J Korean Med Sci.  2018 Oct;33(44):e279. 10.3346/jkms.2018.33.e279.

Magnetic Resonance-Guided Focused Ultrasound in Neurosurgery: Taking Lessons from the Past to Inform the Future

• Jung NY
• Chang JW

• KMID: 2423024
• DOI: http://doi.org/10.3346/jkms.2018.33.e279

Abstract

Magnetic resonance-guided focused ultrasound (MRgFUS) is a new emerging neurosurgical procedure applied in a wide range of clinical fields. It can generate high-intensity energy at the focal zone in deep body areas without requiring incision of soft tissues. Although the effectiveness of the focused ultrasound technique had not been recognized because of the skull being a main barrier in the transmission of acoustic energy, the development of hemispheric distribution of ultrasound transducer phased arrays has solved this issue and enabled the performance of true transcranial procedures. Advanced imaging technologies such as magnetic resonance thermometry could enhance the safety of MRgFUS. The current clinical applications of MRgFUS in neurosurgery involve stereotactic ablative treatments for patients with essential tremor, Parkinson's disease, obsessive-compulsive disorder, major depressive disorder, or neuropathic pain. Other potential treatment candidates being examined in ongoing clinical trials include brain tumors, Alzheimer's disease, and epilepsy, based on MRgFUS abilities of thermal ablation and opening the blood-brain barrier. With the development of ultrasound technology to overcome the limitations, MRgFUS is gradually expanding the therapeutic field for intractable neurological disorders and serving as a trail for a promising future in noninvasive and safe neurosurgical care.

Keyword

High-Intensity Focused Ultrasound Ablation; Magnetic Resonance Imaging; Ablation; Neurological Disorder; Neurosurgical Procedure

MeSH Terms

Acoustics
Alzheimer Disease
Blood-Brain Barrier
Brain Neoplasms
Depressive Disorder, Major
Epilepsy
Essential Tremor
High-Intensity Focused Ultrasound Ablation
Humans
Magnetic Resonance Imaging
Nervous System Diseases
Neuralgia
Neurosurgery*
Neurosurgical Procedures
Obsessive-Compulsive Disorder
Parkinson Disease
Skull
Thermometry
Transducers
Ultrasonography*