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Magnetic Resonance-guided Focused Ultrasound Ablation:Techniques and Neurological Applications Satoshi MAESAWA 1,2 , Daisuke NAKATSUBO 2 , Takahiko TSUGAWA 3 , Sachiko KATO 3 , Masashi SHIBATA 3 , Sou TAKAI 2 , Jun TORII 2 , Toshihiko WAKABAYASHI 3 , Ryuta SAITO 2 1Brain & Mind Research Center, Nagoya University 2Department of Neurosurgery, Nagoya University, Graduate School of Medicine 3Center for Focused Ultrasounds(FUS)Nagoya Kyoritsu Hospital Keyword: 集束超音波治療 , 本態性振戦 , パーキンソン病 , focused ultrasound therapy , essential tremor , Parkinson disease pp.847-856
Published Date 2021/7/10
DOI https://doi.org/10.11477/mf.1436204463
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 Magnetic resonance(MR)-guided focused ultrasound ablation(FUS)is a minimally invasive technique for targeted tissue thermo-ablation and is promising for neuromodulation in various neurological disorders. The effectiveness and safety of this technique have been recognized worldwide. In Japan, the applications of FUS for the treatment of essential tremors and Parkinson's disease have recently been covered under health insurance. The FUS system is composed of a phased-array transducer with 1024 elements, with a beam of ultrasound emerging from each element. The phase and amplitude of the beam are computed and controlled to focus on the target with the calculation of computed tomography(CT)profiles, resulting in optimal thermo-ablation. To utilize FUS safely and effectively, a deep understanding of the physics of this technology is necessary. Furthermore, the technique should be compared with other options including deep brain stimulation(DBS)and radiofrequency thermo-ablation. Although FUS has received attention because of minimally invasive characteristics and a possibility of procedural target refinement, DBS has some advantages on bilateral implantation, a potential of postoperative adjustment, and control of head/leg tremors. In this article, we first reviewed the physics of FUS and demonstrated the typical treatment protocols. Second, we reviewed the outcomes from the existing literature, and revealed the advantages and disadvantages of this procedure, with the evaluation of the optimal condition for FUS.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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