Kranion, an open-source environment for planning transcranial focused ultrasound surgery: technical note

View More View Less
  • 1 Center for Neuromodulation, The Ohio State University, Columbus, Ohio; and
  • | 2 The Focused Ultrasound Foundation, Charlottesville, Virginia
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

Transcranial focused ultrasound (FUS) ablation is an emerging incision-less treatment for neurological disorders. The factors affecting FUS treatment efficiency are not well understood. Kranion is open-source software that allows the user to simulate the planning stages of FUS treatment and to “replay” previous treatments for off-line analysis. This study aimed to investigate the relationship between skull parameters and treatment efficiency and to create a metric to estimate temperature rise during FUS. CT images from 28 patients were analyzed to validate the use of Kranion. For stereotactic targets within each patient, individual transducer element incident angles, skull density ratio, and skull thickness measurements were recorded. A penetration metric (the “beam index”) was calculated by combining the energy loss from incident angles and the skull thickness. Kranion accurately estimated the patient’s skull and treatment parameters. The authors observed significant changes in incident angles with different targets in the brain. Using the beam index as a predictor of temperature rise in a linear-mixed-effects model, they were able to predict the average temperature rise at the focal point during ablation with < 21% error (55°C ± 3.8°C) in 75% of sonications, and with < 44% (55°C ± 7.9°C) in 97% of sonications. This research suggests that the beam index can improve the prediction of temperature rise during FUS. Additional work is required to study the relationship between temperature rise and lesion shape and clinical outcomes.

ABBREVIATIONS

FUS = focused ultrasound; GPi = globus pallidus pars interna; SDR = skull density ratio; VIM = ventral intermediate thalamus.

Supplementary Materials

    • Supplementary Material (PDF 629 KB)

Illustration from Duan et al. (pp 1174–1181).

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Correspondence Vibhor Krishna: The Ohio State University, Columbus, OH. vibhor.krishna@osumc.edu.

INCLUDE WHEN CITING Published online March 1, 2019; DOI: 10.3171/2018.11.JNS181995.

F.S. and D.W.B. share first authorship of this work.

Disclosures Dr. Krishna reports receiving research grants from the following sources: Focused Ultrasound Foundation, Insightec Inc., National Science Foundation, Medtronic Inc., and Ohio Department of Higher Education.

Metrics

All Time Past Year Past 30 Days
Abstract Views 627 350 33
Full Text Views 83 44 7
PDF Downloads 88 33 8
EPUB Downloads 0 0 0