17 32

Cited 4 times in

Factors Related to Successful Energy Transmission of Focused Ultrasound Through a Skull : A Study in Human Cadavers and Its Comparison With Clinical Experiences

Authors
 Na Young Jung  ;  Itay Rachmilevitch  ;  Ohad Sibiger  ;  Talia Amar  ;  Eyal Zadicario  ;  Jin Woo Chang 
Citation
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, Vol.62(6) : 712-722, 2019-11 
Journal Title
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY 
ISSN
 2005-3711 
Issue Date
2019-11
Keywords
High-intensity focused ultrasound ablation ; Skull ; Acoustics
Abstract
Objective: Although magnetic resonance guided focused ultrasound (MRgFUS) has been used as minimally invasive and effective neurosurgical treatment, it exhibits some limitations, mainly related to acoustic properties of the skull barrier. This study was undertaken to identify skull characteristics that contribute to optimal ultrasonic energy transmission for MRgFUS procedures. Methods: For ex vivo skull experiments, various acoustic fields were measured under different conditions, using five non-embalmed cadaver skulls. For clinical skull analyses, brain computed tomography data of 46 patients who underwent MRgFUS ablations (18 unilateral thalamotomy, nine unilateral pallidotomy, and 19 bilateral capsulotomy) were retrospectively reviewed. Patients' skull factors and sonication parameters were comparatively analyzed with respect to the cadaveric skulls. Results: Skull experiments identified three important factors related skull penetration of ultrasound, including skull density ratio (SDR), skull volume, and incidence angle of the acoustic rays against the skull surface. In clinical results, SDR and skull volume correlated with maximal temperature (Tmax) and energy requirement to achieve Tmax (p<0.05). In addition, considering the incidence angle determined by brain target location, less energy was required to reach Tmax in the central, rather than lateral targets particularly when compared between thalamotomy and capsulotomy (p<0.05). Conclusion: This study reconfirmed previously identified skull factors, including SDR and skull volume, for successful MRgFUS; it identified an additional factor, incidence angle of acoustic rays against the skull surface. To guarantee successful transcranial MRgFUS treatment without suffering these various skull issues, further technical improvements are required.
Files in This Item:
T201906338.pdf Download
DOI
10.3340/jkns.2018.0226
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Jung, Na Young(정나영)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175853
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links