Health experts have opened new horizons for the treatment of different neurological brain disorders by successfully treating ten patients using transcranial high-intensity focused ultrasound.
This is the first time that any team of experts at the University Children's Hospital Zurich have successfully used the Magnetic Resonance-guided, non-invasive method for brain surgery.
The team carried out this work as part of a Swiss National research project.
The high-intensity focused ultrasound (HIFU) they used for the surgery has been in use for the treatment of uterine fibroids and tumors of the prostate gland for quite some years.
However, its application to the brain through the intact skull for non-invasive neurosurgery was not possible until recently, because of insurmountable technical difficulties.
In the research project, the university team successfully implemented and optimized a prototype system for transcranial Magnetic Resonance-guided High-Intensity Focused Ultrasound (HIFU) for neurosurgical interventions. The HIFU system ExAblate 4000, developed by the cooperation partner InSightec, Tirat Carmel Israel, has been combined with a 3 Tesla high field GE MR-scanner.
The two systems together provide a platform for image-guided, non-invasive interventions.
Since September 2008 ten patients were treated at the Children's Hospital Zurich with this new neurosurgical procedure in the context of a clinical study. All interventions were completed successfully and without complications.
This novel technology now opens up new horizons allowing to develop non-invasive intervention procedures for a variety of brain diseases including brain tumors.
The whole surgical procedure is planned and monitored in real time by magnetic resonance imaging (MRI).
The HIFU beams produced by 1024 transducers are transferred through the intact skull of the patient into the brain and concentrated onto a focus of 3 to 4 millimeters in diameter.
Thus, sharply defined targets deep inside the brain are coagulated by heating them up to a focal temperature of 60 degrees Celsius.
The temperature increase during the sequential, 'sonications', each lasting 10 to 20 seconds, is continuously displayed and controlled on precise MR-temperature distribution maps.
The whole surgical procedure lasts several hours and is performed without anesthesia. Patients are awake and fully conscious during the intervention.