Document Detail


Magnetic resonance imaging-guided focused ultrasound for thermal ablation in the brain: a feasibility study in a swine model.
MedLine Citation:
PMID:  17415195     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Magnetic resonance imaging (MRI)-guided focused ultrasound is a novel technique that was developed to enable precise, image-guided targeting and destruction of tumors by thermocoagulation. The system, ExAblate2000, is a focused ultrasound delivery system embedded within the MRI bed of a conventional diagnostic MRI scanner. The device delivers small volumetric sonications from an ultrasound phased array transmitter that converge energy to selectively destroy the target. Temperature maps generated by the MRI scanner verify the location and thermal rise as feedback, as well as thermal destruction. To assess the safety, feasibility, and precision of this technology in the brain, we have used the ExAblate system to create predefined thermal lesions in the brains of pigs. METHODS: Ten pigs underwent bilateral craniectomy to provide a bone window for the ultrasound beams. Seven to 10 days later, the animals were anesthetized and positioned in the ExAblate system. A predefined, 1-cm frontal para ventricular region was delineated as the target and treated with multiple sonications. MRI was performed immediately and 1 week after treatment. The animals were then sacrificed and the brains removed for pathological study. The size of individual sonication points and the location of the lesion were compared between the planned dose maps, posttreatment MRI scans, and pathological specimen. RESULTS: High-energy sonications led to precise coagulation necrosis of the specified targets as shown by subsequent MRI, macroscopic, and histological analysis. The thermal lesions were sharply demarcated from the surrounding brain with no anatomic or histological abnormalities outside the target. CONCLUSION: MRI-guided focused ultrasound proved a precise and an effective means to destroy anatomically predefined brain targets by thermocoagulation with minimal associated edema or damage to adjacent structures. Contrast-enhanced T1-, T2-, and diffusion-weighted MRI scans may be used for real-time assessment of tissue destruction.
Authors:
Zvi R Cohen; Jacob Zaubermann; Sagi Harnof; Yael Mardor; Dvora Nass; Eyal Zadicario; Arik Hananel; David Castel; Meir Faibel; Zvi Ram
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  60     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-06     Completed Date:  2007-05-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  593-600; discussion 600     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Sheba Medical Center, Tel Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Animals
Brain / anatomy & histology*,  physiology*
Brain Diseases / pathology,  therapy
Equipment Design
Equipment Failure Analysis
Feasibility Studies
Hyperthermia, Induced / instrumentation,  methods
Magnetic Resonance Imaging / instrumentation*,  methods*
Swine
Ultrasonic Therapy / instrumentation*,  methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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