[Transcranial focused ultrasound: Neurological applications of magnetic resonance-guided high-intensity focused ultrasound].

BACKGROUND: Ultrasound surgery uses the thermal effects of the absorption of high-intensity focused ultrasound to induce localized thermal ablation of diseased tissue. The clinical introduction in recent years was made possible by a better understanding of the interactions of ultrasound with biological structures and the resulting physiological changes, major advances in the design of ultrasound applicators and the development of imaging modalities for reliable guiding the interventions.
METHODS: Magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) is especially appealing for applications in the brain where target volumes have to be accessed with high precision without inflicting collateral damage to surrounding healthy tissue. In 2013 a MRgFUS system was CE certified for the treatment of functional neurological disorders, such as chronic neuropathic pain and movement disorders. Currently, some 400 patients have been treated worldwide using this system, which is also undergoing clinical testing for the treatment of primary brain tumors and brain metastases.
CONCLUSION: This article describes the technical basis of transcranial focused ultrasound neurosurgery and summarizes the current clinical experience of this new class of image-guided, non-invasive interventions.