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Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS.
Front Surg 2019; 6:28FS

Abstract

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.

Links

  • PMC Free PDF
    • Publisher Full Text
    ncbi.nlm.nih.gov
    dx.doi.org

    Authors+Show Affiliations

    Gallay MN
    SoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, Switzerland.
    Moser D
    SoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, Switzerland.
    Federau C
    ETH Zurich, Institute for Biomedical Engineering, University Zurich, Zurich, Switzerland. Department of Radiology, University Hospital Basel, Basel, Switzerland.
    Jeanmonod D
    SoniModul, Center for Ultrasound Functional Neurosurgery, Solothurn, Switzerland.

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31157233

    Citation

    Gallay, Marc N., et al. "Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS." Frontiers in Surgery, vol. 6, 2019, p. 28.
    Gallay MN, Moser D, Federau C, et al. Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS. Front Surg. 2019;6:28.
    Gallay, M. N., Moser, D., Federau, C., & Jeanmonod, D. (2019). Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS. Frontiers in Surgery, 6, p. 28. doi:10.3389/fsurg.2019.00028.
    Gallay MN, et al. Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS. Front Surg. 2019;6:28. PubMed PMID: 31157233.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Radiological and Thermal Dose Correlations in Pallidothalamic Tractotomy With MRgFUS. AU - Gallay,Marc N, AU - Moser,David, AU - Federau,Christian, AU - Jeanmonod,Daniel, Y1 - 2019/05/17/ PY - 2019/01/04/received PY - 2019/05/02/accepted PY - 2019/6/4/entrez PY - 2019/6/4/pubmed PY - 2019/6/4/medline KW - MRgFUS (magnetic resonance-guided focused ultrasound surgery) KW - Parkinson's disease KW - functional neurosurgery KW - imaging KW - incisionless KW - pallidothalamic tractotomy KW - radiology KW - thermal dose SP - 28 EP - 28 JF - Frontiers in surgery JO - Front Surg VL - 6 N2 - 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. SN - 2296-875X UR - https://www.unboundmedicine.com/medline/citation/31157233/Radiological_and_Thermal_Dose_Correlations_in_Pallidothalamic_Tractotomy_With_MRgFUS L2 - https://dx.doi.org/10.3389/fsurg.2019.00028 DB - PRIME DP - Unbound Medicine ER -