Transkranielle MR-gesteuerte hochintensive fokussierte US-Neurochirurgie.
Transcranial magnetic resonance imaging-guided focused ultrasound surgery (tcMRgFUS) is a novel technique to supplement the spectrum of established neurosurgical interventions. It is noninvasive and entirely imaging-guided with continuous temperature measurements at and around the target in real time. TcMRgFUS has no trajectory restrictions and does not involve ionizing radiation. Since no device is implanted into the brain or the body, there is no restriction to future diagnostic work-up with MR imaging. Ongoing clinical studies on over 300 patients worldwide with neuropathic pain, essential tremor and Parkinson"s disease are very promising and demonstrate that ultrasound energy can precisely be focused through the intact skull, without overheating it. We regard targeting of pallido-thalamic tract and cerebello-thalamic tract by high intensity focused ultrasound (HIFU) as an interim but necessary procedure to reach two other future goals by LIFU (low intensity focused ultrasound): Neuromodulation as a diagnostic tool to be able to establish new targets for either deep brain stimulation or tcMRgFUS and BBB opening for anatomical selective targeted drug delivery.
- Dr. med. Ronald Bauer