HIFU treatment: Transcranial HIFU therapy for brain tumor

2/23/2016

Transcranial HIFU therapy for brain tumor

The major obstacle for HIFU technology in brain tumor therapy is skull bone as the focused US field is disturbed and most of the US energy is absorbed by the skull bone. These difficulties have been overcome for the development of adaptive focusing techniques and large-sized phased array US transducers. Trans-cranial MRgFUS has been established and the clinical potential applications are researched in a fast-growing field of neuropathic pain and brain tumor therapy. MRgFUS system may be used to temporarily disrupt the blood-brain barrier for drug delivery to brain tumors.

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A pilot study included 15 patients who underwent MRgFUS for the treatment of medication-refractory essential tremor. The results showed total tremor scores improved from 54.9 to 24.3 (P=0.001). The application of MRgFUS in 13 patients with chronic Parkinson's disease was reported. The authors showed the accuracy, safety and feasibility of the MRgFUS pallidothalamic tractotomy.

The clinical feasibility of trans-cranial MRgFUS was evaluated by McDannold et al. Three glioblastoma patients underwent this procedure of multiple focused ultrasound exposures. The authors demonstrated the beam from HIFU at the brain with the magnetic resonance temperature imaging. However, MRgFUS seemed not to achieve thermal coagulation.

Trans-cranial MRgFUS could be a treatment option for brain diseases. HIFU modality for functional neurosurgery was shown by a clinical study where 9 patients suffering from chronic neuropathic pain were included and all treatments were all well tolerated. The results show the helpful clinical utility of trans-cranial HIFU modality for brain functional diseases. Large randomized clinical trials are needed to assess the safety and efficacy of trans-cranial HIFU therapy for brain tumor and neuropathic pain.

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