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The Magnetic Resonance Center of the University Children's Hospital
Zurich has achieved a world first break through in MR-guided,
non-invasive neurosurgery. Ten patients have been successfully treated
by means of transcranial high-intensity focused ultrasound. This novel
technology now opens up new horizons allowing to develop non-invasive
intervention procedures for a variety of brain diseases including
brain tumors.
In the context of a clinical study at the MR Center of the
University Children's Hospital Zurich, transcranial MR-guided
high-intensity focused ultrasound (HIFU) for brain surgery has been
successfully applied for the first time world-wide. A research team
under the direction of Co-Me Project Leaders Professor Daniel
Jeanmonod, neurosurgeon at the Neurosurgical Clinic at the University
Hospital Zurich, and Professor Ernst Martin, director of the Magnetic
Resonance Center at the University Children's Hospital Zurich,
succeeded in proving the safety and efficacy of this revolutionary
surgical method which permits fully non-invasive brain interventions
even on an out-patient basis.
For quite some years, HIFU has been used for the treatment of
uterine fibroids and tumors of the prostate gland. However, its
application to the brain through the intact skull for non-invasive
surgery was not possible until recently, because of insurmountable
technical difficulties.
Without anaesthesia
Since September 2008 ten patients were treated at the Children's
Hospital Zurich with this new neurosurgical procedure in the context
of a clinical study. All interventions were completed successfully and
without complications. The surgical procedure lasts several hours and
is performed without anaesthesia. Patients are awake and fully
conscious during the intervention.
The whole surgical procedure is planned and monitored in real time
by magnetic resonance imaging (MRI). The HIFU beams produced by 1024
transducers are transferred through the intact skull of the patient
into the brain and concentrated onto a focus of 3 to 4 millimeters in
diameter. Thus, sharply defined targets deep inside the brain are
coagulated by heating them up to a focal temperature of 60 degrees
Celsius. The temperature increase during the sequential "sonications",
each lasting 10 to 20 seconds, is continuously displayed and
controlled on precise MR-temperature distribution maps.
A Co-Me project
In the context of the NCCR Co-Me, the potential of non-invasive,
transcranial MR-guided high-intensity focused ultrasound is
investigated in clinical studies at the University Children's Hospital
Zurich. Scientists working in the Co-Me program pursue the goal of
establishing and developing surgical interventions by means of
tcMRgHIFU, in order to broaden the spectrum of completely non-invasive
interventions for functional neurosurgery and for the treatment of
brain tumors, stroke and various neurological brain disorders by
targeted drug delivery.
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