Factors Associated with Heating Efficiency in Transcranial Focused Ultrasound Therapy.
Factors Associated with Heating Efficiency in Transcranial Focused Ultrasound Therapy.
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DOI：
10.2176/nmc.oa.2020-0225
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发表时间：
2020-12-15
影响因子：
1.9
通讯作者：
Taira T
中科院分区：
文献类型：
--
作者：
Yamamoto K;Ito H;Fukutake S;Odo T;Kamei T;Yamaguchi T;Taira T
经颅磁共振引导聚焦超声(FUS)治疗震颤和其他运动障碍是一种侵入性较小的立体定向治疗方法。在消融过程中，靶区脑组织的足够高的温度对于良好的结果至关重要。因此，在由于患者相关特性而无法实现高温的情况下，最大限度地提高加热效率至关重要。然而，利用FUS达到理想的治疗温度的策略尚未建立。本研究旨在探讨影响FUS加热效率的程序性因素。我们回顾和分析了接受FUS丘脑腹侧中间核(VIM)切开术的患者的资料。总共有30名连续的患者入选。原发性震颤(ET)18例，震颤显性帕金森病(TDPD)11例，Holmes震颤1例。多元回归分析显示，加热效率的下降与较低的颅骨密度比(SDR)和较大的小部分体温上升有关，直到上次超声治疗。为了最大限度地提高加热效率，应在目标对准和验证阶段将温度升高设置为最小值，随后在治疗阶段应充分提高温度。在由于患者相关的特点而无法达到较高消融温度的情况下，这一策略可能特别有益。重要的是，广泛的患者群体将从这一战略中受益，因为它可以减少达到治疗温度所需的高能量，从而降低不良事件的风险。
Transcranial magnetic resonance-guided focused ultrasound (FUS) therapy is a less invasive stereotactic treatment for tremor and other movement disorders. A sufficiently high temperature in the target brain tissue is crucial during ablation procedures for good outcomes. Therefore, maximizing the heating efficiency is critical in cases where high temperature cannot be achieved because of patient-related characteristics. However, a strategy to achieve the desired therapeutic temperature with FUS has not yet been established. This study aimed to investigate the procedural factors associated with heating efficiency in FUS. We retrospectively reviewed and analyzed data from patients who underwent FUS for ventralis intermedius (VIM) nucleus thalamotomy. In all, 30 consecutive patients were enrolled. 18 with essential tremor (ET), 11 with tremor-dominant Parkinson’s disease (TDPD), and 1 with Holmes tremor. Multivariate regression analysis showed that decline in heating efficiency was associated with lower skull density ratio (SDR) and a greater subtotal rise in temperature until the previous sonication. To maximize heating efficiency, the temperature increase should be set to the least value in the target alignment and verification phases, and subsequently should be increased sufficiently in the treatment phase. This strategy may be particularly beneficial in cases where high ablation temperatures cannot be achieved because of patient-related characteristics. Importantly, a broad patient population would benefit from this strategy as it could reduce the need for high energy to achieve therapeutic temperatures, thereby decreasing the risks of adverse events.
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影响因子：
2.4
作者：
Chang, Kyung Won;Park, Yong-Sook;Chang, Jin Woo
通讯作者：
Chang, Jin Woo
影响因子：
4.1
作者：
Bauer, Ronald;Martin, Ernst;Werner, Beat
通讯作者：
Werner, Beat
DOI：
10.2214/ajr.14.13632
发表时间：
2015-07
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Ghanouni P;Pauly KB;Elias WJ;Henderson J;Sheehan J;Monteith S;Wintermark M
通讯作者：
Wintermark M
影响因子：
29
作者：
Bond, Aaron E.;Shah, Binit B.;Elias, W. Jeffrey
通讯作者：
Elias, W. Jeffrey
影响因子：
1.7
作者：
Dobrakowski, Pawel Piotr;Machowska-Majchrzak, Agnieszka Kamila;Pierzchala, Krystyna Barbara
通讯作者：
Pierzchala, Krystyna Barbara