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  • Author or Editor: Ferenc Jolesz x
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The combination of advanced neuro-navigation, 3D multi-modality image fusion and intra-operative MRI can fulfill the promise of an integrated image guidance system for neurosurgery. The concept of MRI-guided neurosurgery is now widely accepted and preliminary evidence suggests that MRI guidance greatly improves the safety and effectiveness of neurosurgical procedures. The application of intra-operative MRI is especially helpful in the surgical excision of low grade gliomas (tumor resection control). Among the currently developed thermal therapy methods, focused ultrasound (FUS) appears to be the most promising method for non-invasive neurosurgery.

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Authors: Csanád Várallyay, György Balázs, Zsuzsanna Lénárd, Viktor Bérczi, Zorán Belics, Gábor Bajzik, Paul Wragg, Kálmán Hüttl and Ferenc Jolesz

Abstract

Rationale and Objectives: MR-guided Focused Ultrasound Surgery (MRgFUS) is an evolving thermoablative technique for treatment of benign and malignant soft tissue tumors. The feasibility and effectiveness of this non-invasive method has been tested by several investigators by treating uterine fibroid. The aim of the present study was to evaluate early and mid-term efficacy of MRgFUS treatment using MR imaging follow-ups. Materials and Methods: 38 patients with uterine fibroids were enrolled and treated by MRgFUS in a single center. MRI follow-up exams were performed 3 and 6 months after the procedure. Total fibroid volumes (FV) and non-perfused volumes (NPV) were compared and evaluated over time. Results: There was a significant reduction of FV at 3- and 6-month follow-ups (10±19%, p=0.022 and 19±29%, p<0.001, respectively). In the subgroup of fibroids smaller than 5.4 cm in diameter a 35±18% volume reduction was found after 6 months. There was also a positive correlation found between the early NPV and the FV decrease at 3- and 6-months follow-ups. Conclusion: This study suggests that MRgFUS can effectively coagulate uterine fibroid tissue. Smaller UFs can be most effectively treated within reasonable time with the used equipment.

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