4.5 Article

Cranial MR-Guided Focused Ultrasound: Clinical Challenges and Future Directions

期刊

WORLD NEUROSURGERY
卷 145, 期 -, 页码 574-580

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.wneu.2020.08.050

关键词

Dentatorubrothalamic tract; Diffusion tensor imaging; Quantitative susceptibility mapping; Tractography

资金

  1. JPB Foundation
  2. Focused Ultrasound Foundation

向作者/读者索取更多资源

Magnetic resonance-guided focused ultrasound is a promising technology for noninvasive treatment of complex brain disorders, but faces challenges in achieving optimal intraoperative imaging, technical limitations, and regulatory barriers that hinder widespread application.
Magnetic resonance-guided focused ultrasound is a powerful new technology that is enabling development of noninvasive applications for complex brain disorders. This is currently revolutionizing the treatment of tremor disorders, and a variety of experimental applications are under active investigation. To fully realize the potential of this disruptive technology, many challenges have been identified, some of which have been addressed and others remain to be solved. As an image-based technology, optimal intraoperative imaging can be difficult to achieve and several factors can influence the quality of these images. Technical issues with current devices can also limit the effective delivery of ultrasound technology to particular targets. While lesioning is the primary approved application of magnetic resonance- guided focused ultrasound at present, the ability to transient and precisely open the blood-brain barrier has the potential to clear brain pathologies and deliver restorative therapies, but this more experimental method presents unique difficulties to overcome. Finally, regulatory and reimbursement hurdles currently remain complex and continue to limit widespread application of even approved, effective applications. Here we review many of these challenges, discuss several solutions that have already been developed, and propose potential options for addressing some of these complexities in the future.

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