Wednesday, June 24, 2009

Brain Surgery With MR Guided High Intensity Focused Ultrasound

Filed under: Neurological Surgery , Radiation Oncology , Radiology


Performing tumor ablations in the brain can be a very risky venture since getting to the diseased site requires avoiding blood vessels and fragile tissue. Radiation therapy has become a common alternative to going invasive, but it suffers from unnecessary radiation exposure to the patient. High intensity focused ultrasound (HIFU), a technology already commonly used for uterine fibroids, has been looked at as a possible alternative for intracranial ablations. Now clinicians at the University Children's Hospital Zurich successfully performed the first transcranial MR guided HIFU procedure.

From the University of Zurich:

The HIFU system ExAblate® 4000, developed by the cooperation partner InSightec, Tirat Carmel Israel, has been combined with a 3 Tesla high field GE MR-scanner. The two systems together provide a platform for image-guided, non-invasive interventions. Since September 2008 ten patients were treated at the Children's Hospital Zurich with this new neurosurgical procedure in the context of a clinical study. All interventions were completed successfully and without complications. This novel technology now opens up new horizons allowing to develop non-invasive intervention procedures for a variety of brain diseases including brain tumors.

The whole surgical procedure is planned and monitored in real time by magnetic resonance imaging (MRI). The HIFU beams produced by 1024 transducers are transferred through the intact skull of the patient into the brain and concentrated onto a focus of 3 to 4 millimeters in diameter. Thus, sharply defined targets deep inside the brain are coagulated by heating them up to a focal temperature of 60 degrees Celsius. The temperature increase during the sequential "sonications", each lasting 10 to 20 seconds, is continuously displayed and controlled on precise MR-temperature distribution maps. The whole surgical procedure lasts several hours and is performed without anaesthesia. Patients are awake and fully conscious during the intervention.

The following video of ExAblate Brain device treatment has been released by the company:

Press release: Successful neurosurgery with transcranial MR-guided high-intensity focused ultrasound

InSightec's HIFU brain surgery info page...

Flashbacks: FDA Expands Indication for Insightec's Uterine Fibroid System ; Ultrasound That Seals Punctured Lungs; Noninvasive Palliation of Pain of Bone Mets; ExAblate Making Waves in US; ExAblate 2000

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replies: 4 comments
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One of the very interesting aspects of this technology is how they us a cranial CT to map skull densities and adjust the transducers in the ultrasound array to focus on the target lesion.


Posted by: medphysphd
on June 24, 2009 09:44 AM GMT

One of the very interesting aspects of this technology is how they us a cranial CT to map skull densities and adjust the transducers in the ultrasound array to focus on the target lesion.


Posted by: medphysphd
on June 24, 2009 09:55 AM GMT

This is really amazing technology which should revolutionize treatment of brain tumors, including both primary and malignant tumors.
It could be utilized both to open up the BBB for chemotherapeutic agents and to actually heat up tumors to destroy them.
Treating radiation resistant tumors might be possible.
Treating meningiomas may also be possible. They probably have some of the same characteristics of uterine fibroids, slow growing solid tumors, which are not malignant.
Also possibly treating epileptic foci might be possible in some cases.


Posted by: Steven Brenner
on November 5, 2009 09:32 PM GMT

This is really amazing technology which should revolutionize treatment of brain tumors, including both primary and malignant tumors.
It could be utilized both to open up the BBB for chemotherapeutic agents and to actually heat up tumors to destroy them.
Treating radiation resistant tumors might be possible.
Treating meningiomas may also be possible. They probably have some of the same characteristics of uterine fibroids, slow growing solid tumors, which are not malignant.
Also possibly treating epileptic foci might be possible in some cases.


Posted by:
on November 5, 2009 09:35 PM GMT

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