Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note
Background: MR-guided focused ultrasound (MRgFUS) offers new perspectives for safe and efficient lesioning inside the brain. The issue of target coverage remains primordial and sub-optimally addressed or solved in the field of functional neurosurgery.Objective: To provide an optimized planning and o...
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doaj-10618309f635488a8ce4eac346b0ad0e2020-11-25T02:49:24ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2019-01-01610.3389/fsurg.2019.00002426059Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical NoteMarc N. Gallay0David Moser1Christian Federau2Christian Federau3Daniel Jeanmonod4Center for Ultrasound Functional Neurosurgery, SoniModul, Solothurn, SwitzerlandCenter for Ultrasound Functional Neurosurgery, SoniModul, Solothurn, SwitzerlandInstitute for Biomedical Engineering, ETH Zürich, University of Zürich, Zurich, SwitzerlandDepartment of Radiology, University Hospital Basel, Basel, SwitzerlandCenter for Ultrasound Functional Neurosurgery, SoniModul, Solothurn, SwitzerlandBackground: MR-guided focused ultrasound (MRgFUS) offers new perspectives for safe and efficient lesioning inside the brain. The issue of target coverage remains primordial and sub-optimally addressed or solved in the field of functional neurosurgery.Objective: To provide an optimized planning and operative strategy to perform a pallidothalamic tractotomy (PTT) in chronic therapy-resistant Parkinson's disease (PD) with the technology of MRgFUS.Methods and results: Histological sections and maps from 6 human brain hemispheres were analyzed and outlines of the pallidothalamic tract on Myelin-stained sections were drawn and superimposed. We determined a standardized PTT target coverage characterized by 5 to 7 preplanned target lesion sub-units of 1.5 × 1.5 × 3.0 mm, which were placed using focal point displacements and shortest possible times, under thermal dose control.Conclusion: We hereby present our current approach to the MRgFUS PTT on the basis of a histological reappraisal and optimized heat application to the pallidothalamic tract in the H1 field of Forel.https://www.frontiersin.org/article/10.3389/fsurg.2019.00002/fullpallidothalamic tractotomyfunctional stereotactic neurosurgeryminimal invasiveincisionlesscumulative equivalent minutes at 43°Chigh intensity MR-guided focused ultrasound |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marc N. Gallay David Moser Christian Federau Christian Federau Daniel Jeanmonod |
spellingShingle |
Marc N. Gallay David Moser Christian Federau Christian Federau Daniel Jeanmonod Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note Frontiers in Surgery pallidothalamic tractotomy functional stereotactic neurosurgery minimal invasive incisionless cumulative equivalent minutes at 43°C high intensity MR-guided focused ultrasound |
author_facet |
Marc N. Gallay David Moser Christian Federau Christian Federau Daniel Jeanmonod |
author_sort |
Marc N. Gallay |
title |
Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note |
title_short |
Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note |
title_full |
Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note |
title_fullStr |
Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note |
title_full_unstemmed |
Anatomical and Technical Reappraisal of the Pallidothalamic Tractotomy With the Incisionless Transcranial MR-Guided Focused Ultrasound. A Technical Note |
title_sort |
anatomical and technical reappraisal of the pallidothalamic tractotomy with the incisionless transcranial mr-guided focused ultrasound. a technical note |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Surgery |
issn |
2296-875X |
publishDate |
2019-01-01 |
description |
Background: MR-guided focused ultrasound (MRgFUS) offers new perspectives for safe and efficient lesioning inside the brain. The issue of target coverage remains primordial and sub-optimally addressed or solved in the field of functional neurosurgery.Objective: To provide an optimized planning and operative strategy to perform a pallidothalamic tractotomy (PTT) in chronic therapy-resistant Parkinson's disease (PD) with the technology of MRgFUS.Methods and results: Histological sections and maps from 6 human brain hemispheres were analyzed and outlines of the pallidothalamic tract on Myelin-stained sections were drawn and superimposed. We determined a standardized PTT target coverage characterized by 5 to 7 preplanned target lesion sub-units of 1.5 × 1.5 × 3.0 mm, which were placed using focal point displacements and shortest possible times, under thermal dose control.Conclusion: We hereby present our current approach to the MRgFUS PTT on the basis of a histological reappraisal and optimized heat application to the pallidothalamic tract in the H1 field of Forel. |
topic |
pallidothalamic tractotomy functional stereotactic neurosurgery minimal invasive incisionless cumulative equivalent minutes at 43°C high intensity MR-guided focused ultrasound |
url |
https://www.frontiersin.org/article/10.3389/fsurg.2019.00002/full |
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