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Cranial MR-Guided Focused Ultrasound: Clinical Challenges and Future Directions.

TitleCranial MR-Guided Focused Ultrasound: Clinical Challenges and Future Directions.
Publication TypeJournal Article
Year of Publication2021
AuthorsJ Chazen L, Stavarache M, Kaplitt MG
JournalWorld Neurosurg
Volume145
Pagination574-580
Date Published2021 Jan
ISSN1878-8769
Abstract

Magnetic resonance-guided focused ultrasound is a powerful new technology that is enabling development of noninvasive applications for complex brain disorders. This is currently revolutionizing the treatment of tremor disorders, and a variety of experimental applications are under active investigation. To fully realize the potential of this disruptive technology, many challenges have been identified, some of which have been addressed and others remain to be solved. As an image-based technology, optimal intraoperative imaging can be difficult to achieve and several factors can influence the quality of these images. Technical issues with current devices can also limit the effective delivery of ultrasound technology to particular targets. While lesioning is the primary approved application of magnetic resonance-guided focused ultrasound at present, the ability to transient and precisely open the blood-brain barrier has the potential to clear brain pathologies and deliver restorative therapies, but this more experimental method presents unique difficulties to overcome. Finally, regulatory and reimbursement hurdles currently remain complex and continue to limit widespread application of even approved, effective applications. Here we review many of these challenges, discuss several solutions that have already been developed, and propose potential options for addressing some of these complexities in the future.

DOI10.1016/j.wneu.2020.08.050
Alternate JournalWorld Neurosurg
PubMed ID33348523