated with the development of these lesions.
- To inform radiologists about this imaging finding to prevent misdiagnosis.
Main Methods:
- Retrospective study of 10 patients undergoing delayed post-treatment MRI.
- Analysis of immediate (<24 hours) and delayed (weeks to months) MRI scans.
- Comparison of energy delivered and skull density ratio (SDR) between patients with and without skull lesions.
Main Results:
- Four out of 10 patients developed skull lesions on delayed MRI; none were present on immediate scans.
- Skull lesions were heterogeneous and prompted metastatic workup in one patient.
- Patients with lesions received significantly higher maximum and total energy and had lower SDR (p<0.01).
Conclusions:
- Skull lesions after HIFUS ablation are typically asymptomatic and linked to higher acoustic energies.
- Recognition of these lesions is crucial for radiologists to avoid unnecessary investigations for metastatic disease.
- Further research is needed to minimize skull heating and understand the long-term clinical significance.
