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@article{Tierney:2021:10.3171/2021.10.JNS21416,
author = {Tierney, TS and Alavian, KN and Altman, N and Bhatia, S and Duchowny, M and Hyslop, A and Jayakar, P and Resnick, T and Wang, S and Miller, I and Ragheb, J},
doi = {10.3171/2021.10.JNS21416},
journal = {Journal of Neurosurgery},
pages = {760--767},
title = {Initial experience with magnetic resonance-guided focused ultrasound stereotactic surgery for central brain lesions in young adults},
url = {http://dx.doi.org/10.3171/2021.10.JNS21416},
volume = {137},
year = {2021}
}

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TY  - JOUR
AB  - OBJECTIVEMagnetic resonance–guided focused ultrasound (MRgFUS) is an incisionless procedure capable of thermoablation through the focus of multiple acoustic beams. Although MRgFUS is currently approved for the treatment of tremor in adults, its safety and feasibility profile for intracranial lesions in the pediatric and young adult population remains unknown.METHODSThe long-term outcomes of a prospective single-center, single-arm trial of MRgFUS at Nicklaus Children’s Hospital in Miami, Florida, are presented. Patients 15–22 years of age with centrally located lesions were recruited, clinically consistent with WHO grade I tumors that require surgical intervention. This cohort consisted of 4 patients with hypothalamic hamartoma (HH), and 1 patient with tuberous sclerosis complex harboring a subependymal giant cell astrocytoma (SEGA).RESULTSIn each case, high-intensity FUS was used to target the intracranial lesion. Real-time MRI was used to monitor the thermoablations. Primary outcomes of interest were tolerability, feasibility, and safety of FUS. The radiographic ablation volume on intra- and postoperative MRI was also assessed. All 5 patients tolerated the procedure without any complications. Successful thermoablation was achieved in 4 of the 5 cases; the calcified SEGA was undertreated due to intratumor calcification, which prevented attainment of the target ablation temperature. The HHs underwent target tissue thermoablations that led to MR signal changes at the treatment site. For the patients harboring HHs, FUS thermoablations occurred without procedure-related complications and led to improvement in seizure control or hypothalamic hyperphagia. All 5 patients were discharged home on postoperative day 1 or 2, without any readmissions. There were no cases of hemorrhage, electrolyte derangement, endocrinopathy, or new neurological deficit in this cohort.CONCLUSIONSThis experience demonstrates that FUS thermoablation of centrally located brain les
AU  - Tierney,TS
AU  - Alavian,KN
AU  - Altman,N
AU  - Bhatia,S
AU  - Duchowny,M
AU  - Hyslop,A
AU  - Jayakar,P
AU  - Resnick,T
AU  - Wang,S
AU  - Miller,I
AU  - Ragheb,J
DO  - 10.3171/2021.10.JNS21416
EP  - 767
PY  - 2021///
SN  - 0022-3085
SP  - 760
TI  - Initial experience with magnetic resonance-guided focused ultrasound stereotactic surgery for central brain lesions in young adults
T2  - Journal of Neurosurgery
UR  - http://dx.doi.org/10.3171/2021.10.JNS21416
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000859705300002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://thejns.org/view/journals/j-neurosurg/137/3/article-p760.xml
VL  - 137
ER  -

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Dr Kambiz N. Alavian, PhD, SFHEA, FLS, FRSB

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