scholarly journals Transcranial Magnetic Resonance-Guided Focused Ultrasound in X-Linked Dystonia-Parkinsonism

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 392
Author(s):  
Roland Dominic G. Jamora ◽  
Wei-Chieh Chang ◽  
Takaomi Taira
Keyword(s):  
Magnetic Resonance ◽  
Scale Score ◽  
Focused Ultrasound ◽  
Botulinum Toxin Injection ◽  
Treatment Options ◽  
The Philippines ◽  
Safety And Efficacy ◽  
Arm Pain ◽  
Oral Medications ◽  
Movement Disorder Society

X-linked dystonia-parkinsonism (XDP) is a neurodegenerative condition found among males with maternal ancestry from Panay Island, Philippines. The treatment options are limited. We report on our experience of three XDP patients who underwent transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) pallidothalamic tractotomy. The three patients were all genetically confirmed XDP, with a mean XDP-Movement Disorder Society of the Philippines (MDSP) Scale score of 68.7/200. All patients were on stable doses of their oral medications and their last botulinum toxin injection was 12 months prior to study. Two patients complained of moderate to severe arm pain 2–7 months after the procedure. There was an overall improvement in the XDP-MDSP Scale score of 36.2% (18.7 vs. 15) at 6 months and 30.1% (68.7 vs. 45.5) at 1 year. Notably, there was worsening of the nonmotor subscale (part IIIB, nonbehavioral aspect) by 350% at 1 year. While these numbers are encouraging, there is a need to do a larger study on the safety and efficacy of tcMRgFUS on XDP.

scholarly journals Updated Costs of Uterine Fibroid Treatments Including Focused Ultrasound Surgery

2018 ◽  
Author(s):  
Bijan J. Borah ◽  
Elizabeth A. Stewart
Keyword(s):  
Magnetic Resonance ◽  
Focused Ultrasound ◽  
Treatment Options ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Invasive Treatment ◽  
Ultrasound Surgery ◽  
Non Invasive ◽  
Focused Ultrasound Surgery ◽  
Reproductive Age Women

Uterine leiomyomas (fibroids) affect 20–40% of reproductive age women and are the major indication for hysterectomy. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) is a new, potentially disruptive, non-invasive and uterine-sparing treatment option that has been shown to yield similar or better clinical outcomes than other uterine-sparing interventions. However, the costs of MRgFUS and other minimally-invasive treatment options have not been studied using US practice data. This study attempts to fill this void. And since uterine fibroids are the first FDA-approved indication for MRgFUS treatment, this study may also have implications for other indications which are now investigational.

scholarly journals Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU): Overview of Emerging Applications (Part 2)

2019 ◽  
Vol 191 (06) ◽  
pp. 531-539 ◽  
Author(s):  
Florian Siedek ◽  
Sin Yuin Yeo ◽  
Edwin Heijman ◽  
Olga Grinstein ◽  
Grischa Bratke ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Magnetic Resonance ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Treatment Options ◽  
Local Treatment ◽  
Review Literature ◽  
High Intensity Focused Ultrasound ◽  
Malignant Tissue ◽  
Safe Alternative

Background High-intensity focused ultrasound (HIFU) allows noninvasive heating of deep-seated tissues. Guidance under magnetic resonance imaging (MR-HIFU) offers spatial targeting based on anatomical MR images as well as MR-based near-real-time temperature maps. Temperature feedback allows delivery of a well-defined thermal dose enabling new applications such as the ablation of malignant tissue. Methods Peer-reviewed publications on MR-HIFU were studied and are summarized in this review. Literature was restricted to applications in oncology. Results Several MR-HIFU-based applications for the treatment of malignant diseases are currently part of clinical trials or translational research. Recent trials regarding the treatment of prostate cancer with MR-HIFU have already shown this to be a safe and patient-friendly method. For the treatment of breast cancer and malignancies within abdominal organs, MR-HIFU has been applied so far only in proof of concept studies. Conclusion MR-HIFU is currently being investigated for the ablative treatment of malignant tissue in a variety of oncological applications. For example, the transrectal as well as transurethral ablation of prostate cancer using MR-HIFU was shown to be a patient-friendly, safe alternative to other local treatment options with low side effects. Key points:  Citation Format

scholarly journals Magnetic Resonance-guided Focused Ultrasound Treatment for Uterine Fibroids: First Study in Indian Women

2012 ◽  
Vol 2 ◽  
pp. 74 ◽  
Author(s):  
Shrinivas B. Desai ◽  
Abhijit A. Patil ◽  
Rahul Nikam ◽  
Ajinkya S. Desai ◽  
Vrushali Bachhav
Keyword(s):  
Magnetic Resonance ◽  
Adverse Events ◽  
Focused Ultrasound ◽  
Uterine Fibroids ◽  
Ultrasound Surgery ◽  
Indian Women ◽  
Safety And Efficacy ◽  
Focused Ultrasound Surgery ◽  
The Mean

Objectives: To study the results of magnetic resonance-guided focused ultrasound surgery (MRgFUS) treatment carried out on Indian patients in our Hospital. Materials and Methods: Fifty Indian women (mean age = 36.2 ± 8.3 years) were treated for fibroids as outpatients using the ExAblate MRgFUS system (InSightec). Non-perfused volumes (NPVs) were measured immediately after treatment to calculate the treatment outcomes. A validated symptom-specific questionnaire to record their symptoms prior to treatment and six months following treatment was completed by patients. The size of the fibroids was measured on the day of the treatment and during the 6-month checkup to calculate shrinkage. Adverse events during and following treatment were recorded and monitored. Results: The average NPV ratio measured after the treatment was 88% ± 6%, indicative of high ablated fibroid tissue. Prior to treatment, the mean Symptoms Severity Score was 56.9 ± 4.8 (n = 50), which is indicative of highly symptomatic patients. Six months following treatment, there was an average fibroid shrinkage of 30% ± 11%, and a significant decrease in the mean score to 28.6 ± 6.0 (n = 50) (P < 0.001). There were no reports of serious or unexpected adverse events at any point during treatment or during the follow-up period from any of the 50 women treated in the current study. Conclusions: The current results obtained after 6 months of treatment corroborated previous data on the safety and efficacy of MRgFUS for treating uterine fibroids. This is the first publication that provides such data for a large cohort of Indian women.

scholarly journals Safety and Efficacy of Magnetic Resonance-Guided Focused Ultrasound Surgery With Autofocusing Echo Imaging

2021 ◽  
Vol 14 ◽  
Author(s):  
Kyung Won Chang ◽  
Itay Rachmilevitch ◽  
Won Seok Chang ◽  
Hyun Ho Jung ◽  
Eyal Zadicario ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Focused Ultrasound ◽  
Imaging Technique ◽  
Density Ratio ◽  
Serious Adverse Events ◽  
Ultrasound Surgery ◽  
Major Barrier ◽  
Safety And Efficacy ◽  
Focused Ultrasound Surgery ◽  
The Mean

ObjectiveMagnetic resonance-guided focused ultrasound surgery (MRgFUS) lesioning is a new treatment for brain disorders. However, the skull is a major barrier of ultrasound sonication in MRgFUS because it has an irregular surface and varies its size and shape among individuals. We recently developed the concept of skull density ratio (SDR) to select candidates for MRgFUS from among patients with essential tremor (ET). However, SDR is not the only factor contributing to successful MRgFUS lesioning treatment—refining the target through exact measurement of the ultrasonic echo in the transducer also improves treatment efficacy. In the present study, we carried out MRgFUS lesioning using an autofocusing echo imaging technique. We aimed to evaluate the safety and efficacy of this new approach, especially in patients with low SDR in whom previous focusing methods have failed.MethodsFrom December 2019 to March 2020, we recruited 10 patients with ET or Parkinson’s disease (PD) who had a low SDR. Two patients dropped out of the trial due to the screening failure of other medical diseases. In total, eight patients were included: six with ET who underwent MRgFUS thalamotomy and two with PD who underwent MRgFUS pallidotomy. The autofocusing echo imaging technique was used in all cases.ResultsThe mean SDR of the patients with ET was 0.34 (range: 0.29–0.39), while that of the patients with PD was 0.41 (range: 0.38–0.44). The mean skull volume of patients with ET was 280.57 cm3 (range: 227–319 cm3), while that of the patients with PD was 287.13 cm3 (range: 271–303 cm3). During MRgFUS, a mean of 15 sonications were performed, among which a mean of 5.63 used the autofocusing technique. The mean maximal temperature (Tmax) achieved was 55.88°C (range: 52–59°C), while the mean energy delivered was 34.75 kJ (range: 20–42 kJ) among all patients. No serious adverse events occurred during or after treatment. Tmax or sonication factors (skull volume, SDR, sonication number, autofocusing score, similarity score, energy range, and power) were not correlated with autofocusing technique (p &gt; 0.05, autofocusing score showed a p-value of 0.071).ConclusionUsing autofocusing echo imaging lesioning, a safe and efficient MRgFUS treatment, is available even for patients with a low SDR. Therefore, the indications for MRgFUS lesioning could be expanded to include patients with ET who have an SDR &lt; 0.4 and those with PD who have an SDR &lt; 0.45.Clinical Trial Registrationclinicaltrials.gov, identifier: NCT03935581.

Safety and efficacy of high-intensity focused ultrasound in pancreatic cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 339-339 ◽  
Author(s):  
Jin Il Kim ◽  
DaeYoung Cheung
Keyword(s):  
Magnetic Resonance Imaging ◽  
Pancreatic Cancer ◽  
Magnetic Resonance ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Tumor Volume ◽  
Advanced Pancreatic Cancer ◽  
High Intensity Focused Ultrasound ◽  
Resonance Imaging ◽  
Safety And Efficacy

339 Background: The aim of this study was to evaluate safety and efficacy of high-intensity focused ultrasound (HIFU) for advanced pancreatic cancer. Methods: Patients with pancreatic cancer TNM stage III or IV were included. Magnetic resonance imaging was performed 2 weeks before and after the HIFU. The ablating tumor volume was calculated by ratio of the non-perfused necrotic area of the planned area on contrast-enhanced T1-weighted image on post-HIFU magnetic resonance imaging. The ablation results were stratified into 4 ranges: 100% to 90% unenhanced area of targeting area, 90% to 50%, within 50%, and no change. Results: High-intensity focused ultrasound treatment was performed without severe adverse event in 52 patients, 53 times (male/female = 28/24; mean age, 62.7 ± 12.1; TNM stage 3/stage 4 = 21/31). Average size of the pancreatic cancer lesion was 4.5 ± 1.6 cm (1.4 - 9.5 cm). After HIFU treatment, ablating tumor volume was as follows: 90% to 100% in 41 lesions, 90% to 50% in 11, and within 50% in 3. Overall median survival (S1) from initial pancreatic cancer diagnosis was 13.1 months. Overall survival (S2) rates at 6, 12, and 18 months from HIFU were 53.1%, 31.6%, and 23.5%, respectively, with a median survival of 7.4 months. Conclusions: High-intensity focused ultrasound is safe and effective, which induced excellent local tumor control in most patients with advanced pancreatic cancer.

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