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Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note.
Front Surg 2019; 6:2FS

Abstract

Background:

MR-guided focused ultrasound (MRgFUS) offers new perspectives for safe and efficient lesioning inside the brain. The issue of target coverage remains primordial and sub-optimally addressed or solved in the field of functional neurosurgery.

Objective:

To provide an optimized planning and operative strategy to perform a pallidothalamic tractotomy (PTT) in chronic therapy-resistant Parkinson's disease (PD) with the technology of MRgFUS. Methods and results: Histological sections and maps from 6 human brain hemispheres were analyzed and outlines of the pallidothalamic tract on Myelin-stained sections were drawn and superimposed. We determined a standardized PTT target coverage characterized by 5 to 7 preplanned target lesion sub-units of 1.5 × 1.5 × 3.0 mm, which were placed using focal point displacements and shortest possible times, under thermal dose control.

Conclusion:

We hereby present our current approach to the MRgFUS PTT on the basis of a histological reappraisal and optimized heat application to the pallidothalamic tract in the H1 field of Forel.

Authors+Show Affiliations

Center for Ultrasound Functional Neurosurgery, SoniModul, Solothurn, Switzerland.Center for Ultrasound Functional Neurosurgery, SoniModul, Solothurn, Switzerland.Institute for Biomedical Engineering, ETH Zürich, University of Zürich, Zurich, Switzerland. Department of Radiology, University Hospital Basel, Basel, Switzerland.Center for Ultrasound Functional Neurosurgery, SoniModul, Solothurn, Switzerland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30733946

Citation

Gallay, Marc N., et al. "Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. a Technical Note." Frontiers in Surgery, vol. 6, 2019, p. 2.
Gallay MN, Moser D, Federau C, et al. Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note. Front Surg. 2019;6:2.
Gallay, M. N., Moser, D., Federau, C., & Jeanmonod, D. (2019). Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note. Frontiers in Surgery, 6, p. 2. doi:10.3389/fsurg.2019.00002.
Gallay MN, et al. Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. a Technical Note. Front Surg. 2019;6:2. PubMed PMID: 30733946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note. AU - Gallay,Marc N, AU - Moser,David, AU - Federau,Christian, AU - Jeanmonod,Daniel, Y1 - 2019/01/24/ PY - 2018/09/20/received PY - 2019/01/09/accepted PY - 2019/2/9/entrez PY - 2019/2/9/pubmed PY - 2019/2/9/medline KW - Parkinson's disease KW - cumulative equivalent minutes at 43°C KW - functional stereotactic neurosurgery KW - high intensity MR-guided focused ultrasound KW - incisionless KW - minimal invasive KW - pallidothalamic tractotomy KW - subthalamotomy SP - 2 EP - 2 JF - Frontiers in surgery JO - Front Surg VL - 6 N2 - Background: MR-guided focused ultrasound (MRgFUS) offers new perspectives for safe and efficient lesioning inside the brain. The issue of target coverage remains primordial and sub-optimally addressed or solved in the field of functional neurosurgery. Objective: To provide an optimized planning and operative strategy to perform a pallidothalamic tractotomy (PTT) in chronic therapy-resistant Parkinson's disease (PD) with the technology of MRgFUS. Methods and results: Histological sections and maps from 6 human brain hemispheres were analyzed and outlines of the pallidothalamic tract on Myelin-stained sections were drawn and superimposed. We determined a standardized PTT target coverage characterized by 5 to 7 preplanned target lesion sub-units of 1.5 × 1.5 × 3.0 mm, which were placed using focal point displacements and shortest possible times, under thermal dose control. Conclusion: We hereby present our current approach to the MRgFUS PTT on the basis of a histological reappraisal and optimized heat application to the pallidothalamic tract in the H1 field of Forel. SN - 2296-875X UR - https://www.unboundmedicine.com/medline/citation/30733946/Anatomical_and_Technical_Reappraisal_of_the_Pallidothalamic_Tractotomy_With_the_Incisionless_Transcranial_MR-Guided_Focused_Ultrasound._A_Technical_Note L2 - https://dx.doi.org/10.3389/fsurg.2019.00002 DB - PRIME DP - Unbound Medicine ER -