Factors associated with successful magnetic resonance–guided focused ultrasound treatment: efficiency of acoustic energy delivery through the skull

Won Seok Chang, Hyun Ho Jung, Eyal Zadicario, Itay Rachmilevitch, Tal Tlusty, Shuki Vitek, Jin Woo Chang

Research output: Contribution to journalArticlepeer-review

124 Citations (Scopus)


OBJECTIVE: Magnetic resonance–guided focused ultrasound surgery (MRgFUS) was recently introduced as treatment for movement disorders such as essential tremor and advanced Parkinson’s disease (PD). Although deep brain target lesions are successfully generated in most patients, the target area temperature fails to increase in some cases. The skull is one of the greatest barriers to ultrasonic energy transmission. The authors analyzed the skull-related factors that may have prevented an increase in target area temperatures in patients who underwent MRgFUS. METHODS: The authors retrospectively reviewed data from clinical trials that involved MRgFUS for essential tremor, idiopathic PD, and obsessive-compulsive disorder. Data from 25 patients were included. The relationships between the maximal temperature during treatment and other factors, including sex, age, skull area of the sonication field, number of elements used, skull volume of the sonication field, and skull density ratio (SDR), were determined. RESULTS: Among the various factors, skull volume and SDR exhibited relationships with the maximum temperature. Skull volume was negatively correlated with maximal temperature (p = 0.023, r2 = 0.206, y = 64.156 − 0.028x, whereas SDR was positively correlated with maximal temperature (p = 0.009, r2 = 0.263, y = 49.643 + 11.832x). The other factors correlate with the maximal temperature, although some factors showed a tendency to correlate. CONCLUSIONS: Some skull-related factors correlated with the maximal target area temperature. Although the number of patients in the present study was relatively small, the results offer information that could guide the selection of MRgFUS candidates.

Original languageEnglish
Pages (from-to)411-416
Number of pages6
JournalJournal of neurosurgery
Issue number2
Publication statusPublished - 2016

Bibliographical note

Funding Information:
This work was supported by the Yonsei University Future-Leading Research Initiative of 2014 (2014-22-0150). We are grateful to Dong-Su Jang, Medical Illustrator of the Medical Research Support Section, Yonsei University College of Medicine, for assistance in preparing the figures.

Publisher Copyright:
©AANS, 2016.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology


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