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. 2018 Feb;44(2):E11.
doi: 10.3171/2017.11.FOCUS17613.

Magnetic resonance-guided interstitial high-intensity focused ultrasound for brain tumor ablation

Jacquelyn MacDonell  1   2 , Niravkumar Patel  3 , Sebastian Rubino  1   2 , Goutam Ghoshal  4 , Gregory Fischer  3 , E Clif Burdette  4 , Roy Hwang  1 , Julie G Pilitsis  1   2
Affiliations

Magnetic resonance-guided interstitial high-intensity focused ultrasound for brain tumor ablation

Jacquelyn MacDonell et al. Neurosurg Focus. 2018 Feb.

Abstract

Currently, treatment of brain tumors is limited to resection, chemotherapy, and radiotherapy. Thermal ablation has been recently explored. High-intensity focused ultrasound (HIFU) is being explored as an alternative. Specifically, the authors propose delivering HIFU internally to the tumor with an MRI-guided robotic assistant (MRgRA). The advantage of the authors' interstitial device over external MRI-guided HIFU (MRgHIFU) is that it allows for conformal, precise ablation and concurrent tissue sampling. The authors describe their workflow for MRgRA HIFU delivery.

Keywords: DOF = degrees of freedom; GBM = glioblastoma; HIFU = high-intensity focused ultrasound; LITT = laser interstitial thermal therapy; MRI guided; MRIT = MRI thermometry; MRgHIFU = MRI-guided HIFU; MRgRA = MRI-guided robot assistant; SRS = stereotactic radiosurgery; brain tumor; high-intensity focused ultrasound; neural ablation.

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Figures

FIG. 1
FIG. 1
Interstitial HIFU utilizes probes that can have multiple transducers in a linear array, allowing for conformal ablation. A: Four probes lined up each with an increasing number of transducers. B: Simulated ablative pattern for 360° transducer scale showing degrees in Celsius. C: TheraVision software is an image-guided ultrasound ablation system that activates the applicator and can monitor the thermal energy emitted by each transducer. D: MRIT allows for real-time monitoring of thermal distribution, reducing damage to adjacent structures. Scale shows degrees in Celsius.
FIG. 2
FIG. 2
The Leksell Stereotactic System from Elekta (left) and the robotic manipulator (right) showing motion capabilities. The robotic manipulator is slid into the guiding rails and locked in place with a thumb screw. The robot registration frame is attached to the robot base and does not need to be mounted/unmounted for each procedure.
FIG. 3
FIG. 3
Triphenyltetrazolium chloride–stained coronal brain slices. The lighter area depicts infarct, and the darker area depicts viable tissue. Area of ablation outlined in the image on the right.
See this image and copyright information in PMC

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