Cranial MRgFUS intraprocedural diffusion and T2 imaging and comparison with postablation lesion size and location.

TitleCranial MRgFUS intraprocedural diffusion and T2 imaging and comparison with postablation lesion size and location.
Publication TypeJournal Article
Year of Publication2023
AuthorsEbani EJ, Strauss S, Thomas C, RoyChoudhury A, Kaplitt MG, J Chazen L
JournalJ Neurosurg
Volume139
Issue4
Pagination1190-1194
Date Published2023 Oct 01
ISSN1933-0693
KeywordsDiffusion Magnetic Resonance Imaging, Essential Tremor, High-Intensity Focused Ultrasound Ablation, Humans, Magnetic Resonance Imaging, Surgery, Computer-Assisted
Abstract

OBJECTIVE: The ability to predict final lesion characteristics during magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy for the treatment of essential tremor remains technically challenging, yet it is essential in order to avoid off-target ablation and to ensure adequate treatment. The authors sought to evaluate the technical feasibility and utility of intraprocedural diffusion-weighted imaging (DWI) in the prediction of final lesion size and location.

METHODS: Lesion diameter and distance from the midline were measured on both intraprocedural and immediate postprocedural diffusion and T2-weighted sequences. Bland-Altman analysis was utilized to determine differences in measurement between intraprocedural and immediate postprocedural images with both sequences.

RESULTS: Lesion size increased on both the postprocedural diffusion and T2-weighted sequences, although the difference was smaller on the T2-weighted sequence. There was only a small difference in intraprocedural and postprocedural lesion distance from the midline on both the diffusion and T2-weighted sequences.

CONCLUSIONS: Intraprocedural DWI is both feasible and useful with regard to predicting final lesion size and providing an early indication of lesion location. Further research should determine the value of intraprocedural DWI in predicting delayed clinical outcomes.

DOI10.3171/2023.2.JNS222608
Alternate JournalJ Neurosurg
PubMed ID36933258

Weill Cornell Medicine
Department of Radiology
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