State of Practice on Transcranial MR-Guided Focused Ultrasound: A Report from the ASNR Standards and Guidelines Committee and ACR Commission on Neuroradiology Workgroup
Transcranial focused ultrasound (FUS) is a versatile, MR-guided, incisionless intervention with diagnostic and therapeutic applications for neurologic and psychiatric diseases. It is currently FDA-approved as a thermoablative treatment of essential tremor and Parkinson disease. However, other applications of FUS including BBB opening for diagnostic and therapeutic applications, sonodynamic therapy, histotripsy, and low-intensity focused ultrasound neuromodulation are all in clinical trials. While FUS targeting for essential tremor and Parkinson disease has classically relied on an indirect, landmark-based approach, development of novel, advanced MR imaging techniques such as DTI tractography and fast gray matter acquisition T1 inversion recovery has the potential to improve individualized targeting and thus potentially enhance treatment response, decrease treatment times, and avoid adverse effects. As the technology advances and the number of clinical applications increases, the role of the neuroradiologist on a multidisciplinary team will be essential in pairing advanced structural and functional imaging to further this image-guided procedure via a precision medicine approach. This multi-institutional report, written by an experienced team of neuroradiologists, neurosurgeons, and neurologists, summarizes current practices, the use of advanced imaging techniques for transcranial MR-guided high-intensity FUS, recommendations for clinical implementation, and emerging clinical indications.
Authors
- Jody Tanabe (ORCID: https://orcid.org/0000-0002-7110-8444)
- Drew S. Kern (ORCID: https://orcid.org/0000-0001-7317-3787)
- Stephen C. Harward (ORCID: https://orcid.org/0000-0002-2424-2587)
- Vance T. Lehman (ORCID: https://orcid.org/0000-0002-8713-8293)
- Kazim Narsinh (ORCID: https://orcid.org/0000-0002-2019-5461)
- Alexandre Boutet (ORCID: https://orcid.org/0000-0001-6942-5195)
- Lubdha M. Shah (ORCID: https://orcid.org/0000-0003-1303-3533)
- Fabrício Stewan Feltrin (ORCID: https://orcid.org/0000-0001-6783-7655)
- Shekhar Khanpara (ORCID: https://orcid.org/0000-0002-9127-196X)
- Bhavya Shah (ORCID: https://orcid.org/0000-0002-0058-6174)
- John E. Jordan (ORCID: https://orcid.org/0000-0002-5779-7538)
- Raghav Mattay (ORCID: https://orcid.org/0000-0002-8506-9503)
- Leo P. Sugrue (ORCID: https://orcid.org/0000-0001-7315-4519)
- Timothy J. Kaufmann (ORCID: https://orcid.org/0000-0001-7483-1569)
- Steven W. Hetts (ORCID: https://orcid.org/0000-0001-5885-7259)
- Vibhash D. Sharma (ORCID: https://orcid.org/0000-0001-5543-0305)
- Kendall Lee (ORCID: https://orcid.org/0000-0001-8729-9452)
- Joseph A. Maldjian (ORCID: https://orcid.org/0000-0002-6384-1072)
- T. Jason Druzgal (ORCID: https://orcid.org/0000-0001-7240-9487)
- Shivanand P. Lad (ORCID: https://orcid.org/0000-0003-4991-5319)
- Padraig O’Suilliebhain
Institutions
- American College of Radiology (US)
- Mayo Clinic (US)
- The University of Texas MD Anderson Cancer Center (US)
- Duke University (US)
- University of California, San Francisco (US)
- University of Toronto (CA)
- University of Utah (US)
- WinnMed (US)
- University of California System (US)
- American Society of Neuroradiology (US)
- Southwestern Medical Center (US)
- American Standard (United States) (US)
- Mayo Clinic in Arizona (US)
- Duke Medical Center (US)
- Little Company of Mary Hospital (US)
- Mayo Clinic in Florida (US)
- Duke University Hospital (US)
- Neurological Surgery (US)
- University of Virginia (US)
- The University of Texas Southwestern Medical Center (US)
- University of Colorado Denver (US)
Publication Details
- Journal
- American Journal of Neuroradiology
- Published
- 2024-11-21
- DOI
- https://doi.org/10.3174/ajnr.a8405
- Citations
- 7
- Primary Topic
- Advanced MRI Techniques and Applications
- Type
- article
- Field-Weighted Citation Impact
- 2.83
Funders
- American Society of Neuroradiology