MRI follow-up after magnetic resonance-guided focused ultrasound for non-invasive thalamotomy: the neuroradiologist's perspective
Open Access
- 2 May 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Neuroradiology
- Vol. 62 (9), 1111-1122
- https://doi.org/10.1007/s00234-020-02433-9
Abstract
Purpose Magnetic resonance-guided focused ultrasound (MRgFUS) systems are increasingly used to non-invasively treat tremor; consensus on imaging follow-up is poor in these patients. This study aims to elucidate how MRgFUS lesions evolve for a radiological readership with regard to clinical outcome. Methods MRgFUS-induced lesions and oedema were retrospectively evaluated based on DWI, SWI, T2-weighted and T1-weighted 3-T MRI data acquired 30 min and 3, 30 and 180 days after MRgFUS (n = 9 essential tremor, n = 1 Parkinson's patients). Lesions were assessed volumetrically, visually and by ADC measurements and compared with clinical effects using non-parametric testing. Results Thirty minutes after treatment, all lesions could be identified on T2-weighted images. Immediate oedema was rare (n = 1). Lesion volume as well as oedema reached a maximum on day 3 with a mean lesion size of 0.4 +/- 0.2 cm(3) and an oedema volume 3.7 +/- 1.2 times the lesion volume. On day 3, a distinct diffusion-restricted rim was noted that corresponded well with SWI. Lesion shrinkage after day 3 was observed in all sequences. Lesions were no longer detectable on DWI in n = 7/10, on T2-weighted images in n = 4/10 and on T1-weighted images in n = 4/10 on day 180. No infarcts or haemorrhage were observed. There was no correlation between lesion size and initial motor skill improvement (p = 0.99). Tremor reduction dynamics correlated strongly with lesion shrinkage between days 3 and 180 (p = 0.01, R = 0.76). Conclusion In conclusion, cerebral MRgFUS lesions variably shrink over months. SWI is the sequence of choice to identify lesions after 6 months. Lesion volume is arguably associated with intermediate-term outcome.Funding Information
- Deutsche Forschungsgemeinschaft (328023777)
This publication has 25 references indexed in Scilit:
- Tractography‐Based Ventral Intermediate Nucleus Targeting: Novel Methodology and Intraoperative ValidationMovement Disorders, 2016
- A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability ResearchJournal of Chiropractic Medicine, 2016
- Different magnetic resonance imaging patterns after transcranial magnetic resonance–guided focused ultrasound of the ventral intermediate nucleus of the thalamus and anterior limb of the internal capsule in patients with essential tremor or obsessive-compulsive disorderJournal of Neurosurgery, 2015
- Intracranial hemorrhage detection over time using susceptibility-weighted magnetic resonance imagingActa Radiologica, 2014
- Imaging Findings in MR Imaging-Guided Focused Ultrasound Treatment for Patients with Essential TremorAmerican Journal of Neuroradiology, 2013
- Signal Changes on T2*-Weighted Magnetic Resonance Imaging from the Acute to Chronic Phases in Patients with Subarachnoid HemorrhageCerebrovascular Diseases, 2013
- A magnetic resonance imaging, histological, and dose modeling comparison of focused ultrasound, radiofrequency, and Gamma Knife radiosurgery lesions in swine thalamusJournal of Neurosurgery, 2013
- Quantitative Susceptibility Mapping Differentiates between Blood Depositions and Calcifications in Patients with GlioblastomaPLOS ONE, 2013
- MR appearance of hemorrhage in the brain.Radiology, 1993
- Sequential magnetic resonance imaging following stereotactic radiofrequency ventralis lateralis thalamotomyJournal of Neurosurgery, 1991