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

Laboratory investigation

Dorian Chauvet Departments of Neurosurgery and

Search for other papers by Dorian Chauvet in
Current site
Google Scholar
PubMed Close
 M.D.
,
Laurent Marsac 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

Search for other papers by Laurent Marsac in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Mathieu Pernot 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;

Search for other papers by Mathieu Pernot in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Anne-Laure Boch Departments of Neurosurgery and

Search for other papers by Anne-Laure Boch in
Current site
Google Scholar
PubMed Close
 M.D., Ph.D.
,
Rémy Guillevin Neuroradiology, Groupe Hospitalier Pitié Salpêtrière, Paris;

Search for other papers by Rémy Guillevin in
Current site
Google Scholar
PubMed Close
 M.D., Ph.D.
,
Najat Salameh 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

Search for other papers by Najat Salameh in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Line Souris 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

Search for other papers by Line Souris in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Luc Darrasse 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

Search for other papers by Luc Darrasse in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Mathias Fink 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;

Search for other papers by Mathias Fink in
Current site
Google Scholar
PubMed Close
 Ph.D.
,
Mickaël Tanter 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;

Search for other papers by Mickaël Tanter in
Current site
Google Scholar
PubMed Close
 Ph.D.
, and
Jean-François Aubry 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;

Search for other papers by Jean-François Aubry in
Current site
Google Scholar
PubMed Close
 Ph.D.
Page Range:
1046–1052
Volume/Issue:
Volume 118: Issue 5
DOI link:
https://doi.org/10.3171/2013.1.JNS12559
Restricted access

Purchase Now

USD  $45.00

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

USD  $525.00

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

USD  $624.00
Click here for subscription options

  • Purchase Now

    USD  $45.00

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

    USD  $525.00

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

    USD  $624.00
USD  $45.00
USD  $525.00
USD  $624.00
Print or Print + Online Sign in

Object

This work aimed at evaluating the accuracy of MR-guided high-intensity focused ultrasound (MRgHIFU) brain therapy in human cadaver heads.

Methods

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.

Results

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.

Conclusions

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.
  • Collapse
  • Expand

Contributor Notes

Address correspondence to: Jean-François Aubry, Ph.D., Institut Langevin, ESPCI, 10 rue Vauquelin, 75005 Paris, France. email: jean-francois.aubry@espci.fr.

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

  • 1

    Aubry JF, , Tanter M, , Pernot M, , Thomas JL, & Fink M: Experimental demonstration of noninvasive transskull adaptive focusing based on prior computed tomography scans. J Acoust Soc Am 113:84–93, 2003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2

    Benabid AL, , Pollak P, , Seigneuret E, , Hoffmann D, , Gay E, & Perret J: Chronic VIM thalamic stimulation in Parkinson's disease, essential tremor and extra-pyramidal dyskinesias. Acta Neurochir Suppl (Wien) 58:39–44, 1993

    • Search Google Scholar
    • Export Citation
  • 3

    Bradley WG Jr: MR-guided focused ultrasound: a potentially disruptive technology. J Am Coll Radiol 6:510–513, 2009

  • 4

    Bricout J, & Guiot G: Stereotaxic atlas of the arterial network of the central gray nuclei. Ann Radiol (Paris) 7:701–722, 1964

  • 5

    Clement GT, & Hynynen K: A non-invasive method for focusing ultrasound through the human skull. Phys Med Biol 47:1219–1236, 2002

  • 6

    Clement GT, , Sun J, , Giesecke T, & Hynynen K: A hemisphere array for non-invasive ultrasound brain therapy and surgery. Phys Med Biol 45:3707–3719, 2000

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7

    Cline HE, , Schenck JF, , Watkins RD, , Hynynen K, & Jolesz FA: Magnetic resonance-guided thermal surgery. Magn Reson Med 30:98–106, 1993

  • 8

    Crouzet S, , Murat FJ, , Pasticier G, , Cassier P, , Chapelon JY, & Gelet A: High intensity focused ultrasound (HIFU) for prostate cancer: current clinical status, outcomes and future perspectives. Int J Hyperthermia 26:796–803, 2010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9

    Fry FJ, & Barger JE: Acoustical properties of the human skull. J Acoust Soc Am 63:1576–1590, 1978

  • 10

    Gâteau J, , Marsac L, , Pernot M, , Aubry JF, , Tanter M, & Fink M: Transcranial ultrasonic therapy based on time reversal of acoustically induced cavitation bubble signature. IEEE Trans Biomed Eng 57:134–144, 2010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11

    Hershkovitz I, , Greenwald C, , Rothschild BM, , Latimer B, , Dutour O, & Jellema LM, et al.: Hyperostosis frontalis interna: an anthropological perspective. Am J Phys Anthropol 109:303–325, 1999

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12

    Hynynen K, , Clement GT, , McDannold N, , Vykhodtseva N, , King R, & White PJ, et al.: 500-element ultrasound phased array system for noninvasive focal surgery of the brain: a preliminary rabbit study with ex vivo human skulls. Magn Reson Med 52:100–107, 2004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13

    Hynynen K, & Jolesz FA: Demonstration of potential noninvasive ultrasound brain therapy through an intact skull. Ultrasound Med Biol 24:275–283, 1998

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14

    Jagannathan J, , Sanghvi NT, , Crum LA, , Yen CP, , Medel R, & Dumont AS, et al.: High-intensity focused ultrasound surgery of the brain: part 1—a historical perspective with modern applications. Neurosurgery 64:201–211, 2009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15

    Jeanmonod D, , Werner B, , Morel A, , Michels L, , Zadicario E, & Schiff G, et al.: Transcranial magnetic resonance imaging-guided focused ultrasound: noninvasive central lateral thalamotomy for chronic neuropathic pain. Neurosurg Focus 32:1 E1, 2012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16

    Larrat B, , Pernot M, , Montaldo G, , Fink M, & Tanter M: MR-guided adaptive focusing of ultrasound. IEEE Trans Ultrason Ferroelectr Freq Control 57:1734–1737, 2010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17

    Louis ED, & Ferreira JJ: How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor. Mov Disord 25:534–541, 2010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18

    Marquet F, , Pernot M, , Aubry JF, , Montaldo G, , Marsac L, & Tanter M, et al.: Non-invasive transcranial ultrasound therapy based on a 3D CT scan: protocol validation and in vitro results. Phys Med Biol 54:2597–2613, 2009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19

    Martin E, , Jeanmonod D, , Morel A, , Zadicario E, & Werner B: High-intensity focused ultrasound for noninvasive functional neurosurgery. Ann Neurol 66:858–861, 2009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20

    McDannold N, , Arvanitis CD, , Vykhodtseva N, & Livingstone MS: Temporary disruption of the blood-brain barrier by use of ultrasound and microbubbles: safety and efficacy evaluation in rhesus macaques. Cancer Res 72:3652–3663, 2012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21

    McDannold N, , Clement GT, , Black P, , Jolesz F, & Hynynen K: Transcranial magnetic resonance imaging-guided focused ultrasound surgery of brain tumors: initial findings in 3 patients. Neurosurgery 66:323–332, 2010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22

    McDannold N, , Park EJ, , Mei CS, , Zadicario E, & Jolesz F: Evaluation of three-dimensional temperature distributions produced by a low-frequency transcranial focused ultrasound system within ex vivo human skulls. IEEE Trans Ultrason Ferroelectr Freq Control 57:1967–1976, 2010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23

    O'Neill BE, & Li KC: Augmentation of targeted delivery with pulsed high intensity focused ultrasound. Int J Hyperthermia 24:506–520, 2008

  • 24

    Parker DL, , Smith V, , Sheldon P, , Crooks LE, & Fussell L: Temperature distribution measurements in two-dimensional NMR imaging. Med Phys 10:321–325, 1983

  • 25

    Pernot M, , Aubry JF, , Tanter M, , Boch AL, , Marquet F, & Kujas M, et al.: In vivo transcranial brain surgery with an ultrasonic time reversal mirror. J Neurosurg 106:1061–1066, 2007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26

    Pernot M, , Aubry JF, , Tanter M, , Thomas JL, & Fink M: High power transcranial beam steering for ultrasonic brain therapy. Phys Med Biol 48:2577–2589, 2003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27

    Shoji S, , Nakano M, , Nagata Y, , Usui Y, , Terachi T, & Uchida T: Quality of life following high-intensity focused ultrasound for the treatment of localized prostate cancer: a prospective study. Int J Urol 17:715–719, 2010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28

    Stewart EA, , Gedroyc WMW, , Tempany CMC, , Quade BJ, , Inbar Y, & Ehrenstein T, et al.: Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive thermoablative technique. Am J Obstet Gynecol 189:48–54, 2003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29

    Tanter M, , Pernot M, , Aubry JF, , Montaldo G, , Marquet F, & Fink M: Compensating for bone interfaces and respiratory motion in high-intensity focused ultrasound. Int J Hyperthermia 23:141–151, 2007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30

    White DN, , Clark JM, , Chesebrough JN, , White MN, & Campbell JK: Effect of the skull in degrading the display of echoencephalographic B and C scans. J Acoust Soc Am 44:1339–1345, 1968

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31

    Wu F, , Wang ZB, , Chen WZ, , Wang W, , Gui Y, & Zhang M, et al.: Extracorporeal high intensity focused ultrasound ablation in the treatment of 1038 patients with solid carcinomas in China: an overview. Ultrason Sonochem 11:149–154, 2004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32

    Yelnik J, , Bardinet E, , Dormont D, , Malandain G, , Ourselin S, & Tandé D, et al.: A three-dimensional, histological and deformable atlas of the human basal ganglia. I. Atlas construction based on immunohistochemical and MRI data. Neuroimage 34:618–638, 2007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33

    Yoon SW, , Lee C, , Cha SH, , Yu JS, , Na YJ, & Kim KA, et al.: Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI. Eur Radiol 18:2997–3006, 2008

    • Crossref
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1895 776 14
Full Text Views 316 25 5
PDF Downloads 247 36 11
EPUB Downloads 0 0 0