Intracranial applications of magnetic resonance-guided focused ultrasound.
The ability to focus acoustic energy through the intact skull on to targets millimeters in size represents an important milestone in the development of neurotherapeutics. Magnetic resonance-guided focused ultrasound (MRgFUS) is a novel, noninvasive method, which--under real-time imaging and thermographic guidance--can be used to generate focal intracranial thermal ablative lesions and disrupt the blood-brain barrier. An established treatment for bone metastases, uterine fibroids, and breast lesions, MRgFUS has now been proposed as an alternative to open neurosurgical procedures for a wide variety of indications. Studies investigating intracranial MRgFUS range from small animal preclinical experiments to large, late-phase randomized trials that span the clinical spectrum from movement disorders, to vascular, oncologic, and psychiatric applications. We review the principles of MRgFUS and its use for brain-based disorders, and outline future directions for this promising technology.
Division of Neurosurgery, University Health Network, University of Toronto, 399 Bathurst Street, 4W-431, Toronoto, M5T 2S8, Canada, nir.lipsman@utoronto.ca.
Nir
N
Lipsman
Todd G
TG
Mainprize
Michael L
ML
Schwartz
Kullervo
K
Hynynen
Andres M
AM
Lozano
D000818:Animals; D001812:Blood-Brain Barrier / Q000378:metabolism; D001932:Brain Neoplasms / Q000628:therapy*; D059350:Chronic Pain / Q000628:therapy; D002986:Clinical Trials as Topic; D020329:Essential Tremor / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000628:therapy*; D009422:Nervous System Diseases / Q000628:therapy*; D019636:Neurodegenerative Diseases / Q000628:therapy; D020521:Stroke / Q000628:therapy; D014464:Ultrasonic Therapy