Targeting accuracy of transcranial magnetic resonance–guided high-intensity focused ultrasound brain therapy: a fresh cadaver model

Laboratory investigation

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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.

Article Information

Address correspondence to: Jean-François Aubry, Ph.D., Institut Langevin, ESPCI, 10 rue Vauquelin, 75005 Paris, France. email:

Please include this information when citing this paper: published online March 1, 2012; DOI: 10.3171/2013.1.JNS12559.

© AANS, except where prohibited by US copyright law.



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    Photograph showing the ultrasonic 512-element array with head holder. A dry skull is placed for illustration.

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    Screen capture showing planning software in use.

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    Sagittal (left) and coronal (right) views of the treatment setup (T1-weighted MR images).

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    Typical MR temperature elevation in a view of the full head (left) and in the VIM (inset and right). deg = degrees.

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    Examples of calcifications on the inner skull surface. Upper: Coronal and sagittal views of the CT data. Lower: Photograph of the inner surface of the corresponding extracted skull bone.


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