The critical points in recent FUS and the possible solutions

MR-guided Focused Ultrasound (MRgFUS) has been well-recognized as a new way of lesioning for various of neurological disease, such as essential tremor (ET), tremor-dominant Parkison’s disease (TDPD), and neuropathic pain. Even though the non-invasiveness of the procedure, real-time thermal measure from the MR, and the real-time clinical feedback from patient provide the physician a safe and effective way for the treatment, there are still few technical challenging in this procedure.

In this presentation we would like to share two challenges in our MRgFUS ablation and the potential solutions for them. Specifically, the less-good SNR from the 3T MR images with body coil might cause the less good image quality for not only the anatomic live image but also for the thermal measurement. We proposed a 3T head coil utility and the according improved MR sequence parameters to facilitate the MR image quality during the treatment. Secondly, for the conventional ET and TDPD treatment, the clinical outcome is directly related with the targeting to the brain. In addition to the conventional indirect targeting, which heavily relay on the experience of the physician, we retrospectively exam the feasibility of a brain atlas and see if the parcellation from that atlas can be a reference of the physician during the targeting. We also analyze the correlation between the side effect to the parcellation from the atlas.