Advanced MRI techniques for transcranial high intensity focused ultrasound targeting

Bhavya R. Shah, Vance T. Lehman, Timothy J. Kaufmann, Daniel Blezek, Jeff Waugh, Darren Imphean, Frank F. Yu, Toral R. Patel, Shilpa Chitnis, Richard B. Dewey, Joseph A. Maldjian, Rajiv Chopra

Research output: Contribution to journalReview articlepeer-review

Abstract

Magnetic resonance guided high intensity focused ultrasound is a novel, non-invasive, image-guided procedure that is able to ablate intracranial tissue with submillimetre precision. It is currently FDA approved for essential tremor and tremor dominant Parkinson's disease. The aim of this update is to review the limitations of current landmark-based targeting techniques of the ventral intermediate nucleus and demonstrate the role of emerging imaging techniques that are relevant for both magnetic resonance guided high intensity focused ultrasound and deep brain stimulation. A significant limitation of standard MRI sequences is that the ventral intermediate nucleus, dentatorubrothalamic tract, and other deep brain nuclei cannot be clearly identified. This paper provides original, annotated images demarcating the ventral intermediate nucleus, dentatorubrothalamic tract, and other deep brain nuclei on advanced MRI sequences such as fast grey matter acquisition T1 inversion recovery, quantitative susceptibility mapping, susceptibility weighted imaging, and diffusion tensor imaging tractography. Additionally, the paper reviews clinical efficacy of targeting with these novel MRI techniques when compared to current established landmark-based targeting techniques. The paper has widespread applicability to both deep brain stimulation and magnetic resonance guided high intensity focused ultrasound.

Original languageEnglish (US)
Pages (from-to)2664-2672
Number of pages9
JournalBrain
Volume143
Issue number9
DOIs
StatePublished - Sep 1 2020

Keywords

  • Deep brain stimulation
  • Dentatorubrothalamic tract
  • Globus pallidus
  • MRgHIFU
  • Ventral intermediate nucleus

ASJC Scopus subject areas

  • Clinical Neurology

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