FOCUSED ULTRASOUND SURGERY

SUBMITTED BY:PRANEETH KUMAR

OUTLINE

• MRI (MAGNETIC RESONANCE IMAGING)• US (ULTRA SOUND WAVE)• PROCEDURE• EXAMPLE USING FIBROID• SIDE EFFECTS• DIFFERENT APPLICATION

MRI :

• MAGNETIC RESONANCE IMAGING (MRI) IS A TEST THAT USES A MAGNETIC FIELD AND PULSES OF RADIO WAVE ENERGY TO MAKE PICTURES OF ORGANS AND STRUCTURES INSIDE THE BODY. • MRI GIVES DIFFERENT INFORMATION ABOUT STRUCTURES IN THE

BODY THAN CAN BE SEEN WITH AN X-RAY, ULTRASOUND, OR COMPUTED TOMOGRAPHY (CT) SCAN

ULTRASOUND :

• PIEZO CRYSTAL• AN ULTRASOUND WAVE IS GENERATED WHEN AN ELECTRIC FIELD

IS APPLIED TO AN ARRAY OF PIEZOELECTRIC CRYSTALS LOCATED ON THE TRANSDUCER SURFACE. ELECTRICAL STIMULATION CAUSES MECHANICAL DISTORTION OF THE CRYSTALS RESULTING IN VIBRATION AND PRODUCTION OF SOUND WAVES

WHAT DOES THE MR GUIDANCE PROVIDE ?

• MAGNETIC RESONANCE IMAGING (MRI) IS ADVANCED DIAGNOSTIC TECHNOLOGY WHICH PROVIDES 3D IMAGING OF INTERNAL ORGANS WITHOUT RADIATION. THE MR GUIDED FUS TREATMENT USES THE MR IMAGES TO IDENTIFY WHERE THE FIBROID IS AND WHAT PORTION HAS BEEN TREATED.

WHAT HAPPENS DURING THE PROCEDURE ?

• HIGH ENERGY FOCUSED ULTRASOUND WAVES HEAT A SMALL SPOT IN THE FIBROID TO A TEMPERATURE OF UP TO 85 C TO CAUSE THERMAL ABLATION (KILLING OF THE CELLS) WITHOUT IMPACTING OTHER TISSUES.

• SO YOU CAN CHANGE THE INTENSITY, THE FREQUENCY, THE DURATION, THE PULSE SHAPE OF THE ULTRASOUND TO CREATE ANYTHING FROM AN AIRBRUSH TO A HAMMER• THIS PROCESS WILL BE REPEATED UNTIL THE REQUIRED

VOLUME IS TREATED, TYPICALLY ABOUT 50 TIMES. THE PROCEDURE LASTS ABOUT 3 HOURS DEPENDING UPON THE SIZE AND NUMBER OF FIBROIDS TREATED.• USING THE TREATMENT, THE BODY GRADUALLY REMOVES THE

TREATED TISSUE OVER A PERIOD OF MONTHS, PROVIDING SYMPTOM RELIEF

THE PROCEDURE: TARGETING

Structures to be avoided

Region to be

treated

THE PROCEDURE: PLANNING

THE PROCEDURE: TREATMENT

Temperaturemeasurement

Point by point or volumetric

THE PROCEDURE

Move to next target

FOCUSED ULTRASOUND FOR UTERINE FIBROIDS

EVOLUTION OF TECHNOLOGY :

• IN 2004, THE FDA HAS APPROVED MR-GUIDED FOCUSED ULTRASOUNDS FOR THE TREATMENT OF SYMPTOMATIC UTERINE FIBROIDS.• TECHNOLOGY ADVANCEMENTS ALLOW• LARGER FIBROIDS• TREATMENT ENVELOPE FOR DEEPER FIBROIDS

EXPECTED SIDE-EFFECTS :

• 30% PATIENTS MAY EXPERIENCE NAUSEA, VOMITING, LEG AND BUTTOCK PAIN, ABDOMINAL TENDERNESS.• LESS FREQUENT, < 10% PATIENTS MAY EXPERIENCE

SWELLING, ABDOMINAL CRAMPING, VAGINAL BLEEDING, URINARY DIFFICULTY.

APPLICATIONS:

• NEUROPATHIC PAIN • BRAIN TUMOURS • LOWER-BACK PAIN • BREAST CANCER