Anatomical and technical reappraisal of the pallidothalamic tractotomy with the incisionless transcranial mr-guided focused ultrasound. A technical note
Open access
Date
2019-01Type
- Journal Article
Abstract
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. Show more
Permanent link
https://doi.org/10.3929/ethz-b-000351568Publication status
publishedExternal links
Journal / series
Frontiers in SurgeryVolume
Pages / Article No.
Publisher
Frontiers MediaSubject
pallidothalamic tractotomy; functional stereotactic neurosurgery; minimal invasive; incisionless; cumulative equivalent minutes at 43◦C; high intensity MR-guided focused ultrasound; subthalamotomy; Parkinson’s diseaseMore
Show all metadata