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

Publication Type	Academic Article
Authors	Ebani E, Strauss S, Thomas C, RoyChoudhury A, Kaplitt M, Chazen J
Journal	J Neurosurg
Volume	139
Issue	4
Pagination	1190-1194
Date Published	03/17/2023
ISSN	1933-0693
Keywords	High-Intensity Focused Ultrasound Ablation, Surgery, Computer-Assisted, Essential Tremor
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.
DOI	10.3171/2023.2.JNS222608
PubMed ID	36933258