Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS
Background: MR-guided focused ultrasound (MRgFUS) offers the possibility of safe and accurate lesioning inside the brain. Until now, most MRgFUS thermal applications have been based on temperature or energy protocols. Experimental studies support however an approach centered on thermal dose control....
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-05-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fsurg.2019.00028/full |
| _version_ | 1818238796657852416 |
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| author | Marc N. Gallay David Moser Christian Federau Christian Federau Daniel Jeanmonod |
| author_facet | Marc N. Gallay David Moser Christian Federau Christian Federau Daniel Jeanmonod |
| author_sort | Marc N. Gallay |
| collection | DOAJ |
| description | Background: MR-guided focused ultrasound (MRgFUS) offers the possibility of safe and accurate lesioning inside the brain. Until now, most MRgFUS thermal applications have been based on temperature or energy protocols. Experimental studies support however an approach centered on thermal dose control.Objective: To show the technical feasibility and lesion size predictability of a thermal dose approach during MRgFUS pallidothalamic tractotomy (PTT) against chronic therapy-resistant Parkinson's disease (PD).Methods: MR and thermal dose data were analyzed in 31 MRgFUS interventions between January and December 2017 in patients suffering from chronic therapy-resistant Parkinson's disease (PD) using a standardized PTT target covered by 5 to 7 target lesion sub-units.Results: Good correlations were found between (1) the mean axial T2 lesion diameter intraoperatively and the mean 240 cumulative equivalent min at 43°C (240 CEM) thermal dose diameter (r = 0.52), (2) the mean axial T2 diameter 48 h post-treatment and the mean 18 CEM thermal dose diameter (r = 0.62), and (3) the mean axial T2 diameter intraoperatively and 48 h post-treatment (r = 0.62).Conclusion: Our current approach using a thermal dose steering for multiple target lesion sub-units could be reproduced in 31 interventions with a good lesion size predictability. |
| first_indexed | 2024-12-12T12:47:21Z |
| format | Article |
| id | doaj.art-af217e87e3a640f3b9f81922726ad0c2 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-12T12:47:21Z |
| publishDate | 2019-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-af217e87e3a640f3b9f81922726ad0c22022-12-22T00:24:05ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2019-05-01610.3389/fsurg.2019.00028446508Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUSMarc N. Gallay0David Moser1Christian Federau2Christian Federau3Daniel Jeanmonod4SoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, SwitzerlandSoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, SwitzerlandETH Zurich, Institute for Biomedical Engineering, University Zurich, Zurich, SwitzerlandDepartment of Radiology, University Hospital Basel, Basel, SwitzerlandSoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, SwitzerlandBackground: MR-guided focused ultrasound (MRgFUS) offers the possibility of safe and accurate lesioning inside the brain. Until now, most MRgFUS thermal applications have been based on temperature or energy protocols. Experimental studies support however an approach centered on thermal dose control.Objective: To show the technical feasibility and lesion size predictability of a thermal dose approach during MRgFUS pallidothalamic tractotomy (PTT) against chronic therapy-resistant Parkinson's disease (PD).Methods: MR and thermal dose data were analyzed in 31 MRgFUS interventions between January and December 2017 in patients suffering from chronic therapy-resistant Parkinson's disease (PD) using a standardized PTT target covered by 5 to 7 target lesion sub-units.Results: Good correlations were found between (1) the mean axial T2 lesion diameter intraoperatively and the mean 240 cumulative equivalent min at 43°C (240 CEM) thermal dose diameter (r = 0.52), (2) the mean axial T2 diameter 48 h post-treatment and the mean 18 CEM thermal dose diameter (r = 0.62), and (3) the mean axial T2 diameter intraoperatively and 48 h post-treatment (r = 0.62).Conclusion: Our current approach using a thermal dose steering for multiple target lesion sub-units could be reproduced in 31 interventions with a good lesion size predictability.https://www.frontiersin.org/article/10.3389/fsurg.2019.00028/fullMRgFUS (magnetic resonance-guided focused ultrasound surgery)Parkinson's diseasefunctional neurosurgerypallidothalamic tractotomyincisionlessthermal dose |
| spellingShingle | Marc N. Gallay David Moser Christian Federau Christian Federau Daniel Jeanmonod Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS Frontiers in Surgery MRgFUS (magnetic resonance-guided focused ultrasound surgery) Parkinson's disease functional neurosurgery pallidothalamic tractotomy incisionless thermal dose |
| title | Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS |
| title_full | Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS |
| title_fullStr | Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS |
| title_full_unstemmed | Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS |
| title_short | Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS |
| title_sort | radiological and thermal dose correlations in pallidothalamic tractotomy with mrgfus |
| topic | MRgFUS (magnetic resonance-guided focused ultrasound surgery) Parkinson's disease functional neurosurgery pallidothalamic tractotomy incisionless thermal dose |
| url | https://www.frontiersin.org/article/10.3389/fsurg.2019.00028/full |
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