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
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