Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Paris;
Institut Langevin, École Supérieure de Physique et de Chimie Industrielles Paris Tech, Centre National de la Recherche Scientifique Unité Mixte de Recherche 7587, Institut National de la Santé et de la Recherche Médicale Unité 979, Université Paris VII–Paris Diderot;
SuperSonic Imagine, Aix-en-Provence; and
Imagerie par Résonance Magnétique Médicale et Multi-Modalités, Unité Mixte de Recherche 8081, Université Paris Sud 11–Centre National de la Recherche Scientifique, Orsay, France
This work aimed at evaluating the accuracy of MR-guided high-intensity focused ultrasound (MRgHIFU) brain therapy in human cadaver heads.
Eighteen heads of fresh human cadavers were removed with a dedicated protocol preventing intracerebral air penetration. The MR images allowed determination of the ultrasonic target: a part of the thalamic nucleus ventralis intermedius implicated in essential tremor. Osseous aberrations were corrected with simulation-based time reversal by using CT data from the heads. The ultrasonic session was performed with a 512-element phased-array transducer system operating at 1 MHz under stereotactic conditions with thermometric real-time MR monitoring performed using a 1.5-T imager.
Dissection, imaging, targeting, and planning have validated the feasibility of this human cadaver model. The average temperature elevation measured by proton resonance frequency shift was 7.9°C ± 3°C. Based on MRI data, the accuracy of MRgHIFU is 0.4 ± 1 mm along the right/left axis, 0.7 ± 1.2 mm along the dorsal/ventral axis, and 0.5 ± 2.4 mm in the rostral/caudal axis.
Despite its limits (temperature, vascularization), the human cadaver model is effective for studying the accuracy of MRgHIFU brain therapy. With the 1-MHz system investigated here, there is millimetric accuracy.
Abbreviations used in this paper:HIFU = high-intensity focused ultrasound; MRgHIFU = MR-guided HIFU; VIM = nucleus ventralis intermedius.
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