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Successful neurosurgery with transcranial MR-guided high-intensity focused ultrasound
June 23, 2009The Magnetic Resonance Center of the University Children's Hospital Zurich has achieved a world first break through in MR-guided, non-invasive neurosurgery. Ten patients have been successfully treated by means of transcranial high-intensity focused ultrasound. This fully non-invasive procedure opens new horizons for neurosurgery and the treatment of different neurological brain disorders.
In the context of a clinical study at the MR Center of the University Children's Hospital Zurich transcranial MR-guided high-intensity focused ultrasound (HIFU) for brain surgery has been successfully applied for the first time world-wide. A research team under the direction of Professor Daniel Jeanmonod, neurosurgeon at the Department of Functional Neurosurgery of the Neurosurgical Clinic at the University Hospital Zurich and Professor Ernst Martin, director of the Magnetic Resonance Center at the University Children's Hospital Zurich succeeded in proving the safety and efficacy of this revolutionary surgical method which permits fully non-invasive brain interventions even on an out-patient basis.
For quite some years, HIFU has been used for the treatment of uterine fibroids and tumors of the prostate gland. However, its application to the brain through the intact skull for non-invasive neurosurgery was not possible until recently, because of insurmountable technical difficulties.
Non-invasive neurosurgery
In a Swiss National research project, the team of the University of Zurich 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 anaesthesia. Patients are awake and fully conscious during the intervention.
A project of the National Centre of Competence in Research (NCCR) Co-Me
In the context of the Swiss National Research Program NCCR Co-Me (computer aided and image guided medical interventions), the potential of non-invasive, transcranial MR-guided high-intensity focused ultrasound (tcMRgHIFU) is investigated in clinical studies at the University Children's Hospital Zurich. Scientists working in the Co-Me program pursue the goal of establishing and developing surgical interventions by means of tcMRgHIFU, in order to broaden the spectrum of completely non-invasive interventions for functional neurosurgery and for the treatment of brain tumors, stroke and various neurological brain disorders by targeted drug delivery.
The research project represents a co-operation between the University of Zurich and the ETH Zurich, through (A) the Magnetic Resonance Center of the University Children's Hospital (Professor Ernst Martin), (B) the Department of Functional Neurosurgery of the Neurosurgical Clinic at the University Hospital Zurich (Professor Daniel Jeanmonod), (C) the Medical Image Analysis and Computer Vision Laboratory of the ETH Zurich (Professor Gabor Székely) and (D) the Institute of Neuroinformatics, ETH Zurich (PD Dr. Daniel Kiper), as well as the industrial partner InSightec Ltd.
University of Zurich
Non-invasive neurosurgery
In a Swiss National research project, the team of the University of Zurich 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 anaesthesia. Patients are awake and fully conscious during the intervention.
A project of the National Centre of Competence in Research (NCCR) Co-Me
In the context of the Swiss National Research Program NCCR Co-Me (computer aided and image guided medical interventions), the potential of non-invasive, transcranial MR-guided high-intensity focused ultrasound (tcMRgHIFU) is investigated in clinical studies at the University Children's Hospital Zurich. Scientists working in the Co-Me program pursue the goal of establishing and developing surgical interventions by means of tcMRgHIFU, in order to broaden the spectrum of completely non-invasive interventions for functional neurosurgery and for the treatment of brain tumors, stroke and various neurological brain disorders by targeted drug delivery.
The research project represents a co-operation between the University of Zurich and the ETH Zurich, through (A) the Magnetic Resonance Center of the University Children's Hospital (Professor Ernst Martin), (B) the Department of Functional Neurosurgery of the Neurosurgical Clinic at the University Hospital Zurich (Professor Daniel Jeanmonod), (C) the Medical Image Analysis and Computer Vision Laboratory of the ETH Zurich (Professor Gabor Székely) and (D) the Institute of Neuroinformatics, ETH Zurich (PD Dr. Daniel Kiper), as well as the industrial partner InSightec Ltd.
University of Zurich
Neurosurgery Current Events and Neurosurgery News RSSBrain injured athletes may benefit from hypothermia research
NFL players and other athletes who suffer serious or multiple concussions may benefit from ground-breaking research being conducted by scientists at Barrow Neurological Institute at St. Joseph's Hospital and Medical Center. The scientists are developing a surgical technique that involves hypothermia in specific regions of the brain.
Barrow study identifies new way to biopsy brain tumors in real time
A new miniature, hand-held microscope may allow more precise removal of brain tumors and an easier recognition of tumor locations during surgery.
Men leave: Separation and divorce far more common when the wife is the patient
A woman is six times more likely to be separated or divorced soon after a diagnosis of cancer or multiple sclerosis than if a man in the relationship is the patient, according to a study that examined the role gender played in so-called "partner abandonment." The study also found that the longer the marriage the more likely it would remain intact.
Muscle weakness a common side effect of long stays in intensive care units
After decades of focusing on the management of respiratory failure, circulatory shock and severe infections that lead to extended stays in hospital intensive care units, critical care researchers are increasingly turning attention to what they believe is a treatable complication developed by many who spend days or weeks confined to an ICU bed: debilitating muscle weakness that can linger long after hospital discharge.
Master regulator found for regenerating nerve fibers in live animals
Researchers at Children's Hospital Boston report that an enzyme known as Mst3b, previously identified in their lab, is essential for regenerating damaged axons (nerve fibers) in a live animal model, in both the peripheral and central nervous systems.
First former college football player diagnosed with CTE
The Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) announced today that a deceased former college football player who died at age 42 was already suffering from the degenerative brain disease, Chronic Traumatic Encephalopathy (CTE).
Compound shows potential for slowing progression of ALS
A chemical cousin of a drug currently used to treat sepsis dramatically slows the progression of amyotrophic lateral sclerosis, better known as ALS or Lou Gehrig's disease, in mice.
Unequal access: Hispanic children rarely get top-notch care for brain tumors
Hispanic children diagnosed with brain tumors get high-quality treatment at hospitals that specialize in neurosurgery far less often than other children with the same condition, potentially compromising their immediate prognosis and long-term survival, according to research from Johns Hopkins published in October's Pediatrics.
Amyotrophic lateral sclerosis may involve a form of sudden, rapid aging of the immune system
Premature aging of the immune system appears to play a role in the development of amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease, according to research scientists from the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center, the Weizmann Institute of Science in Israel, and Sheba Medical Center in Israel.
Historic gene therapy trial to treat Alzheimer's disease underway at Georgetown
Researchers in the Memory Disorders Program at Georgetown University Medical Center are now recruiting volunteers for a national gene therapy trial - the first study of its kind for the treatment of patients with dementia due to Alzheimer's disease.
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