Targeted Neurosurgical Interventions: The Role of Neuroimaging in High-Intensity Focused Ultrasound, Laser...

Targeted neurosurgical interventions have evolved substantially during recent decades, with advanced neuroimaging playing a crucial role in their development and clinical implementation. This review is focused on three key minimally invasive neurosurgical techniques-high-intensity focused ultrasound, laser interstitial thermal therapy, and deep brain stimulation-and examines their mechanisms, neuroimaging considerations, anatomic targets, and clinical applications. These techniques represent a paradigm shift from traditional open neurosurgical approaches to more precise, less invasive interventions that target specific anatomic structures or neural circuits. With overlapping clinical applications yet distinct mechanisms, each of these modalities offers unique advantages in the treatment of movement disorders, epilepsy, and other neurologic conditions. This article provides a comprehensive overview of these techniques, with an emphasis on the important role of neuroimaging in planning, guiding, and monitoring these interventions. ^©RSNA, 2026 Supplemental material is available for this article. See the invited commentary by Rodriguez and Riascos in this issue.